NHS Direct and Infermed

NHS Direct is finalising a groundbreaking project to enhance its web and digital health services through the introduction and implementation of a brand new suite of online clinical self assessment tools.

Digital exceeds telephone service usage

The groundbreaking ‘Digital First’ strategy introduced by NHS Direct has achieved another significant milestone where more people are now accessing NHS Direct’s services online than via the telephone. The online Health and Symptom Checkers (HaSCs) went live in June 2010 and were designed for hourly use by 5,000 users, but their success and huge popularity have seen this figure typically exceed 8,000. Since its introduction, the site has seen an expansion from 5 to 40 HaSCs; delivery of the service on mobile device apps, and a broadening of its scope through syndication partners such as NHS Choices and Directgov who also offer the HaSCs through their websites.

Advanced online assessment
The advanced system was developed by InferMed Limited in conjunction with partners Eduserv and Sitecore, and is hosted in the UK by Rackspace® Hosting. The platform allows the delivery of online assessments, and provides greater choice for the patients that make 780,000 visits per month to access the NHS Direct health and symptom checkers online. The service has met an increasingly important demand in a safe and effective way, and has proved to be very popular with patients and the public. At its peak following the launch of the service on mobile device apps there were a remarkable 20,000 users in one hour.

Digital Remote Care
Duane Lawrence, CEO of InferMed Limited, said, “NHS Direct made an historically important decision to lead the way in the adoption of advanced online services to provide an exciting new platform for the delivery of digital remote care.” These new clinical self-assessment tools are a forerunner of the way in which people will interact with the NHS in the future. The new services were initially available via the web and have since transitioned to wider channels.
The key advantage to the NHS through advanced technology combined with a strategic vision for future Healthcare is the way that the InferMed consortium has created a firm foundation for the future.

Roger Donald, Associate Director for Multichannel at NHS Direct commented, “I believe the work of the InferMed consortium is changing the way in which people interact with NHS Direct, by allowing individuals to take more control over their own health, and saving face-to-face health services for those times when they are most needed.

Cost savings
The secure system allows patients to move seamlessly from the web to a telephone helpline if needed, providing far greater choice as to how patients can access clinical help. This in turn frees up the NHS Direct helpline and reduces the incidence of callouts for ambulance and paramedics, or unnecessary visits to GPs and A&E departments, thus creating significant cost savings. In the first year the use of the website health and symptom checkers (HaSCs) resulted in 1.3m fewer visits to other healthcare professionals, including 0.7m visits to GPs, saving the NHS an annual total of £57m, according to Nick Chapman, chief executive of NHS Direct.

Uptime and availability is key
Duane Lawrence highlighted the dynamics behind the project’s success, “A key factor for any online service has to be guaranteed uptime and availability, it is the foundation of this system; every benefit and advancement in online healthcare is negated if the patient cannot get to the service through technical fault or sheer demand.” Duane went on to say, “To this end it was critical to have the right hosting partner, which is why we chose Rackspace Hosting.”

Service expansion and guaranteed uptime
As a result of the growing popularity of the service through various platforms and delivery channels Rackspace responded with adjustments to the hosting infrastructure. To maintain a smooth, reliable service to the public, the Rackspace support team added additional load balancers and increased the system memory to cope with greater demand.

Intensive Solution is the backbone
Duane summarised, “The Rackspace Intensive hosting package is the backbone of our solution delivery. It provides the 24/7/365 network uptime that is essential for such an operation, and guarantees hardware replacement and rapid scaling to meet new demand. To cap it all, the intensive hosting package from Rackspace has proven to be remarkably cost-effective, and I certainly intend to partner with Rackspace in the future to meet the hosting needs of similar solutions in the UK and throughout the world.”

Patient Record Security
Rackspace Security is a fully integrated portfolio of services, managed devices, and best practices – designed to ensure the highest level of security around customer data. This approach is validated through the ISO 27001 certification and SAS 70 Type II audited hosting facilities. For the InferMed solution with NHS Direct, Rackspace has also facilitated a direct link to the secure NHS N3 network, which provides access to all NHS sites and patient records.

Specialists in online healthcare
InferMed specialises in software for healthcare. The name is derived from ‘Inference in Medicine’ and the suites are designed to help clinicians, healthcare payers and patients get access to the optimal treatment, personalised for each individual. The Arezzo workflow and inference rules engine is the basis of the NHS project and allows design and execution of NHS authored clinical guidelines and patient care protocols in real time.

Arezzo’s key differentiator is that the system makes actionable medical guidelines only asking relevant questions for each individual; tracking that individual over time, and providing timely feedback based on their personal data. Today, Arezzo has the ability to make treatment or next step recommendations based on personal histories, allowing patients to consider all their options before visiting a GP or clinician. If asked to do so, the system could send the GP a report of the patient’s activities / interactions with the system, bringing him/her up to date on the details. The trend towards incorporating evidence based actionable medical knowledge into personal clinical heath records will eventually play a key part in revolutionising the quality, safety and effectiveness of clinical care.

New dawn of Online Health services
Duane Lawrence concluded, “We are confident that the work completed by the consortium has enabled a new dawn of online healthcare services that are helping the NHS deliver a broader, more efficient service to a greater number of people at a considerably lower cost. This is a stated Government objective and we are very pleased to be helping to fulfil these aims.”

Further details about InferMed Limited and their medical software solutions can be obtained from the website, www.infermed.com or call +44 (0) 20 7291 7410

Meeting Challenges
If you require the ultimate critical care hosting service where nothing is left to chance, then the choice has to be Rackspace. Please visit our website at any time www.rackspace.co.uk or call us for friendly and FREE hosting advice on 0800 988 0100.

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