By enabling patients to become active rather than passive passengers along care pathways, we can more efficiently manage care says Jane Tyacke

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Did not attends and cancelled outpatient clinics have always been obstacles to the efficient management of hospital services. With waiting lists now at record levels, the need for booked outpatient appointments to take place successfully has become more important than ever before. The problem, however, is that the NHS’s traditional system of outpatient referral and management is not well equipped to support this outcome. It is not particularly effective at ensuring the right patient is able to attend the right place at the right time and see the right clinician.

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That is because, too often, it serves to make patients passive rather than active participants in their outpatient pathways. This means that the healthcare system operates on the basis that an individual, when sent a letter, will turn up at a specific place at a specific time on a specific date.

Give this some thought and it becomes clear that it is far from patient-centred. It is a system which does not consider whether an individual might have commitments that make it impossible to attend on a certain day, or is only able to receive a lift to the hospital on Tuesdays and Thursdays. Nor does it consider whether an individual would actually still find an appointment helpful, despite the distinct possibility that an individual’s condition will change between a referral and a clinic – particularly when, as at present, waits are long.

Changing this would – along with important measures such as balancing waiting lists and workloads across several organisations in a system – help the NHS more efficiently address the backlog. We need to keep patients updated on their journey through the system. We need to offer easy ways for people to cancel or rebook planned appointments. We need to take into account preferences and needs.

In other words, we need to provide patients with the sort of regular communication and touchpoints that are common in their dealings with commercial enterprises. We need to make healthcare outpatient appointments more like a courier delivery of an online shopping order. Patients need to know an estimated timeline, be updated when a firmer idea of appointment time is in place, and – importantly – have an easy means to alert when the planned arrangements do not suit.

That clearly would constitute a major transformation. Yet the software that could help support it is already well established in other sectors: the customer relationship management system. Introducing this to healthcare would not mean ripping out existing IT setups like patient administration systems or electronic patient records. It would simply involve overlaying these with a CRM.

At Salesforce we are increasingly working with healthcare organisations to introduce this sort of approach. We want to help support a new era of patient engagement in healthcare, helping patients become active partners in referral pathways. That includes supporting safe and effective patient-initiated follow up.

It is a transformation which we believe can help in confronting the backlog. Patients can give us a range of information that will make tackling it somewhat easier – if only they are given a more reliable means to do so.

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Jane Tyacke is director of strategy and business development – healthcare, Salesforce


Communication systems must be updated if patient initiated follow up is to work effectively