The health sector, while innovative in many ways, appears to be the only place where the technology revolution has not been wholeheartedly embraced and used to its full potential, despite huge investment in this area. Practice managers can often feel scared and confused about technology, especially where there is limited evidence of patient benefit. The word usually conjures up thoughts of unwanted ‘extra work’ and possible hassle for a practice with additional maintenance costs. Other managers may worry about its potential to replace patient contact and the personal touch. However, technology is more likely to benefit both your practice and staff - and, when used effectively and efficiently, it should complement your practice systems and offer a more simplistic way of working.
The appropriate use of technology can help your practice work more efficiently, increasing the amount of time that your staff have available for other work. Any extra time involved in setting up technology, such as alternative methods for appointment booking, will be balanced out, and your receptionists’ workload will be redistributed so that they can focus on alternative tasks.
Implementing and streamlining technology systems may seem like hard work now, but once clinical commissioning becomes fully established, and the practice workload continues to increase, you may struggle to find the extra time and resources to meet demand without it.
To ensure that you are using the technology systems in your surgery to the best effect, you will need to think about training your staff, ensuring that your systems are fit for purpose, and ensuring that your practice staff promote the technology to patients.
There are a number of easy, simple and free ways in which you can improve how your practice utilises technology, enabling you to streamline your services and free up valuable staff time.
One simple yet crucial tip is to ensure you fully educate your staff to use all your technology, for example online bookings systems and text appointment alerts. You will be surprised how many practices don’t show their staff what the appointment system looks like from the patient perspective, so they are unable to provide help to patients experiencing difficulties. This will only serve to make the process slower, and your staff may spend more time than before attempting to help patients book an appointment. It is essential that staff know how to resolve any problems quickly; otherwise your patients will become disengaged with the technology too.
Although it is essential that you train all staff in your practice to use different technology systems, you may also find it beneficial to have a few technology ‘experts’. You should identify those who are relaxed and proficient using technology, and ensure that they have an excellent knowledge of the systems in place and are able to deal with both clinical and patient queries. And, by selecting a few, this will mean that if one person is unavailable, there will still be somebody to resolve any problems.
Your GPs and nurses will need to be responsible for the constant marketing of your practices technology offering to your patients – whether it be online patient records or alternative booking methods. Without this, any new technology will become a wasted investment. Encourage your staff to recommend technology to their patients during consultations, especially to those who could benefit from booking online appointments – such as diabetics, who have to regularly visit their local surgery for check-ups. One way of doing this could be by asking staff to hand out forms at the end of consultations.
There are a number of important decisions that you will have to make when implementing the appointment system too - for example, if you decide to give patients access to their online record. Making decisions at the start, such as who is able to access technology, will ensure that you save time later by not having to inform every patient about what they can and can’t do. So, think about how you are going to provide your patients with passwords and confirm that they are who they say they are. Decide who you are going to give access to. Should husbands and wives be able to see each other’s details, and should children be able to access the system, or just their parents?
Obviously, one large benefit of using technology is a reduction in human error. Online appointments will ensure that there is no confusion on either side; receptionists don’t misunderstand what time a patient would like an appointment, and patients don’t misunderstand what time their appointment is. Also, allowing patients to order repeat prescriptions online will save time, as receptionists won’t be required to interpret patients’ descriptions of medication. Patients will only be able to select medications that they currently receive, and not have to describe to a member of staff which ‘red pill’ they usually take.
Twitter and Facebook can also be used successfully to engage with patients, but it should always be approached with caution. With social media there is always the chance that you could break confidentiality protocols or you could receive abusive feedback, which will not provide a positive image of your practice.
If you do decide to set up a Twitter account then you will need to ensure that you have the resource and capacity to update it regularly and monitor it carefully, otherwise it won’t be effective and will provide no benefit to the practice.
Over the past couple of years the population has changed and patients of every age are now engaging with technology, making their lives easier by using online services such as internet banking. This is why many practices are making the decision to allow their patients to book appointments online, via text or through the use of apps. However, before you make your final decision, you need to remember that your patients are at the heart of your practice, so it is essential that you consult with the local population and ensure that you are providing a service that they want and will use. Otherwise you may end up wasting both time and money on unnecessary and unused services.
Perhaps most importantly, the appointment system will have to be fit for purpose, because if it doesn’t work, then the technology will create more problems than it solves. For example, you will have to ensure that the right amount of appointments are available for booking, and that two different patients do not book an appointment at the same time; one through the receptionist and one online. Practice managers may worry that the service will crash, but if you have a good system then this shouldn’t be a problem.
There are a range of benefits that can come from implementing online or text booking systems. They can benefit both patients, and staff. Patients booking online are more likely to write down the reason for booking their appointment. This will mean that staff will be able to make more effective use of the short and valuable time in which they get to see their patients, as they will be able to fully prepare beforehand. Furthermore, if the phone is not ringing constantly in reception, staff may feel that they are working more productively and are making better use of their time.
When implementing the service, you will also have to take into consideration ideas from above, such as ensuring your staff are fully trained. Obviously your receptionists will still receive phone calls, but the time that they would usually spend answering the phone will be redistributed and used more effectively.
There are many simple and easy steps that you can take to ensure that your practice’s technology systems work effectively. Don’t waste financial investments by not taking that extra step to ensure that online appointment bookings work smoothly, or social media sites are being updated.
It is likely that two new directed enhanced services (DES) will be introduced for 2013-14, funded from the demise of the organisational domain, so practices will need to engage to maintain their income. The first DES will focus on virtual access and will run for two years. In year one, practices will need to offer services such as online booking and requests for repeat prescriptions. The second year will expect patients to be able to access their records online, which a number of practices already offer.
The second DES will encourage the use of remote monitoring of patients with chronic conditions to reduce unnecessary attendances at the practice. The extended use of ‘middle-ware’ to manage the electronic transfer of patient correspondence between hospitals and practices, and the potential for shared primary care services through hosted clinical systems, will ensure that the ability of practice managers to keep their heads in the virtual sand will rapidly erode. The movement of IT support, in the majority of cases, to commissioning support units (CSUs) on behalf of clinical commissioning groups (CCGs) should provide a more responsive customer focus to maintain practice IT systems, and it will be vital to understand what your local arrangements are.
The virtual genie is out of the bottle and practice managers need to realise the benefits that technology can bring to their practice and fully embrace them before it’s too late. l
Caroline Kerby is the managing partner of a practice in North West London. She is the joint lead of the NHS Alliance Practice Managers’ Network and is its London representative. She is also a member of the Management in Practice editorial board.