What is e-RS and why was it introduced?
The electronic referral system (e-RS) replaced the NHS Choose and Book service and was introduced with the aim of making all referrals electronic by 2018.
Among its objectives were to provide:
- a safe, secure and reliable system supporting patients
- an easy and reliable way of identifying appropriate services
- clinically appropriate referrals
- a more efficient referral process, including reducing the administrative burden
How effective has e-RS been?
Whilst e-RS has been an effective tool in enabling clinicians to connect patients with hospital services, there have been limitations with the system that have resulted in some of the objectives not being achieved.
One of the biggest issues according to some hospital and GPs leaders is that of interoperability with the system not able to “seamlessly connect” with other primary care systems such as TPP’s Systm One or Emis. As a consequence of this, clinicians are not able to use the system properly which impacts on its effectiveness.
As significant is the ability to identify appropriate service. Clinicians are currently required to refer to local and national pathway guidance, a complex process which involves clinicians needing to complete multiple forms. With GPs having limited time to navigate the different pathways, there is mixed compliance with the guidelines leading to problems identifying the appropriate clinics on e-RS. Hospital data indicates that inconsistent compliance with guidelines results in over 35% of patients discharged after first patient appointment with 46% of e-RS referrals rearranged and rebooked into correct clinics.
The current referral process also relies on a number of manual processes which are not well integrated. This includes requiring clinicians to complete a referral letter (often duplicating information) before manually completing the required fields within eRS, adding unnecessary administrative work for GPs.
What is Rego Care Navigator and why was it developed?
Rego Care Navigator is an AI platform that helps clinicians to identify the most appropriate care for their patients by operationalising pathways, making it easy for clinicians to determine the best option according to these guidelines. Its connection to all providers presents clinicians with a number of care service options.
The platform was initially developed in response to challenges faced by dentists in the referral process where there were a number of complex routes to send patients down and where hospital was often chosen as the default option when a local provider may have been a better choice. Its importance has since been recognised as being able to reduce referrals to secondary care and it has been continually developed to ensure its effectiveness in medicine. Indeed it is seen as a powerful solution in helping reach the NHS target of reducing outpatient appointments by 50%.
Among the platform enhancements there are numerous functions, such as automatons and pre-populated information, to help GPs save time in the referral process and reduce the amount of administrative work.
How does Rego Care Navigator support e-RS?
Before being implemented in medicine, Rego Care Navigator was adapted so that it could be integrated with e-RS acting as a wrap around to the existing system. As such, it can be considered as complimenting e-RS rather than replacing it, providing significant enhancing functions.
For example, Rego Care Navigator automatically validates a referral against local and national guidelines. Within seconds, the booking screen of e-RS is displayed with all relevant information such as the appropriate specialty and clinic type allowing the patient to view and select a list of providers from the directory of services.
How the Rego platform is now a powerful A&G service?
At the onset of the pandemic, hospitals struggled to cope with the unprecedented demand for their services, and several CCGs and Trusts requested Vantage Health’s support to ensure that patients continued to receive appropriate care.
Using e-RS to access advice from consultants had proven too difficult for GPs to use given the guidance forms that needed to be completed and the time it took to identify the correct consultant, which resulted in significant delays between the GP’s request and the referral being submitted.
To resolve these issues, Vantage Health worked with GPs, hospital consultants and managers to provide a platform that allowed patient information to be sent from a GP, directly to a hospital consultant, with no paper or manual intervention; and to allow for the consultant to offer advice and guidance directly to the GP.
Rego A&G has been effective in reducing outpatient attendance, enabling 70% of patients to receive treated in their homes or at their local surgeries, and the incorporation of AI into the service allows referrals to be automatically validated against local pathways, making it easy for GPs to refer requests to the right consultant and for the consultant to respond to the correct clinic or GP. For further information on Rego Care Navigator and Rego A&G and how it can be integrated with e-RS, please contact us.