HTN Now: automation in primary care processes with Healthtech-1

For our recent webinar on automation in primary care processes, we were joined by Dr Lydia van Hamel-Parsons, GP and founding clinician at Healthtech-1, to discuss all things automation, with a specific focus on new patient registrations and lab report filing. Used in more than 493 practices to date, Lydia shared with us some insight on how Healthtech-1’s solutions can offer functionality that helps save GP time.

Introducing herself and the company, Lydia shared: “As a GP by background and founding clinician at Healthtech-1, I have been on quite an interesting journey, and all of it centres around this very personal mission that I’m on to change the way we work in primary care for the better of staff and patients. 6-7 years ago, I became the original clinical lead at Accurx, helping build their text messaging and Florey products, and worked with the incredible team there for nearly two years before founding my own company to automate admin in primary care. After going back to general practice, I found Healthtech-1, our missions aligned, and here I am.”

On the background of Healthtech-1, Lydia talked about the company’s journey with co-founders Raj and Pete, and the fact that the company’s office is based in a GP surgery owned by Raj’s parents.

“The whole company grew out of Raj and Pete, who were childhood friends, being asked by Raj’s parents to help to digitise their practice, and we’ve grown from there. We’ve built a great team, including Dr Dom, who’s a GP but also engineers on our team; Mike, who is an ex-engineer from Accurx that helped build the COVID vaccine booking platform, the triage platform, the batch messaging; and an old friend of mine, Laurence, who is an ex-co-founder of Accurx and is now a senior lead on our engineering team.”

Bringing automation into primary care

Lydia talked about Healthtech-1’s focus on automation in new patient registrations and lab result filing, sharing some statistics that show that the company is now responsible for around 10 percent of the nation’s registrations, and noting that the company has been selected as a supplier by the NHS central team to automate the NHS national form.

Moving on to talk about some examples of the ways we already use automation in our everyday lives, such as when ordering food shopping online, or when using Siri to set alarms or reminders; Lydia highlights that automation is “everywhere”, and is about “making our lives easier, more enjoyable and actually more tailored, as well.”

“We want automation in primary care to save admin and clinical time, to save staff members from doing repetitive manual tasks, and to get them working on tasks that really matter, spending time on providing that quality care. We don’t want practice staff to experience decision fatigue, and applying best practice every single time is made easy through automation. We can automate things like checklists that make our work safe, and can also realise financial benefits from using automation to increase efficiency.”

Lydia told us that one of the main motivations for practices to choose to work with Healthtech-1 is workload.

“A good example is the national registration form that has opened up channels for a lot of practices, who are now getting lots of PDFs through their email, and who then have to have their team manually entering that data. If we can automate that, we can save time. Another great example is staffing gaps, like at Christmas, where a lot of practices we work with struggle, but by bringing in automation it brought a lot of resilience to their teams. Through these time savings and efficiencies, our practices have described boosting list size, or having more time to tick-off QOF boxes, which helps with income and optimising your quarterly capitation payments if you have same day registrations.”

“Collectively, our practices have saved 93,000 hours of staff time, or over 45 years’ worth of administration work, for practices across the country, which is a huge achievement.”

Realising patient benefits

Lydia moved on to discuss the use of automation in new patient registrations, and how Healthtech-1’s registration form offers a secure, configurable way for practices to get new patients onto their system.

“Patients can access it through your website or via a QR code on your front desk, and the automation registers that patient in your clinical system, whether that’s EMIS or SystmOne, and does all of the coding associated with that registration, getting patients registered same day, in about 10 hours. The practice team can then manage registrations from the hub, and there aren’t registrations sitting in an inbox somewhere for weeks on end. You can also get so many more data points added to your record, on things like ethnicity, language needs, and so on, and uplift your processes around things like child safeguarding by flagging higher risk registrations, and getting school details in the record.”

“We built this product with our users, and we can give you a real insight into your own data. The whole onboarding process can be completed in as little as 30 minutes to go live with automated registrations. We’ve roughly halved the cost of manual registrations to around £2 plus VAT per registration, with no setup fees, training fees, or licence fees. We have no long-term contracts, and we do offer a free trial as well, so you can try us and see what you think. We hope to offer an average 10k list size practice an income benefit over the course of the year of around £3,000.”

Highlighting use cases

Lydia introduced Patrick Denston, business manager at Alexander House Surgery, and David Gunion, digital programme manager at Sunderland GP Alliance, to talk a little bit about their own journey with automation.

From his experience of automating registrations, David shared that his team had already been looking into creating a digital front door and enhancing practice websites, and that the decision to try automation was borne from a desire to improve access for patients, save time for practice, and lower costs.

“Having the website work completed, we moved everybody onto a single supplier platform, and that gave us massive amounts of data, and we could suddenly start seeing aggregated data across the city. From an RPA (robotic process automation) point of view, we looked at key things that everybody goes to a practice website for, like appointments, prescriptions, sick notes; registrations were also in that list. We looked at how we could make changes around those things, got introduced to Lydia, and then that kind of snowballed.”

