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A revolution in health care

According to the World Economic Forum we are standing on the brink of change, a time in which the Fourth Industrial Revolution is taking hold of the world. Looking back into the past, the first industrial revolution ushered in an era of mechanisation, process driven and with people merely seen as cogs in the industrial wheel. Then came electric power and mass production followed by the third industrial revolution which ushered in the use of information technology as a driver of automated production.


The fourth Industrial Revolution is one step further on, driven by a ‘fusion of technologies that is blurring the lines between the physical, digital, and biological spheres.’ Put simply, technology has gone so far and is so interconnected that people have stopped becoming cogs in the wheel and instead are the prime drivers of service delivery.


In other words, what differentiates businesses nowadays is user excellence. As a result technological developments are increasingly being focused towards delivering great customer outcomes rather than simply as a way of reaching a mass audience or delivering cost savings.


What’s that got to do with delivering healthcare? Well in this regard there is no difference between the way in which we look to deliver customer or patient outcomes. So much so that there is an increasing recognition that targeting healthcare delivery towards an individual patient can significantly improve recovery. For example, we look to gene mapping as a means of best identifying cancer treatments, or we look to devise treatment plans which fit in with a patient’s lifestyle.


One prime example of this has been highlighted on the Chartered Society of Physiotherapy website. The Western Isles Hospital in Stornoway has linked up with a Glasgow orthopaedic surgeon who specialises in hand injuries. Initial assessments take place via a video-conferencing link with x-rays viewed over the National PACS system. Not only does this save patients the cost and time of a trip to Glasgow for initial assessment, it also speeds up decision-making. If there then is an identified need for surgery, preoperative procedures can be carried out in Stornoway; thereby minimising the time which patients have to spend away from their home base.


This is a perfect example of the way in which integrated technology can not only improve the patient experience but also treatment outcomes. It also illustrates the way in which digitising patient records can help to improve consultation options with patient information being rapidly shared over secure systems. Of course, electronically storing patient records also helps the practitioner; enabling them to call up records quickly and easily as well as saving the time taken in manual filing and retrieval.


Setting people outcomes at the heart of process may require a re-evaluation of the way in which we work. It may also cause us to question the reason behind certain processes, and to evaluate whether there may be alternative approaches which would improve delivery. The fourth Industrial Revolution isn’t simply a revolution in the way in which we use technology, it is also a revolution in attitudes and approaches which truly sets people first.

Waiting for A&E care

Accident & Emergency; we can’t live without it but it appears that increasingly we are having to be patient if we have need of its services. So much so that research carried out by the BBC has revealed that in the past year three million A&E attendees had to wait in excess of four hours in order to be treated.

To put that in context, nearly twenty-four million people were treated or admitted within the four hour time band. Or to put it another way, if each A&E attendee visited once then 41% of the UK’s population stepped through the A&E doors in just one year. It’s hardly surprising therefore that the president of the Royal College of Emergency Medicine, Dr Taj Hassan, commented to the BBC that the A&E system had been “stretched to its very limits.”

Accepting that the answer probably isn’t going to come from finding the money required to set up and staff an additional twenty A&E units, health services across the UK are looking to new ways of coping with demand; adopting a variety of methods in order to reduce footfall and speed up throughput. Whilst the Department of Health has turned aside suggestions that patients should be required to receive a referral from their doctor or NHS 111 before visiting A&E, it is true that just 20% of those attending A&E have first tried to access health advice via the 111 service. Perhaps if they had sought alternative advice either from 111 or their local pharmacy they would not have resorted to A&E for help with broken false fingernails, splinters in finger, paper cuts or shaving cuts; all of which featured in the 2016 top ten list of inappropriate trips to A&E in Cambridgeshire.

It’s hardly surprising therefore that a number of health trusts have been launching awareness campaigns in a bid to educate people on A&E alternatives including one video from NHS Wakefield Clinical Commissioning Group set to the tune of the 12 days of Christmas. Inappropriate visits aside, health authorities are also working to free up beds in order to speed up treatment times. Measures here include partnering with care homes and other health care professionals in order to deliver more health care in the community.

Undoubtedly this will put additional pressure on external health care services but perhaps it will also help to ensure that treatment is available at the most appropriate point of contact. For example, another on the Cambridgeshire inappropriate visit list was an individual who had suffered months of back pain without calling on the services of a health professional. Had they been given access to a physiotherapy service they could have saved themselves months of pain and saved the A&E department from having to assess their needs.

