Feature Content, Primary Care News

HTN Now: Dr Andrew Whiteley on supporting Citizen Access

For HTN Now: Citizen Transformation, we interviewed Dr Andrew Whiteley, Managing Director of Lexacom, to find out more about Lexacom’s role in primary care and how they support the Citizen Access programme through their digital dictation and speech recognition software.

On Lexacom’s beginnings

We go back to the mid 1990s, when I first became a doctor working in Warwickshire. I found it frustrating that every day when I went into work I had to find a tape machine, make sure the batteries were okay, make sure that the tape was actually at the start and not halfway through, and then I had to go through the day building up referrals and notes that I wanted to have typed up. From the secretary’s point of view, every lunchtime they would have ten doctors dropping a tape on their desk and telling them that different transcriptions on those tapes were urgent. I thought that there must be a better way to do this with technology, even though it now feels like tech was in the dark ages back then!

I then wrote the very first version of Lexacom, which took the dictation, prioritised it, and sent it to the secretary. Just with that, I found that it took the turnaround time from days or even weeks in some cases down to minutes. It meant that patients were happier and -my colleagues were keeping up with their work and also potentially enjoying the job a bit more.

Even though I was working full time as a doctor, the company grew organically by word of mouth, reputation and trust in the product. We are now completing in excess of 50 percent of all referral letters in the NHS.

It very much started with a GP focus, because that’s where I come from, but the other founder in the company is a surgeon so there’s also been a hospital interest in this type of technology. We’re going to be doing a lot more across the health sector in the UK and beyond, in vertical and horizontal professions.

Essentially, we save Lexacom users time, as efficiently and as securely as possible. Lexacom 3, our original digital dictation platform, has saved so many hours for each of our clinicians in creating referrals, documents and patient notes. We aim to bring the efficiency savings to almost every aspect of their work.

We’re in a unique position, I feel, to link primary and secondary care in ways that have never been achieved before, so there are a lot of exciting opportunities for us and our customers in the future.

Supporting patients to be better informed

Looking to the Citizen Access programme, I firmly believe that a patient does much better if they know what is wrong with them and they can understand what’s going on; what they can do to help themselves; and most importantly, what the doctor is thinking.

In the pressures of a consultation there isn’t a lot of time to get all that information across. I can see the logic of putting that information on a mobile app so that patients can read it, but the problem is, there’s so much information available on the internet and patients don’t necessarily have the medical know-how to make sense of it. I think it’s essential that doctors explain what is actually wrong with a patient in a way that they understand.

The issue is that for hundreds if not thousands of years, doctors have learned their own language, a medical shorthand that explains the situation perfectly to another doctor but not necessarily to the average patient. Either the doctors are going to have to change the way they are programmed to work, which will take them more time and extend the length of time a consultation takes, or we need to offer them a solution to work around this, which I believe we have with the addition of the Lexacom Comprehension Engine to our speech recognition software, Lexacom Echo.

On new product update, the Lexacom Comprehension Engine 

The last figures we have for data from the NHS is 2021 and in that year there were 311 million GP consultations, if you exclude the vaccinations. 80 percent of them were face-to-face, which works out to around 46 consultations per GP per day.

However, the NHS’s own research has shown that 42 percent of working age adults are unable to understand and make use of everyday health information. That rises to 61 percent when you actually take numeracy into account and ask if people have the numeracy skills needed to understand the information given.

That means that out of each GP’s 46 consultations per day, between 19 and 28 of patients will not understand what the GP has written. The worry is that they might need to contact the GP again to ask them to explain medical terms, further increasing the GP workload; but if patients don’t call back, then they are no better informed.

With the Lexacom Comprehension Engine, the GP uses the latest version of Lexacom Echo to dictate or write the patient notes in the clinical system and Lexacom Echo will automatically add plain English explanations for every medical term, closely following the NHS style guide of health writing. When the patient reads those notes in the NHS app, they see the medical term directly followed by the plain English explanation in brackets. For example, if the GP writes or states, “the patient was apyrexial”, with Lexacom Echo the patient reads “the patient was apyrexial (did not have a high temperature)”. Not only will that reduce the number of contacts a GP has after a consultation, but it  will also better inform their patients and better involve them in their own healthcare.

Providing solutions to support GPs with evolving roles

We understand that around the country and even within the same areas, the needs of a customer vary massively. Some are very IT-literate whereas others see IT as a necessary evil. With this in mind, we ensure that our solutions are intuitive. Most of the functions to get up and running in our software don’t require training to use, and we try to offer as many ways as possible to do the work that needs to be done.

For example, a Lexacom 3 user will be able to use direct dictation to their own secretary from their consultation room or mobile, linked to the patient notes to ensure that there is probity within the system. If the secretary is too busy to transcribe the dictation, it can be sent securely to Lexacom Scribe, our UK-based outsourced transcription service with next working day turnaround. Or users could create their own letters, emails and notes using Lexacom Echo.

The addition of the Lexacom Comprehension Engine to Lexacom Echo means that we can support Citizen Access.  Other modules to be released in 2023 will allow coding whilst doctors are working. There are a lot of other features which will be announced over the coming months – it’s a very exciting time for us.

Expanding to other sectors of care

Since 2019, we have been on the SBS Framework for digital dictation, speech recognition and outsourced transcription, allowing us to work directly with secondary and community care as well as primary care.

The next version of our product, which will be released early next year, is completely cloud-based which will support mobile workers and people who hot desk to work efficiently and securely wherever they are. They will also be able to use our software to leverage their own IT systems to become more productive using their voice or typing.

Looking to the future

There’s a lot happening, but obviously I can’t share everything just yet! There’s a genuine buzz of excitement in our offices here. We believe that we have a unique product and a unique view on how we approach problems faced by our users. We base every decision that we make on the needs of our customers.

2023 is going to be a year of major announcements and innovations and developing new solutions to make everyone’s life a little bit easier, both in the UK and overseas. We can’t wait to begin.

Success in digital primary care over the coming years

From a personal point of view, we already regularly hear people using Lexacom as a verb like people used to do with Hoover or still do with Google. I think success for us will be the use of our solutions where people feel they won’t be able to do their job as well without us.

More globally, I think IT has to be designed and work for the people using it. That is the doctors and clinicians as well as the patients. An awful lot of work needs to be done within the health sector on that basis, and we’re very happy to help link it all together.

I honestly feel that we need and deserve a well-funded and efficient NHS that treats people at our time of need. Ultimately, we just want to continue to help make that a reality.

Many thanks to Andrew for joining us and for sharing his thoughts. Please see the video below to watch the interview: