One million patient milestone reached by online consultation and workflow system askmyGP
One million patient requests have been managed by GP practices using the askmyGP online consultation and workflow system since September 2018. The system is used by practices across the UK with a combined list size of 545,485. Clinicians at the practices use the system’s online triage tools to prioritise and deliver care by secure message, telephone, video or face-to-face appointment.
64% of patients chose to contact their GP online via the practice website, while the remaining patients phoned their practice. Half of patient requests were completed by the practice in two hours or less, including requests made online outside normal surgery hours.
Patients asked for face-to-face appointments in only 25% of cases. 45% of patients asked to be contacted by the practice by phone and 30% asked for a secure message from their clinician.
On reviewing patient requests, clinicians decided to see 37% of patients face-to-face. 88% of patients who needed an appointment attended the practice on the day they contacted the practice.
Across the one million patient requests, 6.5% of patients on the practice list made contact each week.
The one millionth patient request was received by the Concord Medical Centre in Bristol, which has been using askmyGP to manage all of its patient requests for more than two years. Senior partner Dr Simon Bradley said: “With askmyGP we are getting through the work more efficiently and continuity of care has improved too, with more patients consulting with their preferred GP. There are days where all outstanding consultations have been completed by 5.30pm, allowing the duty GP to manage urgent problems and process late requests that otherwise would have been passed forward to the following day.”
Harry Longman, chief executive of GP Access Ltd, the company behind askmyGP, said: “This is a major milestone and we are delighted that askmyGP has enabled a million patients to get help sooner from their own GP. That’s only possible by making it easier for practices to understand, predict and manage patient demand much more flexibly, putting them in control of who they see and when, managing their resources appropriately for each patient.”
The latest figures from askmyGP reporting patient contact preferences are consistent with those from earlier in the year. Data show continued low demand among patients for video consultations (0.06%).
When offered a choice of ways to talk to their GP, 27% of patients expressed a preference for a face-to-face appointment, 28% preferred to be contacted by secure message and 44% by phone. Slightly more patients asked for a face-to-face appointment than in previous months, but clinical decisions and actual method of delivery remain consistent.
The askmyGP data is drawn from practices with diverse patient populations receiving a total of 308,000 patient requests during the period. The data illustrates patient contact by clinical episode, with video consultation with the patient’s usual NHS GP offered at no extra cost to either the practice or the patient.
Clinical judgement always takes precedence, meaning in some cases simple queries might be addressed by a quick answer by phone or message, while more complex presentations will warrant a face-to-face appointment, even in cases where this has not been requested by the patient. Practices are not bound by their patients’ contact preferences, but they use the information to guide their responses to patients.
13 November 2019
The latest figures from askmyGP reporting patient contact preferences show there has been no change in the low demand among patients for video consultations.
The askmyGP data for the second quarter of 2019 is drawn from practices with diverse patient populations receiving a total of 220,000 patient requests during the period. The data illustrates patient contact by clinical episode, with video consultation with the patient’s usual NHS GP offered at no extra cost to either the practice or the patient.
When offered a choice of ways to talk to their GP, 21% (Q1 25%) of patients expressed a preference for a face-to-face appointment, 29% (Q1 28%) preferred to be contacted by secure message and 49% (Q1 47%) by phone. Patients requested a video consultation in less than 0.1% (Q1 0.1%) of cases.
While practices are not bound by their patients’ contact preferences, they use the information to guide their responses to patients. Clinical judgement always takes precedence, meaning in some cases simple queries might be addressed by a quick answer by phone or message, while more complex presentations will warrant a face-to-face appointment, even in cases where this has not been requested by the patient.
13 August 2019
Does F2F frequency affect patient satisfaction in digital first primary care? SAPC Exeter ASM poster
Many have wondered whether patient satisfaction is affected by their chance of seeing a GP face to face. The study done for the Exeter Annual Scientific Meeting of SAPC (Society for Academic Primary Care) analysed 14,009 patient feedbacks from 423,143 episodes managed through askmyGP from 1 January to 26 June 2019.
Presented by Ian Barratt and Steve Black at the conference. Download pdf here.
We’re delighted to inform you today of the open access publication from Abi Eccles et al:
It’s the first independent study of askmyGP and it’s well worth reading in full. I will quote the conclusion briefly:
“Patterns-of-use and patient types were in line with typical contacts to GP practices. Though the age of users was broad, highest levels of use were from younger patients. The perceived advantages to using online triage, such as convenience and ease of use, are often context dependent.”
What comes through for me is the very ordinariness of the online demand. It’s the same as normal demand, same patients, same conditions, same frequency by day of week and time of day.
