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Trust makes huge saving with digital solution

A partnership with a digital appointment management system in on course to save The Royal Orthopaedic Hospital over £100,000 this year.

DrDoctor is a booking and patient interaction software company whose aim is to catalyse technology-led change in hospitals and healthcare systems.

In 2017, the ROH had a Did Not Attend (DNA) appointment rate of 10.9% and were using a non-interactive text messaging reminder system. Although below the national average as a high performing specialist centre, the Trust decided to partner with DrDoctor to improve their DNA rate.

In 2019, the Trust implemented DrDoctor’s Patient Platform and Appointment Management with a view of rolling out digital letters and patient-led booking as a second phase.

Within nine weeks, the overall DNA rate was reduced to 8.08% in the clinics where DrDoctor is turned on. This was an improvement of 26%. The estimated 2019-2020 full year equivalent financial benefit for the Trust is £103,017. 

The vast majority of patient interactions with secondary care are through outpatient clinics; 85% of all UK hospital-based activity (excluding A&E) is accounted for by outpatient appointments. One in five potential appointments in England, and one in four appointments in Wales, are cancelled or reported as DNA.

A recent OFCOM survey showed that smartphone ownership in those aged over 60 years was at 72%, and over 90% for the remainder of the population.

Before partnering with DrDoctor, the ROH’s DNA rate for all specialties across the Trust was at a high baseline of 10.9%. This was costing ROH approximately £1.3 million per year in lost income.

Appointment Management was implemented to improve efficiency and patient experience throughout the Trust. Specifically, ROH’s aim was to: 

  • Reduce DNA rates
  • Generate realisable financial savings
  • Improve administrative efficiencies
  • Digitise outpatient services.

The Trust rolled out Appointment Management in all selected clinics, which accounts for 70% of all outpatient clinics, in nine weeks. The Trust had a dedicated Programme Manager from DrDoctor on-site throughout this process - enabling the Trust to quickly start to see tangible improvements to DNA rates and patient satisfaction. 70% of clinics were live within nine weeks, and the entire implementation process was completed within 10 weeks. Success, an ongoing work stream to maximise the benefits of Appointment Management, will continue to run indefinitely.

Integration with patient administration system iPM was successfully completed in the pre-project phase. By the end of the project in June 2019, all required staff at the Trust were trained and on-boarded to use DrDoctor. Within a week, there was a reduction in DNA rate, showing a clear correlation to the send rate of DrDoctor message. The number of DNAs is forecast to be just under 1000 for the year.

What’s next?
Looking ahead, the ROH is beginning a digital letters project, as well as expanding the use of DrDoctor’s functionality through See Me Sooner and Slot-based Rescheduling. The Trust has recently begun implementing a ‘partial booking’ process which means they can now implement DrDoctor’s Patient Led Booking solution, unlocking more value.

Piri Amalan, Transformation Manager at DrDoctor said: "We are incredibly proud of what our technology has been able to achieve. This has only been possible through the culture and strong drive for digital transformation at the Trust."

Matt Payne, Clinical Service Manager – Patient Access, Performance and Outpatients Department at the ROH, said: “DrDoctor were engaged throughout the process and worked closely with the operational team to ensure that the system was set up quickly, and thorough testing was undertaken to make certain that there were no technical issues at ‘go live’.

“The feedback from the booking team, whom I manage, has been very positive including a significant reduction in telephone traffic and a reduction in the amount of time taken to reschedule patients’ appointments.”