NHS Health and Symptoms Checker Digital Leaders Presentation (23.10.2011)

Health and Symptom Checkers 13th October 2011

Ronnette Lucraft – Chief Operating Officer

Agenda

• Why health and symptom checkers were developed

• How the health and symptom checkers were developed

• How they perform

• Current development activity

• Potential development strategy

Over 70% of UK internet userslook for health issues

46% of those looking at health on the internet are trying to self diagnose = over 17million people

Sources: McDaid & a-la-parke 2010 – Online health – untangling the web

• Multi-channel strategy developed during the Autumn of 2007, and

agreed by Board in February 2008. Its objectives were to:

Increase channel choice

Improve reach

Create a consistent, re-usable set of digital assets

Improve channel efficiency & integration

Develop a reputation for innovation

Improve reach – attract new service users & encourage channel switch

• More people use our web-services in 2010/11 than contacted the service directly via the phone

• 4.4m direct dialled calls (including CAT C)• 5.6m symptom checker transactions• 217k Click to Call Backs • 3.6k web chats

• Web first messaging at peak times to caller and in marketing

Improve reach – Syndication

• 10 current syndication partners – get H&SCs where people go already

Channel 4 ManMOT Co-op pharmacy

http://www.livefromtheclinic.channel4.com/symptom-checkers

Maverick Productions (on behalf of Channel 4) has made video versions of popular H&SCs for their Embarrassing Bodies show

Improve reach – TV tie in

Increase range of channels available to patients for contact & fulfilment

• Ambulance trust integration •Web chat

• On-line Enquiry Service

• Live chat-rooms (Habbo Hotel)

• Mobile version of website

• Web -apps

#1 free

app!

• Re-use of assets used within call centres

• Ability to syndicate simply

• Digital library project underway

• Video ‘celebrity’ doctors media

Create a consistent, re-usable set of digital assets

Improve channel efficiency & integration

• All symptom checkers have a trigger if further nurse assessment/support is required

• Reduced whole economy costs due to patient self-serve (£57m in 2010/11 using the Value Proposition calculation)

• Click to Call Back (CTCB) reduces HA time – 30secs vs 316 secs each use

If all of the ‘call back’ contacts in 2010/11 had been direct-dialled phone calls it would have required an additional 23 staff

• Multiple awards won

• Management of the NPFS (also had a web-first strategy)• Consideration as partner for 111 on-line

Develop a reputation for innovation

Agenda






Evolution of symptom checkers

Oct 2008

July 2010

2005

Jan 2011

Self assessm

ent tools

Self help guides

Health &

symptom

checkers

Enhanced logic, greater range of topics. Manually coded HTML.

Still used by NHS Direct Wales

New HaSCs use advanced logic, based on a intuitive logic engine and instantly

updateable CMS

Very earliest online tools. Simple logic embedded in to manually

coded HTML. Still used by NHS 24

Design Principles

• Easy to use• Expert developed• Fast answers• Confidential

Outcomes consistent with the phone

Decreasing demand on core NHS services

Patient Urgent Care Need

Self care advice online

Web chatwith NHS

Direct

Callback from NHS Direct

Pharmacy

Referred to GP, A&E,

Dentist or 999

Expert developed

Rigorous clinical governance and sign-off

Clinical Advisor panel

UK specific algorithms, updated regularly

Directly linked to NHS Direct call centres

Agenda






Web demand for symptom checkers

HaSC forecast and demand via website 2011 / 2012Data source: Urchin 7

Currently over 500,000 uses per month via NHS Direct website

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar0

100000

200000

300000

400000

500000

600000

Web HaSC forecast

Web HaSC Actual

Website HaSC usage

Data: September 2011 – Source: Urchin 7

Total web HaSC usage since Apr 2011: 4,037,638

Initia

l Ass

essm

ent

Abdom

inalP

ain

Rashe

sAnd

SkinPro

blem

s

colda

ndflu

fem

alese

xualh

ealth

DandV

5And

Over

Gener

alIlln

ess1

2And

Over

Chest

AndBac

kPain

Joint

PainAnd

Swelling

Male

Sexua

lHea

lth0

20000

40000

60000

80000

100000

120000

Visits

Visits

App usage vs web usage

Total App HaSC uses since launch 1 June 2011: 959,111

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar0

100000

200000

300000

400000

500000

600000

Web HaSC Actual

Mobile App Actual

Overall benefits

Patient NHS

Fast answer from anywhere

Range of options for onward care

Gives best care for the medical problem

Uses technology that they can relate to

Allows non-urgent patients to treat themselves

Frees up valuable resource

Reduces total cost to NHS

Allows NHS advice to prevail over ‘chat room’

Agenda






Current developments

Advanced multi-variable logic – e.g. postcode

Improved interface

Instantly updatable for clinical changes or major incidents

Ready for instant syndication to 3rd party websites

Agenda






Future enhancements

Realtime call waiting times for CallBack requests

Enhanced body map

Improved entry point to HaSCs

Endpoint reasoning – WHY you should follow our advice

Reviewing ‘flow’ to reduce dropout rates

Potential enhancements

Alternative endpoints – time based

Multiple languages

111 version

Realtime call waiting times for CallBack requests

Patient rating and feedback

Vision - central platform, local delivery

Symptom checker

Clinically developed online care

Local advice

Local advice

Local advice

NHS Health and Symptoms Checker Digital Leaders Presentation (23.10.2011)

Health & Medicine

Transcript of NHS Health and Symptoms Checker Digital Leaders Presentation (23.10.2011)