There’s more on patient feedback too, with themes extracted which are very familiar to us. We’ve quantified the age question in our study on “Age specific adoption of online consultations.”
What this study adds is online usage orders of magnitude greater than any previous paper, with 5447 patient episodes from 9 practices in 10 weeks. Data collection was May to July 2017, which was our previous version 2 platform. Since then the same principles have been carried forward to v3 with a new design and many more features. Growth in usage means that we are now collecting the same volume of data roughly every two days.
The scope for further research is increasing daily with an anonymised database of some 300,000 episodes, unique in general practice. If you’re an academic in the field, we welcome the opportunity to collaborate, particularly on studies of the GP practice as a whole, not just online components.
Benefits for patients and GPs are the product of system change.
PS See how patients interact with askmyGP on our Bramley Demo Practice.
To experience the GP side, start with our free online demo.
The latest data from our chief analyst Dr Steve Black (@sib313) shows remarkable adoption of online consultations across all ages and 10 diverse practices. n = 37,674 requests, date range is 1/1/2019 to 8/2/2019.
The context is all askmyGP practices operating in “total flow” mode where all patient demand goes through the system in two modes. Online, patients submit a request for help from their NHS GP practice either for themselves (dark blue) or as a proxy (light blue), mostly children but also vulnerable adults, most over 75. They may also telephone the practice, and a receptionist creates the request on their behalf (orange).
The key point is that all demand is covered in the chart, not from a self-selected subset of patients, and these are regular GP practices where there is no change in registration.
What the data shows
For infants and children, over 60% of parents chose to send their request online.
For young adults aged 20 – 40, over 70% submitted online.
With increasing age, the proportion online falls slowly, but even at 65 – 70 it is 40%.
Over 70 the proportion falls more steeply and significant numbers are by proxy.
It is clear that when designed for ease of use and universality in respect of patients and their medical problems, coupled with rapid response by providers, the online offer is highly attractive to patients.
The vision for “digital-first” providers who are at the same time traditional, local GP practices is achievable and already being achieved.
Founder, Chief Executive, askmyGP
Good news has a hard time getting heard.
This week we’ve seen new, comprehensive data from NHS Digital on the wait to see a GP, splashed across all the papers:
It’s all “true”, though I’m afraid the spin is not. The argument that “40% are seen the same day” rings hollow with anyone who has hung on the telephone for half an hour, to be told that all the same day slots have gone. Many of those 40% have been trying for several days just to get through.
Blame the patients, blame the government, blame whoever else we can think of. Or take a different look.
These tiny stories from the last few days are just a handful of the hundreds we see each week from patients grateful to their GP:
Your service and reliability are amazing. Thank you! (f 85)
Amazing fast system thank you (m 41)
Amazingly swift and very easy process than trying to jugggle around work – thank you so much! (f 24)
Amazing…More personal…Super speedy (parent, boy, 3)
Love how easy it is to speak to your own doctor . Amazing (parent, girl, 4)
Love this new system…so easy and quick , and have the problem solved without having to sit around at the surgery. (f 49)
Love ‘askmygp’. Making it so much easier to get info and solve problems whilst holding down a full time job! (f 40)
Wow. I am impressed! (m 69)
Wow, just wow. Have been in terrible painall night…absolute godsend… Thank you so much for your skills and innovations (f 65)
WOW, great system, quick easy, and no need to travel. Many thanks (m 63)
We’re now over 4,600 feedbacks from 80,000 episodes since August, and the trend is better and better. Please do have a look at the live rolling 7 day summary chart. We ask patients whether it’s better or worse and the ratio as I write has moved up to 9 which is so exciting.
These patients are getting an outstanding service from their own regular NHS GPs. The GPs have no extra funding (they pay us), and no complicated extended hours 8 to 8 hubs (that didn’t work)
Patients didn’t have to switch to an out of area GP. They could name their own GP. They were seen same day if needed.
And the GPs are happier too – happier professionally to be giving such a service and bringing the joy back into their working lives.
If you haven’t yet watched the Burnbrae video, please do and click for the demo at the end. This is one of her 5,000 patients last week, helped within 2 hours:
“fantastic service and Dr Arnott is an amazing doctor, Shotts is lucky to have all these new changes.”
How do we get this into the headlines?
It’s remarkable for a quote that seems almost modern in politics, often attributed to Abraham Lincoln, but it seems he was quoting John Lydgate of Suffolk, writing in the fifteenth century, “You can’t please all of the patients, all of the time.”
