For those managing outpatient care within the NHS, it is essential to see the opportunities available and to feel that there are ways to improve productivity and patient outcomes.
At present, large numbers of patients are at risk but this can be fixed. There are people who have the knowledge and experience to help. We have identified the following top 10 priorities to improve outpatient care and productivity.
Improve data health – Technology is only ever as good as the data it is being fed. With lots of new technologies appearing on the market its promise is clear to see. However, unless the data underpinning technology is of the highest quality, none of this fancy technology will be of use. Incorrect decisions made on inaccurate data poses an even greater challenge in the future. Aspirations of making appointment scheduling seamless, care coordination, advanced analytics, artificial intelligence etc all rely on accurate data. Not enough focus has been placed on this area within healthcare. Validating NHS waiting lists is an essential step to improve data quality.
Enhance care coordination – Fragmented, episodic care is a major pitfall in outpatient settings. Patients, especially those with multiple chronic conditions, need proactive coordination across providers, settings, and services. Health systems should invest in care management teams, tools to facilitate referrals and follow-up, and better information sharing between sites and specialists. Studies show this can reduce hospitalisations by 11%.
Streamline appointment scheduling – Missed appointments and scheduling hassles frustrate patients and reduce efficiency. Patients need expanded self-scheduling options, appointment reminders, and clinics should overbook strategically. Open access scheduling should allow for same-day appointments. Technology is simply better in almost every other industry at doing just that (however every other industry has better data quality).
Incentivise group visits – Seeing patients with similar conditions in a group setting provides peer support and more time with providers. This approach could be particularly valuable when dealing with patients with chronic conditions.
Engage primary care – Not enough thought has gone into the link between the unreported follow up list and primary care. Patients not being seen for their follow ups inevitably end up back in primary care and this has led to a large increase in demand. New models of care working closely with primary care colleagues are required to work out the most appropriate setting for managing patients and this is highly likely to be outside rather than inside hospitals.
Deploy advanced analytics – Powerful data analytics can identify at-risk patients, customise interventions, and provide population health insights. Building analytics capabilities through patient data, risk stratification models, and AI should be a priority. Natural language processing applications can extract key information from unstructured physician notes and patient reports to provide more complete health profiles and medical histories. This additional context assists faster diagnosis and treatment. MBI’s LUNA technology is making huge strides in this area. Artificial Intelligence and machine learning tools can analyse large datasets such as from patient medical records, lab tests, and imaging studies, to uncover patterns and aid clinical decision-making. This can help reduce diagnostic errors.
Address social determinants – Screening patients for social determinants of health like food and housing insecurity can facilitate referrals to community resources that address needs. Identifying at-risk cohorts of patients and managing them differently through enhanced care coordination can yield significant benefits.
Strengthen patient education – Improving patients’ knowledge and self-management skills leads to better health outcomes. Clinics must integrate patient education into visits via teach-back methods, videos, discharge instructions, classes, and more. Patients and referrers should have access to waiting times, what their role is in the process and what their rights are. My Waiting Time is a prime example of this approach.
Explore point-of-care diagnostics – Devices like portable ultrasounds and rapid diagnostic tests allow obtaining lab-quality results at the clinic should be heavily rolled-out. A focus on One-Stop appointment and diagnosis should be a central aim of any outpatient improvement. This facilitates faster and more accurate diagnosis.
Make use of mobile health applications – Health apps on smartphones and wearables allow patients to track symptoms, share data with providers, and receive reminders for health events. This generates more longitudinal data for diagnosis, and allows both patient and clinician to know when things have gone wrong and patients need to be seen.