Moving the clinical conversation
Helping GPs reduce referrals
Kinesis has the potential to significantly reduce inappropriate outpatient referrals into secondary care.
Kinesis main screen - find and contact Consultants
On average, outpatient referrals across the country have risen by as much as 13% during 2008/091, with many referrals made because the GP merely wishes to seek advice. Anecdotal evidence also suggests that up to 65% of patients attending outpatient specialty clinics are discharged with no significant pathology being detected.
Use of Kinesis by GPs as a tool for seeking timely advice and input from specialists to allow the patient to be treated in primary care rather than by referral could considerably reduce the number of referrals for a proportion of patients.
Anticipated Benefits
There are significant benefits for GPs, patients, PCTs, Acute Trusts and the SHA as a whole which include:
- The ability for GP’s to access expert advice when they and their patients need it;
- A reduction in the number of unnecessary referrals into secondary care;
- Improving the patients’ experience, the right advice, the first time and in the right place – providing planned care closer to home;
- Better patient outcomes and improved observation and management of chronic diseases in primary care;
- Quicker treatment pathways for patients, treatment can commence in primary care weeks before an outpatient appointment would have been available;
- More appropriate use of specialist time and reduced interruptions to inpatient work from unscheduled calls and unnecessary referrals
- Improved quality of referral into secondary care where appropriate;
- Improved management of long-term conditions within Primary Care.
Use of Kinesis is assocaiated with substantial cost savings. One NHS region generated over 1.8 million GP referrals during 2008/09, resulting in over 1.5 million new patient attendances. This represents approximately 4,178 referrals per day. Referrals into just 6 of those specialties: trauma & orthopaedics; cardiology, nephrology, gastroenterology, rheumatology and neurology represents approximately 20% of total referrals into all specialties and generated over 331,000 new attendances.
The cost of each of these referrals ranged from £135 – £385 per appointment. Reducing referrals by 20% across these 6 specialties alone could save the region over £10 million per year. Even based on a 5% reduction in referrals this still represents a significant cost saving of over £2.5million in the first year.
Other uses of Kinesis
- Mental Health – Shortage of mental health specialists was an issue everywhere. Having psychiatrists and psychologists available for instant advice was a very popular request.
- Community Nurses / HCPs – The system was seen as ideal if working in a community setting and to help decide whether to admit a patient to hospital.
- Referral management centres – Giving triage doctors direct contact with consultants
- Organisation Directory – providing a one stop shop for contact numbers for local Trusts practice secretaries, PAs, etc.
- Education system – Enabling communications between GPs and GP Trainees
- Locums, Out-of-hours and Walk-in centres – as GPs are often working with limited local knowledge and do not know their patients well.
- Patient engagement – for patients to contact nurse specialists and other health professionals
Kinesis technology
Kinesis is a simple to use application running entirely in a browser and hosted on an N3 cloud service: no need to install new software on PCs or servers. Kinesis provides:
- Powerful people search, filtered by specialty, trust etc.
- User profiles, Presence
- Instant Messaging, email and voice based conferrals
- SMS messaging for users who are away from their desk
- Desktop Snapshotting for review of clinical data
- Buddy list, Star Ratings
- Conferral feedback to assess outcomes
- Secure message store for users without NHS Mail accounts
The Kinesis application is extremely easy to use and generally requires no training. From the responsive browser interface GPs can identify a suitable consultant or other colleague, see whether they are online and available for an immediate conferral or send a message (via the secure message store or traditional email). SMS alerts advise users who are away from their PC that there is a conferral waiting for attention.
There is no requirement to install anything on the client desktop, (an ActiveX component needs to be installed for the Snapshot feature, but this is an automatic download).
The entire system is secure, using NHS standards compliant SSL and running exclusively on the NHS N3 network
Read the Kinesis Factsheet
Please contact us if you require further information.
1 HES online: www.HES.nhs.uk
