How can data fuel future innovation and development?

How did eConsult start?

The idea for eConsult started nearly 10 years ago when a south London GP saw three patients in succession with the same hay fever symptoms requiring the same prescription. After spending time diagnosing all three, they thought: “There has to be a better way.”

It was that mentality that led to the development of a new and innovative web-based algorithm for triage. This idea shortly became a successful business after GPs in Tower Hamlets decided that following an initial trial, they wanted to roll it out across 36 of their practices.

What makes the company different?

What makes us unique is that we now have triage solutions for primary care, accident and emergency and more recently, outpatients, and were the first to market in each area.

In primary care the solution will raise red flags when more serious treatment is necessary, directing patients to 111 or A&E. In A&E we assess clinical acuity from the information patients input into our tablets upon arrival. Our outpatient triage quickly identifies the most at-need cases and removes appointments no longer necessary.

We are medically driven and 20 per cent of our personnel are in fact practising clinicians. eConsult is a health company in a technical space, rather than a technology company in the health space. That makes us clinically robust, enabling those in the field of medicine to make better decisions remotely using our secure and accurate data. As a business, we address the fundamental challenges within the health system, including the ever-rising demand, insufficient clinicians and inadequate resources. While progress is being made, there is unfortunately still a way to go to improve the overall efficiency of triage, which we now estimate inflicts costs of £3.25bn per year. Helping to reduce those costs and improve outcomes is what we’re proud to do.

Where are we now?

We are proud to say that eConsult, our primary care platform, has the highest number of implementations in the UK, in use with 3,300 practices serving 30 million patients. Ten trusts are also currently using eTriage in their A&E departments.

For most patients, GPs can perfectly well conduct consultations remotely via a phone call, electronic prescription or video. We find that 70 per cent of patients don’t actually require face-to-face consultations, but when they do, eConsult ensures that it is with the right person at the right time, freeing up resources and improving the overall efficiency within healthcare.

How will eConsult develop digital triage?

Our strategic vision is to join up all aspects of triage, moving patients seamlessly across different areas. For example, eConsult’s algorithm could detect that back pain may be cancer-related, immediately putting the patient into a two-week appointment. We want to create a massively effective triage ecosystem that will deliver huge benefits not only to the patients who require help, but also provide major system efficiencies for the NHS as well.

Where does the data fit into this?

For us, data is critical. With more than 25 million consultations being made on our platform, we have accumulated a very high volume of valuable, structured data, which is all about the front end of the patient journey. For us, this provides the missing piece of the jigsaw puzzle.

eConsult’s seamless integration with other systems is utterly vital in the healthcare ecosystem, as it means that we can move patients’ data across health information systems without friction. For us to succeed, we need interoperability with patient record systems, however, this bit of work can sometimes take years. This is why our relationship with InterSystems is so important.

As the use of eConsult continues to grow and expand, we now need to integrate our A&E and outpatients’ triage with specific EPR and PAS systems. While we are the experts in clinical triage, we engage with experts in integration like InterSystems as we know they will play a critical role in helping us to become an integrated triage platform. Their extensive expertise means that we can move data between or within Integrated Care Systems and trusts to inform commissioning decisions and in turn, improve patient and clinical outcomes.

What’s next for eConsult?

One of the goals we wish to achieve is to establish a data partnership within the NHS, so we can share the entirety of patient journey data in trusted research environments. As part of this, we are working on building an AI engine that allows ML loops to ensure triage is consistently and constantly improving.

For us, the vision is to work with best-of-breed partners in technology and life sciences that can plug into our platform and help us to offer value within the triage process in both the front end and back-end. With InterSystems expertise in data management, it made them an obvious choice to be one of the first strategic partners in this longer-term plan.

Our ambition is to capture vital signs in triage as well as a patient’s history to get a much more accurate picture. If A&E is provided with the right information in a timely manner, it could septic-screen patients within minutes of arrival, potentially saving thousands of lives through earlier detection. As an extension of this, we are also looking at integrating testing after triage as well, and integrating clinical decision support tools.

Our major aim is to support the development of preventive medicine through the examination of trends. Part of this is through the use of bio-markers, genomics and propensity-to-disease data. Due to our partnership with InterSystems, the potential for data is hugely exciting, and can help to not only fuel research, but also improve the all important patient outcomes as well.