Triage outpatient referrals without the admin

Outpatient services under pressure

Current waiting lists standing at over 7.7 million underscores the huge pressures on secondary care that was profoundly impacted by Covid-19. Easing these pressures, improving patient flow and creating capacity for treatment is crucial for reducing the number of patients on the waiting list. The NHS delivery plan calls for better use of technology and data to alleviate these pressures.

Managing the build-up of referrals

One of the biggest challenges for hospitals is how to manage the large numbers of referrals sent from primary care. Doing this efficiently is critical, as the length of time to process each referral impacts on the time for each patient to be treated. With referrals being sent in different formats from multiple channels, the task of triaging is made significantly more difficult. With many referrals being made by e-RS, others by email, fax also being used together with other legacy systems, clinicians are needing to switch between systems simply to access the relevant referrals.

And that is not all. Information in the referrals is not always complete, and with no standard formatting or structure, they can be difficult to read, making it hard to determine the right clinic for a patient or if a patient should even be referred to hospital. The need to download documents from the referral source e.g. an email, log into each patient’s electronic record to see their history, and then manually update the electronic patient record and book the patient in to the right clinic only adds to the time and administrative burden to process a referral.

A single point of access for all referrals

How can technology and improved data management support hospitals in reducing the time to process referrals? Imperial College Healthcare NHS Foundation Trust, Chelsea & Westminster NHS Foundation Trust and North West London ICB London have implemented the NEC Rego platform which receives referrals from any source, be it e-RS, email, fax or other system and presents them in one place, so consultants no longer have to search in multiple places for the referrals.

The platform also brings in referral information into a structured format so that the information is easier for clinicians to read, assess and make decisions on how to treat patients.

Integrating with all secondary care systems

Since many referrals are sent from primary care via e-RS, fully integrating with the electronic referral system is important for the efficient sharing of clinical information.

Rego’s Single Point of Access uses the full set of e-RS APIs so that the systems talk to each other. As such, when something is updated in one, it is updated in real time in the other. This significantly reduces the time for consultants to triage patients as any data input in e-RS is automatically updated on Rego and vice-versa, removing the need for consultants to re-type. This is similarly the case with PAS systems where full integration with Rego enables referral information to be updated in real time, so that cases can immediately be triaged with all information available.

The process for triaging is also familiar for clinicians because it works with the smart card and mirrors what they do in e-RS as well as all other systems. A built-in image viewer further reduces admin time as no one has to download images and delete them afterwards.

Removing clinical risk using APIs

Using full integration to create a seamless flow of data between Rego Single Point of Access and secondary care systems reduces the number of manual tasks in triage. It also overcomes the risks associated with other automation technologies, most notably robotic process automation (RPA), where data is scraped from e-RS to the PAS system. Whereas with APIs, the data is updated in real time and reflects exactly what is in Rego, with RPA, the updates can take one or two days to complete. If a clinician makes changes in e-RS, this may not be reflected in the PAS system at the point of triage, creating a clinical risk.

Using data to provide insights

Efficiently triaging the thousands of referrals being sent to outpatient services is one important element of referral management. Having quick access to data to understand overall outpatient activity, where resources may be needed and where there are potential bottlenecks that cause delays in patient treatment is also critical.

Rego brings all relevant data together from clinical systems as well as recording every touchpoint so that referrals can be tracked and reported on in real time, something that is not possible using other referral sources. Hospital management do not need to wait months to access manually collated data, they are able to view performance data when needed and make decisions based on this insight.

North West London ICB have used the data insights for Advice & Guidance where Rego accurately monitors how much advice has been provided, where it has been used and how much time it took to be sent, so that it can be matched against national targets.

Supporting the use of Advice & Guidance

Flexibility within the Rego platform supports hospital in further reducing pressures on outpatient services and patient waiting times by enabling clinicians to respond to referrals with advice rather than simply accepting or rejecting a referral. This helps hospitals in meeting their targets for advice and guidance intended to reduce outpatient attendance and support the Recovery Plan.

Hillingdon hospital uses Rego for all potential routine referrals and it’s seen their consultants return 46% of cases back to primary care. It’s freed up much-needed space in clinics and meant less worry for patients.

For more information on NEC Rego Single Point of Access, visit the Referral Management page or register for our webinar on managing hospital demand in partnership with HTN.