The winter flu season is not yet upon us and that will undoubtedly bring further challenges for A&E departments as will an increase in demand for treatment of strains and sprains as a result of icy conditions. Many of these conditions can be treated equally well by health providers such as pharmacists, physiotherapists or chiropractors. We’ve already seen pharmacists take up the strain in respect of flu jabs; perhaps this is the start of a wider acceptance of alternative providers helping to deliver health care in the UK.



Planning The Working Day

In our earlier article ‘Mobile data – changing lives’ we commented about the global sleep crisis and the way in which our sleeping patterns are changing in response to societal pressure. Now another study has raised some interesting insights into the effect which getting up early may have on our lives.

Commissioned by Hillarys Blinds, the survey examined whether work patterns and outcomes were different for those who got up before and after 7am.  Interestingly, the research revealed that average salaries for the 37% of respondents who got up before 7am amounted to £36,500 whilst average salaries for those arising later came in at £21,300. Early risers were also likely to have had more jobs than those getting up later; eleven for early risers against five for late risers.

On the negative side, when asked what they did first thing in morning, those getting up before 7am are most likely to turn their attention first to work tasks. What is not clear from the study is whether this means that getting up early in order to work results in obtaining a higher salary, or whether higher salaries naturally come with the downside of a higher workload.

Either way, unless the early start also comes with an early finish, those putting in excess hours at the beginning of the day simply in order to stay ahead would do well to reappraise their working practices. For those in health practices who need to stay mentally sharp in order to best help their patients, cutting down on excess working hours is not only recommended but a necessity. And there are plenty of options available to those who want to work smarter rather than harder.

Let’s start with client appointments. Admittedly you are unlikely to be returning client calls at seven in the morning but are you stuck doing early paperwork because so much of your free time during the day is taken up with appointment calls? Simply by offering an online booking service or switching calls to a virtual assistant service can mean that your diary is taken care of whilst you take care of your patients.

And what about patient notes; do you really have to spend all that time in filing notes from the previous day and in searching out patient details for today’s set of appointments? By moving to an electronic filing system your patient notes are there at the touch of a button; adding precious time to your day and clearing paperwork out of your office at the same time.

Of course, with cash flow being the lifeblood of any business you could be getting up early in order to raise and send out invoices for the previous day’s appointments. Or, you could adopt an electronic card payment system which takes payment details at the time of booking and automatically collects payment once the appointment is over. The other advantage of this service is that it enables you to take a fee even in the event of no-shows, making your time more productive. And if you want to cut down further on no-shows then sending out appointment reminders by SMS text linked to your booking service is a good way of helping to ensure that patients either attend or cancel in good time, thereby enabling you to rebook the appointment slot.

Even if you are a natural early riser there are much better ways to be spending the early hours of the morning, other than work. Get some exercise, listen to or play some music, take photographs of the dawn…; in other words spend your time getting yourself mentally and physically fit for the day. You will benefit, your patients will benefit and in the long run your business will benefit too.

A culture of compassion

Following a number of high profile reports into the standards of care within the NHS the Prime Minister has announced a package of measures which are aimed at raising the standard of care provided by health services.  Alongside measures such as improved training for dementia carers and a defined career pathway for care assistants comes a vision for strengthening district nursing.

The attention grabbing element of this new package is the introduction of a “friends and family” test which will encourage patients to report back on hospitals.  Designed to be in place from April 2013 the test will then be gradually rolled out over the rest of the health service.

The measures have been broadly welcomed by health bodies with the NHS Confederation chief executive, Mike Farrar, saying that “we have got to ensure that a culture of compassion is running through the veins of every place that provides care, no ifs, no buts and no exceptions.”  But whilst greater training and a renewed emphasis on care and compassion is a major step forward, there still remains the twin challenge of providing patient care whilst coping with the day to day paper work and interruptions.

A survey of social care workers in 2012 revealed that just 15% of time was spent in face to face meetings with clients with the rest of the time taken up with paperwork, phone calls, travelling and other meetings.  If that figure were to be reflected across the health sector then there is precious little time available for patient care.

This time challenge is one which is not simply confined to those working in the NHS, but is also a problem for those providing other health services such as physiotherapy and osteopathy.  For them, every minute spent on paperwork and answering calls is a non-earning minute which is spent away from patient care.  This is where the services of a virtual receptionist can make a difference. With calls being diverted to a virtual receptionist the clinician can concentrate on providing treatments.

With diary management and patient records also being taken care of, the percentage of time spent on patient care can soar.  More time means the ability to provide full treatments to more patients; it means less of the “next please” and more holistic treatment of the person not just the symptoms.  In short more time means that clinicians can step up to the culture of compassion demanded and in the process help to take health services to the next level.

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