Simon Hudson is a Director and Co-Founder of Kinesis A&G. He recently sat down and spoke about how Kinesis A&G came about, the importance of advice and guidance plus the staggering savings that could be realised in the NHS.
He covers who’s it for, how it can help GPs and CCGs and how it is specifically designed for ease of use and availability.
Kinesis A&G is the Advice and Guidance software which is focused on improving patient outcomes as well as saving the NHS money.
You can see the full transcript below:
Simon Hudson: [00:00:01] Interestingly the history of Kinesis doesn’t start with us. It starts with the East of England SHA and Dr. Shane Gordon who is a GP there and did some work that identified that 63 percent of all patients being sent by the GP quite rightly to outpatient clinics were being seen by other consultants and the consultants declaring that this was an issue which could have been managed by the GPs. If only the GP had the knowledge that they needed to do so. So the SHA approached Microsoft and Microsoft approached us, one of their valued HealthCare Partners to see if we could do something about building an application that would facilitate that interaction that, conversation between GPs and consultants and thereby reduce the quite significant, up to 18 week patient wait times for outpatient appointments.
Simon Hudson: [00:00:49] So we did and we built the application that they said they wanted and it was all using video and voice and many other advanced technologies and then the interesting thing is it turned out that’s not what they needed. What they needed was a different tool that let them do the same approach a consultant for advice and guidance, but do it in a way which was more consistent with their work practices, not quite real time, maybe they could get an answer tomorrow that would be fantastic. So we threw away about 100 thousand pounds worth of initial development and we rebuilt it and the Kinesis you see today is a product of that. Built since 2012 and developed continuously over that period of time. Kinesis today is the most advanced advice and guidance solution around.
Simon Hudson: [00:01:28] To date we have saved over 13000 patients attending hospital appointment because the GP is able to rapidly get advice from consultants when they need it in the timescale and in the process it makes sense for them and it’s been a remarkable success.
Simon Hudson: [00:01:45] A good question is who is Kinesis actually for?
Simon Hudson: [00:01:48] At first glance it appears to be for GP is to get advice from consultants and that is its core purpose. But actually there’s more to it than that. It’s really for patients and consultants and GPs and everybody involved in the clinical chain. Everybody. GPs really like it because it lets them maintain control of their patients instead of deferring to an expert colleague they can get the advice and guidance they need from an expert colleague. Usually their consultant at one of their local hospitals and use that insight in order to continue to manage the patient in their own primary care setting. And that’s good for them. It’s equally good for the patient. The patient doesn’t have to go off to a clinic an appointment, they don’t have to take a day off work, they don’t have to wait 18 weeks of uncertainty.
Simon Hudson: [00:02:35] The consultants of course they like it as well. They get better quality of patients turning up at their clinics. They’re able to contribute more to the patients that do come. They’re able to pass down their expertise to their primary care colleagues, which is very satisfying for them. It’s even good for the health economy. By avoiding unnecessary referrals, that de-loads the secondary care out patient process and ensures that patients get appropriate care much more quickly and that quicker care means get better patient outcomes and actually a reduced risk of a patient attending an A+E appointment, instead of going the full 18 weeks waiting for their appointment. So it’s for everybody.
Simon Hudson: [00:03:14] The other really good thing about Kinesis is that it’s really, really simple system to use. GPs that I’ve trained personally they get the whole thing easy within 15 minutes. If you can use any modern application, whether that’s word or an email system or Facebook or anything like that you can easily use Kinesis – the process is really simple. In fact we’ve got the process down to just four steps.
Simon Hudson: [00:03:36] Find someone they can help using the system, ask them a question about a patient under your care. Act on the advice that you’re given. You usually get that the following day. Decide what you’re going to do about it and then close out the process.
Simon Hudson: [00:03:50] Very, very simple – really easy to understand. Super quick. None of the delays either with waiting for answers or indeed waiting for the system to keep out of the system itself is very quick and rapid and that drives adoption. Everybody really likes it and we’ve got data to prove that.
Simon Hudson: [00:04:05] The other thing of course is that it fits really well with everybody’s working schedules. So most GPs don’t use Kinesis while they’re sitting there with the patient, they are waiting until their wrap up session at the end of the day and then they’ll do a number of Kinesis conferrals. The consultants they’ll get notified as soon as there is any request for advice from them but they choose when they’re going to answer it. If they don’t respond within 24 hours there are a number of things that remind them that they actually get back to the GP is in a very rapid, clinically relevant time period.
Simon Hudson: [00:04:35] Right now not everybody is using advice and guidance. I think that’s a shame. Effective advice and guidance as we, and the NHS, NHS England have stated on many occasions has enormous benefits – it has patient benefits in reducing time to effective treatment. It has benefits for the health system as a whole. It definitely saves the health economy money, by avoiding unnecessary referral fees, by reducing more complicated situations occurring during the wait for an outpatient clinic. And in some cases it helps identify patient action in need of rapid admission rather than the standard admission. So, all sorts of benefits associated with using advice and guidance.
Simon Hudson: [00:05:15] The problem with advice and guidance is making sure you use effective advice and guidance – not just something, not just some ad-hoc solution which may well be set up very professionally with good intent by the cardiology department for instance, but something which is ubiquitous and consistent and let’s all GPs access all specialties on demand. That’s what’s really required and not everybody has that. Those who do though, are seeing some remarkable changes. Right now with our Kinesis clients, we’re seeing around 80 percent of all requests for advice being responded to within one to two working days. For every two requests for advice made, one patient never goes to hospital as a consequence of that particular health incident. So they’re saving better than 50 percent of all referrals where advice and guidance via Kinesis is used. We have about eight clients, CCGs using Kinesis and their experience is very different. So about half of all conferrals (actually slightly better than half). Result in an avoided referral.
Simon Hudson: [00:06:16] Consequence of that is that the average CCG is saving around quarter million pounds a year in avoiding referral fees and that number seems to go up every year and they’re serving about as much again in improved patient health, which means that they’re not having to pay for more expensive treatments or drugs or more GP time so there’s more benefits in the the health outcomes that are improved as well.
Simon Hudson: [00:06:38] GPs really like it as well because they’re getting answers to their advice requests within a clinically meaningful period of time, typically 24 hours. About 80 percent of all questions answered within 48 hours.
Simon Hudson: [00:06:50] To date over 13000 patients have not had to go to an outpatient clinic because of advice and guidance being delivered in this way. So to date we’ve avoided about 13000 patient visits to hospital because of Kinesis. If you do the maths on that because of the cost of a referral which the CCGs pick up, which is around 200 ish pounds per referral. If you avoid those referrals the average cost saving by using Kinesis to date has been over 2.5 million pounds. If you scale that up to all CCGs, that’s an immediate saving of around 36 million pounds per year every year to the NHS.
Simon Hudson: [00:07:27] Actually the savings are bigger than that. Use of advice and guidance is by no means saturated even amongst our active users. There’s lots more individual GPs could do to use more advice and guidance. This is so important to the NHS that they’re introducing CQUIN to encourage this kind of activity.
Simon Hudson: [00:07:44] Obviously we believe in advice and guidance and we’ve got the data to back it up, so we really think you should give us a call, have a chat with me or better still, book it through a website. We can do an online demo and really prove to you that this is great as we think it is. You’ve got nothing to lose and so much for you and your patients to gain.