Overview of Challenge
Birmingham Children’s Hospital Kids Intensive Care and Decision Support (KIDS) have been using Kinseed’s MediLog application as their Electronic Patient Record System for a number of years. As a result of this successful partnership, University Hospital Birmingham, together with Bsol ICS, wanted to develop a similar system to support a new Unified Paediatric Advice and Guidance Service (“UPAGS”) within the West Midlands Region (University Hospital Birmingham, Good Hope and Hartland).
The UPAGS team approached Kinseed to help co-design a digitised care pathway, with the engagement of primary care workers, patients and the public. A core objective was to address health inequities, whilst resolving a key problem: reducing the large volume of unnecessary referrals to A&E / outpatients by providing care in local settings through timely advice and guidance.
In addition, Primary Care providers were continuously frustrated by unanswered calls and not knowing when they would get a call back if they left a message during busy periods. As such, the aim was to develop a system for UPAGS that ensured community care providers get access to the right advice at the right time.
Initially, Kinseed gathered insights about the existing service by closely working with patients and clinicians. Working with public contributors, we gained a deep understanding of the specific needs of different people, enabling tailored solutions to reduce local health inequalities.
SwiftCare’s MediLog solution was then deployed to UPAGS as a single system to manage and automate the process of getting patient referrals from GPs and other first-line services. The MediLog application enabled live collaboration between Referrers and Consultant Paediatric clinicians, with the ability to simultaneously update patient data at the point of call and resulting in either providing local treatment / observations, or more rapidly triaging patient to the right care settings.
Impact and Results
Implementing the UPAGS service on MediLog resulted in several significant improvements, including reducing the number of non-urgent calls being referred to the hospitals, and enabling General Paediatricians to provide remote consultations with decision support before Hospital referral. The efficiency of core data collection was also substantially increased, supporting effective reporting and governance, enabling much earlier intervention for safeguarding and special need issues.
Overall, the use of UPAGS has notably improved communication between referral and clinical teams, including gathering rich data analytics of call management for the ongoing enhancement of the service. The service has now been in operation for 18 months; every month over 40% of patients are managed and treated directly through advice and guidance from the service. The remaining are cared for in other more appropriate local settings, such as Rapid Access Clinics, leaving only a small number triaged to Emergency Departments when absolutely necessary.