Health Service Focus

Moving beyond email

Coleridge Medical Centre, the largest practice in Devon, has implemented a new communication system that has all but replaced internal email and phone calls. NHE hears more from practice partner and IT lead Dr Alex Long.

Coleridge Medical Centre’s 13 doctors and 60 support staff, concerned that emails and phone calls were too exclusive and often left out people from conversations when their contributions could have been valuable, wanted to do something different.

Partner Dr Alex Long, a ‘self-professed early adopter’ who looks after the centre’s IT infrastructure, said he and colleagues wanted more inclusive communications that involved more support staff in decision-making, instead of letting bossy GPs – or “strong personalities”, as he more tactfully put it – have it all their own way.

They chose a cloud-based secure system called Huddle, which allows quick and easy conversations between all staff. It has proved a huge success, with senior staff far less involved in making every decision than they used to be.

Dr Long told NHE: “Emails and phone calls are fantastic for direct communications between two people, or a small cluster, but emails in my experience rapidly became disjointed – when accessing NHSmail through its web interface, for example, it doesn’t cluster together thread headings, so you can rapidly lose track of what’s going on.

“Phone calls and emails are an exclusive form of communication: we became increasingly concerned that a few people may be talking to each other, but if the person ‘over there’ had a means of being pulled in, or more importantly coming across it by accident, and offering their viewpoint, that may add value and perspective to a conversation or problem that otherwise may not be found.”

He gave a recent example – doctors and district nurses discussing a way to ensure the right people knew when patients had died. In a Huddle forum, a member of the admin staff came up with a solution the medical staff hadn’t thought of. Dr Long said: “We’re busy people, doctors and nurses seeing patients, admin trying to do their admin: having a third way to come together on an ad hoc basis, to dip in and dip out but in a centralised way, seemed the right way forward.

“We’ve tried to agree, with reasonable success, that we’ll abandon email as a means of internal communication.”

Some staff with heavy external email traffi c have found this harder to adjust to. They have been the more “resistant”, Dr Long said, along with those less IT-literate, but most people took to it “like ducks to water”, he told us.

He added: “It’s defi nitely brought added value to face-to-face communication. For example, some admin staff identifi ed a problem trying to collect some metrics from patients. The conversation started on Huddle and then coffee-time came and a few of them expanded that conversation, and then other people logged on and added their thoughts. Over a few hours, they came up with really quite a good solution that had evaded other people. It interlinks and meshes well with offl ine communications.”

The practice paid to implement the system, rather than relying on PCT funding, meaning it was relatively easy for the partners to get it done, after taking advice on information governance. Neither the centre nor Huddle would discuss costs, beyond saying it was a per-user subscription model, but Dr Long did say: “We’ve tried to quantify a fi nancial ROI [return on investment], which I’ve found almost impossible: it’d be easy if we made cars, but we deal in healthcare. As such, the benefi ts that a collaborative platform like this can bring are in the added value of improved collaboration and involving a wider range of stakeholders, sometimes incidentally, in projects or problem-solving.

“Out of that comes better patient care, because we have better solutions to problems and better means of looking after people. That brings benefi ts for patients, and for the practice – if we operate with more financial effi ciency, that’s good news all round.”

Informal reaction among his peers has been positive, he told us: “I’m 37 – the younger generation of GPs think this is great.

“They immediately get it. But – ‘what does it cost, who’s going to pay for it?’ If PCTs/CCGs could get themselves organised, this sort of platform would be a fantastic way for practices to centrally collaborate and talk to other practices.

“There are obvious benefits there, such as in protocol development. Practices have protocols for the management of, say, high blood pressure, based on NICE guidance – but every practice in the country has one of those, individually written by a doctor, and it strikes me as a huge waste of time and effort.

“It would be much better to have networks of practices who could come together, share information, then collaborate to revise protocols when the national guidance changes. “I can see a huge number of applications – especially if you’re a small practice.”

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