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Situation

Guy’s and St. Thomas’ is one of the UK’s leading foundation trusts, with 2 large central London hospitals, 2.3 million patient contacts, and 1.2 million outpatient appointments through their 1,000 inpatient beds per year.

Following a successful pilot primarily with the Women’s Services Department in 2015 (resulting in ‘Did Not Attend’ rate dropping by 30% and attendance rates improving – equivalent to an extra 2,440 patients over a year, and worth £317k profit), DrDoctor was implemented to all outpatient’s departments throughout the Trust beginning in April 2016.

The fastest, most effective and fun IT rollout this trust has seen

Keith Plumb, IT Project Manager, Guy's and St. Thomas'

Goal:

To mirror the success Guy’s and St. Thomas’ Women’s Services Department had with DrDoctor throughout their outpatient care, with an implementation process lasting no more than 6 months.

To create tangible savings of between £2.5-3.5 million annually.

The DrDoctor team were really hands-on, really helpful. They were here a lot, training up all the various members of staff and really holding your hand through every stage through it to make sure that it all rolled out and everything went according to plan

Annabel Balcombe, Service Manager, Women’s Services, Guy’s and St Thomas’

What DrDoctor Did:

We split the deployment into three main stages;

  • Technical Integration – DrDoctor technically integrates with the hospital’s Patient Administration System (PAS)
  • Training – Onboard staff members with different roles and responsibilities
  • Go-Live – Turn on functionality and provide support.
Role Responsibility Number of Staff Trained at GSTT
Lead Provide oversight and action reporting 20
Super-User Maintain content and system setting 142
Booking Clerk Action patient requests 224

 

DrDoctor created a bespoke training regime for each of the different roles and responsibilities tailored to the size and scale of the organisation. Each role was trained in a series of practical sessions run by the DrDoctor team, where the department were not only shown how to use the software but how to align their processes with the new system.

The DrDoctor functionality is grouped depending on session code, which gives super-users the ability to customise patient information to a high level of detail. During the go-live process, super-users were given the responsibility to customise and turn-on features at their discretion and shown the process to turn off the legacy reminder system.  Weekly team meetings were held to feedback turn-on progress and early benefits.

Evaluation/Lessons learned:

At the end of the six-month onboarding phase, the DNA rates across the Trust dropped from 11.7% to 10.4% (11.1% reduction). The table below shows the rates as calculated for the 2016/2017 financial year.

Activity Type Baseline DNA rate Post DrDoctor DNA rate Change in DNA rate Percentage Change
New 13.0% 11.0% 2.0% 15.5%
Follow-up 13.8% 11.3% 2.5% 17.7%
Total 13.6% 11.2% 2.4% 17.2%

Guy’s and St. Thomas’ internal reporting has calculated the 2016/17 full year equivalent financial benefit for the trust as £2.6 million. However, this figure was calculated during deployment and go-live phase – realistic full first-year results will be higher.  As such, the Trust has projected further savings between £600,000 and £650,000 by increasing feature use to 80% – as this figure rises, further savings will be made, while keeping satisfied patients and staff.

Since ending this project DrDoctor is being supported by Digital Health.London and the NHS Innovation Accelerator and working with two further London Trusts.

The portal is really easy to use. Once you log in and everything, it’s really easy to navigate, really simple and straightforward.

Lauren Haynes, Patient Pathway Co-ordinator, Women’s Services, Guy’s and St Thomas’