Health and Symptom Checkers13th October 2011Ronnette Lucraft – Chief Operating Officer
Agenda• Why health and symptom checkers were developed• How the health and symptom checkers were developed• How they perfo...
Agenda• Why health and symptom checkers were developed• How the health and symptom checkers were developed• How they perfo...
Over 70% of UK internet userslook for health issues46% of those looking at health on theinternet are trying to self diagno...
• Multi-channel strategy developed during the Autumn of 2007, and  agreed by Board in February 2008. Its objectives were t...
Improve reach – attract new service users & encourage channel switch• More people use our web-services in 2010/11 than con...
Improve reach – Syndication• 10 current syndication partners – get H&SCs where people go already     Channel 4            ...
Improve reach – TV tie inMaverick Productions (onbehalf of Channel 4) hasmade video versions ofpopular H&SCs for theirEmba...
Increase range of channels available to patients for contact & fulfilment • Ambulance trust integration •Web chat • On-lin...
Create a consistent, re-usable set of digital assets • Re-use of assets used within call centres • Ability to syndicate si...
Improve channel efficiency & integration • All symptom checkers have a trigger if further nurse assessment/support is requ...
Develop a reputation for innovation • Multiple awards won • Management of the NPFS (also had a web-first strategy) • Consi...
Agenda• Why health and symptom checkers were developed• How the health and symptom checkers were developed• How they perfo...
Evolution of symptom checkers    2005                                                                                Very ...
Design Principles                    •   Easy to use                    •   Expert developed                    •   Fast a...
Outcomes consistent with the phone            Patient Urgent Care Need                                                    ...
Expert developed Rigorous clinical governance and sign-off Clinical Advisor panel UK specific algorithms, updated regularl...
Agenda• Why health and symptom checkers were developed• How the health and symptom checkers were developed• How they perfo...
Web demand for symptom checkers 600000                                                                                Curr...
Website HaSC usage                           Visits       120000       100000        80000        60000        40000      ...
App usage vs web usage   600000   500000   400000   300000                                                                ...
Overall benefits          Patient                            NHS                                   Allows non-urgent patie...
Agenda• Why health and symptom checkers were developed• How the health and symptom checkers were developed• How they perfo...
Current developments          Advanced multi-variable logic – e.g. postcode                       Improved interface    In...
Agenda• Why health and symptom checkers were developed• How the health and symptom checkers were developed• How they perfo...
Future enhancements    Endpoint reasoning – WHY you should follow our advice       Realtime call waiting times for CallBac...
Potential enhancements       Realtime call waiting times for CallBack requests              Alternative endpoints – time b...
Vision - central platform, local delivery                                     Local advice                   ClinicallySym...
NHS Health and Symptoms Checker Digital Leaders Presentation (23.10.2011)
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NHS Health and Symptoms Checker Digital Leaders Presentation (23.10.2011)

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  • Sources: McDaid & a-laparke 2010 – Online health – untangling the web
  • Ref: ‘Government services wherever you are’ – Open Public Services white paperDiscuss other options for syndication as well, e.g. kiosks, IPTV, consoles and other mobile apps
  • Into the overview of H&SCs
  • Outcomes same as calling the NHSD service
  • All subject to business case and budget
  • NHS Health and Symptoms Checker Digital Leaders Presentation (23.10.2011)

    1. 1. Health and Symptom Checkers13th October 2011Ronnette Lucraft – Chief Operating Officer
    2. 2. 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
    3. 3. 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
    4. 4. Over 70% of UK internet userslook for health issues46% of those looking at health on theinternet are trying to self diagnose= over 17million people Sources: McDaid & a-la-parke 2010 – Online health – untangling the web
    5. 5. • Multi-channel strategy developed during the Autumn of 2007, and agreed by Board in February 2008. Its objectives were to: Improve reach Increase channel choice Create a consistent, re-usable set of digital assets Improve channel efficiency & integration Develop a reputation for innovation
    6. 6. Improve reach – attract new service users & encourage channel switch• More people use our web-services in 2010/11 than contacted theservice 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
    7. 7. Improve reach – Syndication• 10 current syndication partners – get H&SCs where people go already Channel 4 ManMOT Co-op pharmacy
    8. 8. Improve reach – TV tie inMaverick Productions (onbehalf of Channel 4) hasmade video versions ofpopular H&SCs for theirEmbarrassing Bodies show
    9. 9. 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
    10. 10. Create a consistent, re-usable set of digital assets • Re-use of assets used within call centres • Ability to syndicate simply • Digital library project underway • Video ‘celebrity’ doctors media
    11. 11. 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
    12. 12. Develop a reputation for innovation • Multiple awards won • Management of the NPFS (also had a web-first strategy) • Consideration as partner for 111 on-line
    13. 13. 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
    14. 14. Evolution of symptom checkers 2005 Very earliest online tools. Simple logic embedded in to manually coded HTML. Still used by NHS 24 Self help guidesOct 2008 Self assessment tools Enhanced logic, greater range of topics. Manually coded HTML. Still used by NHS Direct WalesJuly 2010 Health & symptomJan 2011 checkers New HaSCs use advanced logic, based on a intuitive logic engine and instantly updateable CMS
    15. 15. Design Principles • Easy to use • Expert developed • Fast answers • Confidential
    16. 16. Outcomes consistent with the phone Patient Urgent Care Need Referred CallbackSelf care Web chat to GP, from advice Pharmacy with NHS A&E, NHS online Direct Dentist or Direct 999 Decreasing demand on core NHS services
    17. 17. Expert developed Rigorous clinical governance and sign-off Clinical Advisor panel UK specific algorithms, updated regularly Directly linked to NHS Direct call centres
    18. 18. 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
    19. 19. Web demand for symptom checkers 600000 Currently 500000 over 500,000 400000 uses per 300000 Web HaSC forecast month via Web HaSC Actual NHS Direct 200000 website 100000 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar HaSC forecast and demand via website 2011 / 2012 Data source: Urchin 7
    20. 20. Website HaSC usage Visits 120000 100000 80000 60000 40000 Visits 20000 Data: September 2011 – 0 Source: Urchin 7 Total web HaSC usage since Apr 2011: 4,037,638
    21. 21. App usage vs web usage 600000 500000 400000 300000 Web HaSC Actual Mobile App Actual 200000 100000 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Total App HaSC uses since launch 1 June 2011: 959,111
    22. 22. Overall benefits Patient NHS Allows non-urgent patients to Fast answer from anywhere treat themselves Range of options for onward Frees up valuable resource care Gives best care for the medical Reduces total cost to NHS problem Uses technology that they can Allows NHS advice to prevail relate to over ‘chat room’
    23. 23. 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
    24. 24. 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
    25. 25. 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
    26. 26. Future enhancements Endpoint reasoning – WHY you should follow our advice Realtime call waiting times for CallBack requests Improved entry point to HaSCs Enhanced body map Reviewing ‘flow’ to reduce dropout rates
    27. 27. Potential enhancements Realtime call waiting times for CallBack requests Alternative endpoints – time based 111 version Multiple languages Patient rating and feedback
    28. 28. Vision - central platform, local delivery Local advice ClinicallySymptom developed Local advice checker online care Local advice

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