West Hertfordshire Teaching Hospitals NHS Trust procured Patient Portal UK (PPUK) with Induction Healthcare in September 2022.
PPUK is a collaborative solution between Induction Healthcare and Oracle Health, offering full integration from the Induction patient portal into Oracle’s EPR/PAS platform, Cerner Millennium.
The portal aims to improve the patient experience by providing access to health information, enhancing communication between patients and healthcare teams, managing appointments, supporting a paperlight environment to drive towards NHS Net Zero targets, and reducing overall operational costs.
More importantly, all information and activities between the healthcare team and their patients can be directly recorded in the EPR/PAS without requiring additional effort from the trust integration or administrative teams.
The operational challenge – Managing resource and supporting patients efficiently
Like many other trusts, West Hertfordshire Trust faced difficulties in effectively managing staff resources and providing support to patients efficiently.
To overcome these challenges, West Hertfordshire identified the need for a portal that could support the following:
Better communication:
Healthcare providers required a solution to better communicate key appointment information with their patients, ensuring that both patients and clinical teams were well-prepared before appointments and that patients could access their own healthcare information digitally in a timely manner.
Embed digital automation into processes:
With functionality such as digital waitlist validation questionnaires; administrative heavy tasks could be delivered at scale.
Support capacity:
The target was to reduce DNAs and burden on admin teams, while improving the utilisation of clinical appointments and capacity.
NHS App:
Delivering a patient portal that connects to the NHS App across all Wayfinder programme phases 1, 2 and 3. Enhancing portal usage and additional ease of access to information for patients.
The technical challenge
West Hertfordshire presented a first of type technical challenge for Induction and Oracle as the trust share an instance of their Oracle Millennium PAS with the another NHS Trust.
With both trusts belonging to different ICS, it was necessary to have two separate patient portals that were, in some cases, also sharing a care record.
The other Trust were long time users of the Induction Patient Portal and utilise the paperless letter workflows, it was essential that the West Hertfordshire solution could be implemented without disrupting the 400,000+ patients already using the service.
The technical solution –
Overcoming challenges
West Hertfordshire collaborated with Induction’s development team to create a custom solution that allowed for the logical separation of data in the EPR/PAS from the two systems.
We made sure that the development included the ability to update Induction Zesty’s HealthStream integration engine to ensure that data flow and messages were handled correctly and directed to the appropriate patient record at the appropriate trust.
The user experience was carefully tested to ensure that these updates to the portal would not negatively impact the patient.
The project was developed to ensure it could be continually utilised and adapted in the future.
The operational solution – Equipping the trust and its patients with the right digital tools
“We offered a standardised approach to our rule settings for appointment visibility and rescheduling across all departments as we wanted to offer a consistent experience to our patients”
When implementing the portal, the trust adopted a platform-wide approach instead of allowing individual services to choose whether to use the portal.
During the initial implementation, the trust made sure that most types of appointments were fully manageable, giving patients the ability to view, reschedule, or cancel their appointments across various specialities.
The integration development allowed for two-way read and write communication capabilities, ensuring information was directly updated in the EPR/PAS systems.
This helps to reduce the workload on administrative teams and provides patients with efficient an immediate responses to their appointment changes.
The portal was also designed to send appointment reminders via SMS, which helps to decrease missed appointments.
“We didn’t realise the capabilities beyond appointments and how quickly the patient portal would scale from the moment we introduced it”
Before the implementation of PPUK, a survey was carried out which asked patients what they would want to see within their patient portal.
Test results for radiology and pathology was a high area of interest for patients.
This feedback was important to West Hertfordshire and soon after the initial roll out, patient portal invites were set up for patients who attend the emergency department or have been an inpatient, to provide patients access to their clinical information (discharge summaries and test results) shortly after leaving the hospital.
After a successful initial rollout, we continued to work with West Hertfordshire to build on the capabilities of the portal, offering:
Access through the NHS App.
As part of the NHSE Wayfinder Programme, we have built integration into the NHS App, offering patients the convenient ability to access and review their secondary care information in conjunction with their community or GP data.
Furthermore, patients are provided with the option to receive notifications through the NHS App, significantly enhancing direct communication between healthcare providers and patients.
“The CRIS integration is so important, often patients are required to have a scan to help with diagnosis, defining a care plan or active monitoring of a condition.
“If a patient does not attend, because they were unable to attend for some reason, this can impact their care pathway and delay their treatment”
Access to radiology appointments by developing Integration into the radiology Cris® PAS system, allowing patients to easily access diagnostic appointments through the patient portal.
This increases visibility and control for patients, reassuring them that they are receiving the appropriate care and ultimately boosting patient satisfaction with NHS services.
Bulk Message’ capability through our Induction Form Builder platform, West Hertfordshire has piloted ‘Waitlist Validation’ with 7,315 patients across several small cohorts of patients within multiple specialities, including; Urology, Cardiology, and Dermatology.
They contacted all patients who had waited more than 12 weeks for an appointment, to see if they still needed their appointment.
This gave the trust the ability to monitor patients and ensure they were waiting well.
By doing so, the trust achieved up to 20 per cent reduction across the multiple waiting lists, helping to reduce unnecessary appointments, did-not attends (DNAs) and minimising call centre waiting times, which has helped to enhance the patient experience and improve the utilisation of clinical resources.
This has now been rolled out across all specialties for all patients that have waited more than 12 weeks for their first appointment to be booked.
“The speed of responses has been incredibly exciting, when we first trialled this, we contacted 2492 patients. Within 30 minutes we have had 314 responses”
Patients & clinicians can now also access Video Consultation appointments through our Induction Attend Anywhere integration into Oracle Healthcare Millennium system.
This enables clinical teams to launch the video consultation directly from the PAS/EPR system, removing the need for them to open and log in to another system, this provides efficiency across workflows, and patients can easily access their video consultation appointment link directly from within the Induction Zesty Patient Portal on their appointment information.
The outcome – Improved care coordination and increased patient access to information
The implementation of a patient portal at WHTH has achieved significant results so far.
These include:
Increased patient engagement and reduced administrative burden:
Over 100,000 patients registered and actively using functionality in the portal within the first year, enabling them digital access to letters and documents and the ability to confirm, cancel, and reschedule their appointments.
This has drastically reduced the number of administrative requests coming into the trust as patients can clearly see the details for the upcoming steps in their care journey on the portal.
Enhanced patient access:
Over half a million patients can now access their health information via the NHS App, enhancing patient experience and satisfaction.
Reduction in paper usage:
The trust transitioned to a paperless system for clinical and administrative correspondence. 65 per cent of patients registered for the portal have opted to receive only digital communications going forward.
Between January and June 2024 an additional 21,000 letters were sent digitally and not printed, equating to a cost saving of c.£14,000.
Decreased DNA (Did Not Attend) Rates: This year so far has seen a reduction by 3,500 in DNAs due to improved appointment management and patient engagement, saving clinical time equivalent to 38 clinics.
This is all part of West Hertfordshire’s goal to be a “digital-first” hospital, where digital communication is the default.
Their patient-first strategy ensures that those who can use digital services have faster and improved access to information about their care.
Importantly, this approach also supports those who use traditional methods of accessing information by freeing up capacity within the hospital admin teams, to support those who need it.
By encouraging as many patients as possible to go digital, the waiting times in non-digital pathways are shortened as fewer people are accessing the traditional channels.
West Hertfordshire’s success highlights the importance of leveraging technology to streamline processes, enhance patient experience, and optimise healthcare delivery.
For more information on Induction Zesty visit: www.Inductionhealthcare.com