“It absolutely improves access for patients, because it’s just a click of a button from the website. We do about 26,000 registrations per year, on average, which takes about 6,500 hours of staff time doing it manually, and it made sense to look at how we could reduce that time. Now that automating that has worked, we’re starting to think about other things that we could maybe do to reduce that workload burden.”

On the concerns around automation before the project got going, David shared that feedback suggested that there were worries about how the process worked and how it would impact practice.

“A lot of it was, ‘I’m just happy with what we’re doing, and it’s easier just to keep what I’ve got, rather than change’, which is fine, but it’s the demand from the patient almost that drives that. We looked at it as a federation, and what we needed to do to achieve what we wanted over the next 12 months. We’re still in that pilot stage, we’re about 8 months in now, but key things for us to think about were people adopting the software, completing the training, and how we get practices to do that; that’s the first hurdle. Feedback so far is that it’s a really good product, people like it, and it’s saving them time, so that’s the important thing. We’re also looking at engagement, so more people are aware that they can register online.”

David shared with us that about 26 of his practices were live with automated registrations at the moment, with plans for the remainder to be onboarded by the end of the 12 month period.

“The speed of registrations is actually ramping up, because we’re getting more practices on board, and people are starting to see the benefits. From an onboarding point of view, it’s very simple, and then Healthtech-1 help complete the back-end stuff, so that’s all taken care of as well. We’ve done about 4,500 registrations to date, and we had a big spike at university intake time, and that’s meant around 1,100 hours of staff time saved.”

Patrick shared his insights from a practice level, saying that after coming across Healthtech-1, he had chatted to his admin team to find out what the registration process currently looked like, and that they had highlighted the workload around these registrations and what it meant for them in terms of struggling to get through them all. After weighing up the costs and benefits, the practice decided they should “give it a try”.

“We thought we were spending 15 minutes on registrations, but we realised that once you start asking all the other questions, the other 96 points of data, not just the purple form; it was coming up to nearly half an hour to get everything you needed, and then there’s the follow up. It’s quite a lot of work, and it’s not really skilled work. There was some hesitation that we might be stopping older people being able to join, but I’ve just had a look at my stats, and I think the oldest person that’s used it so far is 103 years old!”

“It can be any time of the day, and it even registers over the weekend, so it’s all sorted by Monday morning. We’ve got their medications, we can have an appointment, we can send to the GP, we can get them in for anything that they might need. That ‘sorry we’re still waiting for records, we’ve emailed your previous GP practice, I know it’s been weeks’, has just gone away. The GPs love it because of the speed, especially with the more vulnerable patients, and equally with newborns – patients are registering when they’re still in hospital, and their children are not even registered as being born yet.”

Onboarding and outcomes

Patrick talked about the ease with which his practice completed the onboarding process, with ongoing support available from Healthtech-1 making it “like having another member of the team”.

On the time saved since implementation, Patrick shared that his team have finished QOF ahead of the April deadline, and now have much more time to provide better patient care.

“We’ve got our NHS health checks through the roof, we’ve started next year’s QOF work to get it out of the way, and we hadn’t quite appreciated how much time was wasted chasing registrations.”

When looking at value returned on investment, Patrick highlighted that previously, “the unpredictability of when the registrations came in, and wanting to have a quick turnaround, generally meant that there was almost a blank cheque for overtime”, which has since “vanished”.

Lab reports

Lydia’s next few slides covered Healthtech-1’s functionality in terms of lab reports, detailing how the automation scans inboxes for lab reports it is allowed to file, using a hard-programmed protocol, leaving an audit trail in the hub for GPs to choose to check the work it has done.

“We’re live in 22 practices including Patrick’s, and we’ve started with things that a lot of practices are asking HCAs and administrators to file with a protocol. We’ve started with those results, because we know that they are lower complexity and lower risk, but we can do things like vitamin D, and if there’s insufficiency we can read and interpret that report, text patients asking them to go and pick up a supplement from the pharmacy, save a consultation note, and we can file that result with a comment or with a task.”

In the future, examples of more complex actions that the automation will complete include adding SNOMED codes, calculating Qrisk score, requesting prescriptions, reading medical records, requesting blood tests and sending emails; but Lydia emphasises that her team are keen “not to run before they can walk”.

“We’re purposefully doing things slow, starting with the lower risk things, so that we can prove that we have the responsibility, the reliability, and can be trusted to file these results. What we’ll be working on soon are the more complex results, and we’re taking more time to make sure these protocols are watertight, that everyone’s happy with them, we’re getting them signed off by GPs.”

In terms of cost, Lydia emphasises the company’s commitment to making everything “cheaper, faster, and safer than current processes”.

“You’ll always be able to rely on the fact that our price point is set below what it would cost you to pay one of your team members to do this work. At the moment, those less complex results will be priced at 20p per lab report; to put this into perspective, if we were to do all 200 labs that your practice receives per day, it would cost £40.”

Lydia then moved on to take questions from our live webinar audience.

We’d like to thank the panel for taking the time to share their insights with us.