In October 2016 BEMS launched a 6-month pilot of a new community care service – Earlier Home Visiting Service (EHVS) – enabled by RIVIAM’s Pathway Hub. This is the second community service BEMS has launched and run using RIVIAM’s secure digital pathway service which supports digital referral management, mobile care and digital discharge.

This post explains what BEMS hopes to achieve with the EVHS, why they are doing it and how RIVIAM helps. We customised RIVIAM for this service, and supported its roll out with BEMS in less than four weeks, connecting with GP systems EMIS and TPP.

GP federation

BEMS is a not-for-profit organisation based in Bath. It brings together a federation of 26 local GP practices enabling them to speak with one voice on NHS initiatives and to be innovative in their approach to running local community care services. These GP practices, like so many others in England, are under pressure to become more efficient whilst finding ways to meet the increasingly complex needs of patients.

What’s the challenge the EVHS addresses?

Patients falling ill who require an urgent home GP visit are usually seen at the end of a morning's clinic. If the visiting GP then decides the patient needs to be seen at the local acute hospital, evidence suggests that by the time the patient presents to the hospital it is more likely that they will need admission. If they were seen earlier in the day it is more likely that they will be discharged on the day. Admitting a patient means one less available bed and fewer resources to care for other patients.

How the EHVS aims to create a new model of care

The EHVS is split into two pilots, one using a specialist paramedic and the other with local GPs. Every morning (from 8.30 am to 12.30 pm) the service can visit eight patients. The paramedic covers the 5 practices in Bath, and the GP responds to patients who need a home visit from the 7 practices in Norton Radstock.

Those patients whom the clinicians think require immediate onward referral to the hospital can arrive there early enough to see a hospital doctor on the same day. They can receive immediate treatment and potentially go home without needing to be admitted to hospital.

Smart and digital

The EHVS highlights how BEMS is thinking smartly and best-utilising resources across its GP practices to offer a better quality service for patients, whilst simultaneously saving costs. Their use of RIVIAM’s Pathway Hub meant they could mobilise the EHVS quickly, knowing RIVIAM can extract referral information directly from EMIS and TPP and that it can be securely shared with clinicians on the move out in cars or in people’s homes.

The clinicians share two mobile tablet devices between them. This is a unique, cost-saving feature of RIVIAM where it’s possible to have more than one user per device.

Using RIVIAM, the clinician receives an alert when there is a referral that needs attention. With the navigator on the mobile device they can easily find their way to the patient’s home. They have access to the referral information and the patient’s recent clinical history. During their visit they can record their notes, refer the patient onwards (to the RUH if necessary) or digitally discharge the patient. The GP practice which has referred the patient receives an update straight to their GP system. This is helpful because it’s Transfer of Care compliant. Overall, it’s a quick, seamless digital process for everyone involved and BEMS can rely on data security at all times.

It’s too early to assess the benefits of EHVS but RIVIAM is providing BEMS with data on activity and outcomes. This will help them assess if they are achieving their KPIs for the new service. Feedback from the clinicians using RIVIAM so far is very positive.

Update Feb 2018: this links to a post which provides an update on the progress of the service.

If you think a digital pathway service could help you deliver new GP-led community care services for your patients, please get in touch.

If you are interested in reading about BEMS use of RIVIAM for their Focused Weekend Working service click here to read our case study.