How to maintain and improve standards while driving down costs? For patient transport, a new wave of technology is about to provide the answer, says Geoff Welsh of 3tc Software
In recent years the NHS has opened up areas of competition, looking to improve efficiency and drive down costs. NHS clinical commissioning groups (CCGs) now procure patient transport services from private companies that account for some 25% of the total, and which are still free at the point of delivery. The trend to outsource patient transport began some five years ago but has gathered pace more recently as the pressure to cut costs has increased, and a number of ambulance services have now shifted to a new business model that enables them to also compete for private contracts.
Despite NHS cutbacks it would be wrong to assume that this growth in outsourcing is driven by budget ‘at any cost’, as many CCGs are also looking to drive up standards in a very visible area of the NHS – one that can define the patient experience. CCG key performance indicators (KPIs) for their chosen suppliers vary from contract to contract but are typically centred on patient hospital arrival and pickup times (for example within a 30 minute window in 95% of cases). Patient-ready times can be difficult to predict, with clients also having a variety of travel needs, depending on their mobility.
Their geography may also be scattered. Specialist services (for example renal dialysis) may also involve patient travel to a more distant hospital.
Increasingly, suppliers of this logistically complex service have looked to technology to help them balance performance and profit, with the ultimate objective being to optimise both.
Autoscheduling: riding the crest of a new technology wave
Autoscheduling has long been the holy grail of patient transport. It will be the latest and arguably most important addition to a new wave of specialist technology for the sector. Autoscheduling is complex, powerful and can deliver resource savings and significant improvements in performance.
Autoscheduling’s main advantage is that it can automatically maximise available resource on the day while also optimising performance, meeting contract KPIs with just the right level of assets (so no wastage of either staff or vehicles – very economical). It will make possible a situation where a single vehicle might be carrying patients covered by a range of contracts, each with a different set of KPIs – each and all of which will be met thanks to super-smart scheduling and an in-depth, technology-driven knowledge of patient handling and history.
Autoscheduling will enter an arena where technology is already playing a growing role in optimised service delivery, maximising income and driving down costs.
For example booking transport requests through a web portal saves time and resource, speeds up the process and requires fewer office staff. Technology enables a higher volume of call bookings from a single centre, which has the effect of smoothing demand, minimising peaks and troughs and ensuring accurate staffing. A single-centre team can manage calls nationwide with the support of a system that holds in-depth information on and automatically manages multiple contracts from different regions, screening bookings with validation questions and scoring matrices to quickly establish whether the patient is eligible to travel. This ensures that the transport company does not provide any service that they are not contracted to deliver; it also ensures that any additional agreed service attracts a separate charge, payable by the CCG.
Currently ward and clinic clerks notify the transport provider online that a patient is ready for collection; the control room then assigns patients to drivers. Autoscheduling will have the power to fully automate that process by auto-allocating ready patients to vehicles and notifying (say) the relevant ambulance crew by auto-despatching a message to their in-vehicle PDA, or in the case of a volunteer driver their smartphone. And as mobile devices are GPS-enabled, the system will factor location into its decision making. This use of technology could save a significant over conventional, more ‘manual’ processing.
Mobile devices already allow the ongoing collection of KPI performance data that proves contract compliance, when for example an ambulance crew click on their PDA to record arrival time at pick-up. Mobile devices can also be used to notify crews to stand down and await further instruction from control when a booking changes. When a patient booking is cancelled it is automatically removed from the mobile device with no control intervention needed.
Systems that capture information also allow sophisticated analysis. Autoscheduling will increase the power of that facility, but even now technology and enabling smart tools exist that analyse demand (where, when?), patient types (mobility level?), and performance data (were KPIs met?). Authorised CCG users can be given access to the report data, slashing report unit costs.
The power of technology to simultaneously cut costs and improve performance in patient transport is about to increase exponentially, with the advent of autoscheduling. This game-changer will have a permanent and lasting effect on the sector.
Geoff Welsh is Ambulance Products Director at 3tc Software, a patient transport specialist.