Evaluating the economics, efficiencies and health inequalities associated with Self-Book technology.
Self-Book by Accurx is a new technology that supports primary care practices to schedule and book appointments online, without the need for phone calls to facilitate the process. The technology aims to address growing pressure within primary care and declining patient satisfaction with access to GPs.
A new evaluation of Self-Book by Accurx, undertaken by Prova Health and Unity Insights, and partially funded by Kent Surrey Sussex Academic Health Science Network (KSS AHSN), has found this technology could deliver benefits of over £0.65M to a single Integrated Care Board (ICB) of a mean size and appointment rate in the next year, equating to £3.2M over five years. These benefits include a reduction in the number of phone calls GP practices handle and a reduced number of patients who do not show up for their appointments.
In the same evaluation, patients and practice staff reported positive experiences of using Self-Book to access and manage primary care appointments. 77% of patients found using Self-Book easier than calling their practice to make an appointment. Practice staff unanimously reported that Self-Book has saved their practice time, improved staff ways of working, helped to fill unused capacity (often at short notice), and improved overall practice efficiency.
One practice employee reported: “It makes you feel like you’ve done a good job and you’ve not got that pressure of ‘there are 10 other people who you haven’t had this same conversation with’, because they’ve already been dealt with and they’ve managed their own appointments.”
As well as exploring potential economic and efficiency aspects of using Self-Book, KSS AHSN funded additional research to understand how Self-Book may impact health inequalities, specifically on age, language and deprivation.
In this analysis, Self-Book was found to reduce call queues for patients that need support on the phone and provided an easier alternative to phoning for non-English speaking patients. Deprivation was found to be a factor affecting engagement with Self-Book but is not a barrier.
Age was seen as a factor that may impact a patient’s ability to use Self-Book. However, by utilising Self-Book with younger patient populations, practice staff reported that they had more time to speak to older patients.
“So I feel like we get to be… more personable with the (older patient populations).”
“Previously, older patients would be waiting in significant phone queues (“40-60 minutes”) and may have given up rather than completing the call.”
Age should not be seen as a strict barrier to engagement, but practices may want to segment patients by age and adopt strategies to overcome potential barriers associated with older patient populations.
Self-Book facilitates access for non-English speaking patients. Language can be a significant barrier to accessing healthcare. This is particularly true for navigating the appointment system via a telephone conversation for non-English speaking patients. However, Self-Book was an intuitive way to book appointments for non-English speaking patients.
“So then you’re not having to just keep offering appointments and dates, and then sometimes they’re getting confused because you’re just spewing information at them in their second language. So, it’s… easier to see it written down.”
Across all booking activity, areas of lower levels of deprivation are more likely to engage with Self-Book. Once immunisation links were removed from booking activity, this trend reversed with a slightly higher booking success rate shown for areas with higher levels of deprivation.
The use of Self-Book may affect the likelihood of success within communities that may otherwise face challenges to access healthcare. Individual and targeted batch messaging appear to be more successful in more deprived areas.
Exploring health inequalities from the outset
‘It’s pleasing to see Accurx seeking to understand the potential impact of their technology on health inequalities. All too often health inequalities are an afterthought, meaning many people miss out on the improvements offered by these solutions.’
‘By understanding health inequalities early on, innovators will be able to collaborate closely with the healthcare system to overcome potential barriers to adoption and ensure that all patients, regardless of background, receive improved access to the care they need. Accurx is a simple but seamless technology that is improving the experience of patients and professionals across England.’
We are now looking to develop case studies to support the effective adoption, sharing knowledge and success across organisations. These will focus on key considerations that have arisen through analysis into potential health inequalities, highlighting the age and deprivation status of the local population as key considerations, but not barriers to the effective use of Self-Book.