Patient Automated Triage and Clinical Hub Scheduling system (PATCHS)
What we did
The Patient Automated Triage and Clinical Hub Scheduling system (PATCHS) has been designed by GPs and academics to help manage patient workload in primary care. PATCHS is an online consultation and triage system approved for use in the NHS.
This project will tested if the triage is safe and acceptable prior to use in clinical practice. This is necessary prior to its wider deployment and evaluation, which will be the focus of future studies.
This Innovate UK funded research project was led by Dr Ben Brown, Senior Academic GP, with the software developed by Spectra Analytics Ltd in partnership with Advanced Health and Care.
Why was it important?
Primary care accounts for 90% of all NHS contacts with over 340m appointments per year. GP practices are under increasing strain due to increasing demand, staffing issues and budget constraints. An effective triage process that would efficiently and accurately direct patients to the appropriate services, be that a GP, alternative health professional or self-care - could significantly ease pressures on GPs by reducing avoidable consultations; estimated at 27%.
This could save the NHS over £700m per year (based upon NHS England estimates of £100k annual savings per practice for telephone triage) while improving patient satisfaction, due to shorter waiting times and longer appointments. Unfortunately, current triage processes are inconsistent and often ineffective, relying on non-clinically trained staff such as GP receptionists.
On top of this, the NHS has mandated that all GP practices should provide online access to their patients, as part of long-term policy plans but also in response to the COVID-19 pandemic. Many of these systems are difficult to use for patients and do not have automated triaged built in.
How we did it
We tested if the system is safe and acceptable prior to use in clinical practice by:
- Comparing PATCHS’ triage performance to that of a ‘typical’ GP.
- Conducting usability tests with patients and GP staff using PATCHS in a simulated environment, in addition to interviewing them about their experience. All users are also able to submit feedback about their experience using PATCHS.
- Conducting a systematic review of the evidence on understanding how the design and implementation of online consultations influence primary care outcomes. With recommendations for designers, providers and researchers
Findings
The systematic review synthesised 62 studies in nine countries covering 30 unique Online Consultation systems.
The review contributes new knowledge that in addition to producing positive outcomes such as increased access and patient satisfaction, online consultation systems can also have negative outcomes such as increased workload and costs. These negative outcomes can be mitigated by appropriate design (e.g. free-text format), incorporating advanced technologies (e.g. Artificial Intelligence tools), and integrating new online systems into technical and organisational workflows (e.g. timely responses).
Downloadable resources
- Publications
- Darley S, Coulson T, Peek N, Moschogianis S, Van der Veer S, Wong D C, Brown B., (2002).Understanding how the design and implementation of Online Consultations influence primary care outcomes: Systematic review of evidence with recommendations for designers, providers, and researchers. MedRxiV
- Darley S, Coulson T, Peek N, Moschogianis S, van der Veer SN, Wong DC, Brown BC
Understanding How the Design and Implementation of Online Consultations Affect Primary Care Quality: Systematic Review of Evidence With Recommendations for Designers, Providers, and Researchers
J Med Internet Res 2022;24(10):e37436
Who we worked with?
More information
Head of ARC-GM