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Embedding eConsult into your practice workflow

Designing a workflow model for your practice

Laura Perring avatar
Written by Laura Perring
Updated over a week ago

This article covers:


Why your workflow is important

Whether you're new to online consultations or have used eConsult or another provider previously, you'll know that how you embed them into your practice is important for success.

Designing a workflow model that works for your patients and importantly for your practice team is the key to delivering efficiencies, reducing pressure on your service and improving team morale.

Bolting on eConsult to full clinics when you are already struggling with the demands of patient needs will simply increase the pressure, the work and the feeling of drowning.


Different workflow models

Practices using eConsult traditionally use one of three models:

  • Total Triage

  • Same Day

  • Routine

Total Triage

Introduce eConsult as the main route for accessing help or an appointment.

Practices review eConsults as they come in and respond to all eConsults within an agreed time scale or by the end of the next working day.

Benefits:

  • Easiest model for patients/practice

  • Patients get the quick response they expect when using digital

  • Improved access for patients and zero pressure on the phones

  • Patients are seen based on clinical need

  • Better resources of practice staff and time

  • Reduced appointment wait time

  • DNA’s reduced to Zero

Same Day

Introduce eConsult as the main route for accessing help or an appointment today.

Practices review eConsults as they come in and respond to all clinical eConsults at an agreed same-day response.

Benefits:

  • Patients get the quick response they expect when using digital

  • Improved access for patients and less pressure on the phones

  • Patients are seen based on clinical need

  • Better resources of practice staff and time

Routine

Introduce eConsult as the practice’s preferred route for accessing help or an appointment as they may not need a face to face appointment.

Practices review eConsults as they come in and respond to all clinical eConsults by the end of the next working day.

Benefits:

  • Improved access for patients and less pressure on the phones

  • Patients are seen based on clinical need

  • Better resources of practice staff and time

  • Reduced waiting time for next routine appointments

Each of the three models has its benefits. All require planning, training, regular communication with patients and a constant review to ensure the workflow model chosen continues to be effective and achieves its best results.

Once you have chosen the workflow model that works best for your practice, the eConsult Transformation team are there to help you to understand the workflow models, support you throughout the process and are available should you want advice and guidance during your programme of change. Feel free to reach out to us at practice.support@econsult.health.


How to prepare for change

Demand and capacity in general practice have always been the Achilles heel of the NHS with the desire to meet and match patient expectations.

Understanding your current demand!

  • How many appointments do you offer each week?

  • What is the makeup of your appointments? (F2F, telephone, email, online consultations, task, and website forms).

Running clinical searches will readily identify this information, however, don't forget to include tasks (and any other patient interaction that is not included in your appointment screens). In most cases, tasks are work that requires patient contact!

Nationally there are several formulae to help practices understand appointment demand. They include:

  • 72 appointments per 1000 patients = appointments required each week

  • 6% of a practice list size = appointments required each week (for all clinicians involved in triage appointments in practice)

Using the 6% example (Triage only clinicians - GPs NP, Pharmacist etc)

List size

6% Demand Calculation

Actual Appointments In Practice

Variance Demand vs Actual Appointments

5,000

300

330

+30

10,000

600

620

+20

20,000

1,100

1,200

+100

30,000

1,800

2,000

+200

We recommend that you audit your appointment usage for a minimum of 4 to 6 weeks to evaluate your trends and understand your demand against your current capacity.

What is the patient journey?

From the patient's perspective, the eConsult journey is quite straightforward: A patient selects the most relevant condition template and completes an eConsult by answering relevant questions. As a result, they are contacted by the practice with the next steps.

In reality, we know that there is a lot more happening. For example, if a patient has serious symptoms they will be redirected away from eConsult and advised to seek more urgent care. When an eConsult reaches the practice, there is also triaging that needs to happen as part of your workflow.

How do your patients interact with the surgery to make appointments?

Regardless of the workflow model chosen for online consultations, the message is the same: eConsult should not be seen as additional work and should become one of the many ways a patient can make contact.

A digital front door, if promoted correctly, will reduce the number of patients calling the surgery each day. It is important to remember that regardless of the workflow model you choose, not all patients will be able to submit an eConsult.

Your practice will need to consider 3 cohorts of patients:

  1. Those who cannot complete an eConsult - for example, they have no internet, have difficulties with their vision or speech, have learning difficulties or are aged under 6 months old.

  2. Those who have started their eConsult journey but are unable to complete an eConsult for safety reasons.

  3. Everyone else.

Changing your workflow model of care to embrace the world of online consultations ultimately means that the practice has to reduce options for patients to make an appointment.

For example, reducing the number of F2F and telephone appointments available. Otherwise, any eConsult report received will be additional work for the practice team to manage. This is why it is critical to understand your demand and capacity.

Don’t make eConsult extra work.

If you add anything to the end of your normal working day, it becomes additional work. We find that once comfortable with eConsults, GPs can review and close 3 to 4 patient requests in a normal 10-minute slot. Some actions can then be passed to the admin or reception team to respond to the patient.

Finally

Once your patients know about eConsult you will have a steady and predictable number of eConsults each week. Looking at data from 3,000 GP practices we know that the demand across all practices is almost identical. Look at the number of eConsults you have received over the past few weeks and plan your GP sessions and staff resource around this.

Top Tip: If you move users online you will see fewer phone calls and walk-ins.

Contact practice.support@econsult.health for workflow support.


If you have any questions or you feel that this article could be improved, please feel free to give us some feedback by emailing us, pressing the emojis below or using the chat button on the bottom right-hand side of this page to speak to one of the eConsult team.

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