OK he said people, not patients, but the point is made. You’d be mad to try and please all of the patients, all of the time, because whatever you do, some won’t like it, and that’s the thing about people. Perhaps that’s what makes us interesting.
Having said that, “Happier Patients” is one half of our motto and it is of utmost importance for us to do what is best for patients in the quality of service both we and the doctors provide. We ask patients directly for their feedback to help us achieve that.
In our version 2 askmyGP we’ve had over 4,500 patient comments from 105,000 episodes in the last 18 months. They have been overwhelmingly positive, with some negatives and some suggestions, and they have been a big part of our design process for version 3.
One difference is that where we used to collect feedback when the patient submitted the request, in the new version it’s done after the request has been completed. Ah, we thought, all those complaints based on the patient not believing it possible would vanish, and positivity would go up.
So far (first 4,000 episodes) it hasn’t quite worked out like that. We’ve structured the feedback very simply. The killer question is whether the new system is Better, Same or Worse, and the figures as I write are 98, 4, 27.
Yes, it’s overwhelmingly positive, and I’d love to share all the comments with you but even though we ask patients not to enter personal details, sometimes they do so we can’t do a real time feed. Some examples are below.
But I know what you’re thinking. I’ve been working with GPs for over nine years now and if I may be allowed a little over-generalisation, you’re really interested in the negatives. (btw academics are worse. They couldn’t find the silver lining in a solid silver tea service, present company excepted of course).
What’s interesting is that with the 21% who say it’s worse we are picking up reactions not only to askmyGP (though some are, and there were a couple of technical issues), but mainly to patients’ views of the GP. The main driver for negatives at 16/27 is very poor on “solving your problem”. It might be that something went wrong with the process, there was a delay, or the patient just didn’t like what the doctor said. Well, it happens, and you can’t please all of the patients all of the time.
Anyway, it’s good to see that 76% of those responding say the new system is better, while for those of you who think they are trumped by the 21%, you are amply justified in doing nothing.
Everyone can enjoy our star comment of the week, from a fellow Yorkshireman. This is only the opener and the rest has had to be moderated for family viewing, but you get the gist: “Whoever thought of this stupid idea wants a good kicking up the arse.”
PS Some of the feedback this week:
“Very good service it’s been amazing when I’ve needed advice for my children never waited longer than an hour for reply”
“far easier using this system than actually going through the surgery reception” male 28
“The new system is so much better, especially if you only want to ask a question rather than seeing a doctor. Massive thumbs up 👍” female 45
Thoughtful for others: “Ok for those who are familiar with the use of computer systems but I have concerns for elderly who would have no idea how to use a computer” female 70
Hypothesis: efficient operation of primary care depends on clinical triage of all demand, to optimise the use of scarce consulting resource – GP time.
The faster and simpler the system, the more patients will co-operate.
Who does what, when and how?
Patient “I need help…” Make it easy to provide enough detail for triage. Online, anytime.
Reception ”I’ll assign you to a clinician, unless I can help you myself” (within minutes, verify patient, choose clinician)
GP “I’ll work out how to help, usually phone, may see you, send a message, or refer” (take seconds, within minutes, from online entry)
Consult & complete – precisely appropriate for the patient and episode.
Presented at EFPC European Forum for Primary Care, Annual Conference Porto 24-26 September 2017
Download the poster here:
A quick note with exciting news, we’ve just had our poster published at the Society of Academic Primary Care SAPC Annual Scientific Meeting in Warwick.
askmyGP has now passed over 50,000 patient episodes, 4,000 of them on the all new platform launched just two months ago.
The case study with Concord Medical Centre, Bristol, is here:
What took demand to 30% online? In a nutshell, it’s:
– Personal (“Hello, I’m Dr Bradley…)
– Universal (all patients, all problems)
– Responsive (we’ll get back within the hour)
– Simple (“Easy to use” main theme of feedback)
We took the decision in version 2 to take OUT the clever technology we’d put in v1.
It’s much simpler, with the aim of putting patients in faster, easier, touch with their GP, and vice versa. It builds trust by allowing patients to express exactly what they mean.
The result? Positive feedback has shot up, both from patients and GPs.
Dr Simon Bradley comments:
“The thought that goes into putting something into writing often helps the patient to have reflected on their problem prior to initiating a request.
Then for the clinician to have reflected on the request and reviewed relevant elements of the record means we can be more aligned with the patient’s agenda.
Online communication is asynchronous which allows both patient and practice to use their time more effectively.”
Aha. Time. The only absolutely finite resource.
Time for recreation too – enjoy the weekend.
Download pdf: What makes patients use online consultations?