Name: DILO02
Job Title: Virtual Receptionist
Organisation: NHS - Medical Records
Health Board: HDUHB
Introduction
In recent years, Video Consultation (VC) appointments have become more readily available for medical appointments. The Covid-19 pandemic saw an increased demand for VC appointments as the stay-at-home order saw a lack of face to face (FTF) appointments available. VC is suitable for nearly all types of medical appointments, including dermatology and gynaecology. VC platforms provide a reduction in the disruption to a patient’s day as they are not required to travel to appointments. In rural areas, this could prevent patients from having to travel up to two hours for a routine appointment.
A Virtual Receptionist (VR) monitors patients who are waiting for their VC in virtual Waiting Areas using the Attend Anywhere (AA) platform. The role of a VR aids with the flow of VC appointments for both patients and clinicians. The VR position is situated in the contact support centre of Prince Phillip hospital in Llanelli. The role was established at the beginning of the Covid-19 pandemic. Responsibilities of the role include keeping track of patients within virtual Waiting Areas and informing patients when clinics are running late or have been cancelled. The Waiting Areas on AA are organised via clinics rather than by clinician, this ensures that the VR can monitor all clinics with greater ease as all patients are situated in the same Waiting Area. The Attend Anywhere dashboard is set up so that the VR can see all the Waiting Areas of the clinics that she is managing. She can clearly see which clinics have patients waiting, how long each patient has been waiting and if any patients are in an appointment with a clinician. At present, there is only one VR within the organisation.
The VR monitors each clinic Waiting Area and interjects once a patient has been waiting 30 minutes after their appointment time. This process is done after the patients’ original appointment time as opposed to the time a patient logs on to the AA platform as patients often log on to the site prior to their appointment time to ensure there are no technical problems. If an appointment has been delayed by 30 minutes, the VR will contact the clinician’s secretary to establish the reason behind the delay, the VR is then able to relay this information back to patients through the AA message function. The VR also has access to the Welsh PAS to contact patients via phone.
Process map of a Virtual Receptionist Role
When the VR is not monitoring and contacting patients, other tasks that are involved with the role include answering calls for the contact centre, helping other staff within the team and completing tasks for the medical records departments which includes folding patients’ appointment letters.
Technology, training and staff capacity
The technology that is used within the VR role daily include a computer/monitor, the Attend Anywhere online platform, the Welsh PAS service and a telephone to contact patients. The role of VR does require a technology savvy individual as there are multiple devices that they need to know how to navigate. Standard training on the AA platform is the only specified training required for the role. Digital difficulties that can be a part of the role of VR include poor digital infrastructure for patients who live in rural areas.
DILO02 expressed that at present, there are enough staff to meet the demand of the service and that another VR is currently not required. On days where there is low demand, DILO02 will assist with tasks associated with the medical records contact centre.
Benefits of the role
The role of the VR provides many benefits to both patients and the service. The role ensures that patients are continuously monitored while in an AA Waiting Area like if they were having a FTF appointment. Furthermore, this role contributes to the reduction in DNA (did not attend) rates, as patients are kept up to date with delays in appointment schedules and helps prevents patients leaving the appointment before the clinician is ready. Furthermore, the efficient set up and organisation of Waiting Areas by the organisation results in easier management of patients. The set up of the VR role within the contact support centre provides efficient communication through the support team. Messages about delays and cancellations are quickly relayed throughout the team who are then able to pass this information on to patients who may call the centre. There are limited risks associated with the role.
Challenges with the role
There are some clinics, such as mental health services, that the VR does not have access to patient information. However, the VR is still able to view the clinic Waiting Areas and establish if patients are waiting over their appointment time. As DILO02 does not have access to the Welsh PAS information for these clinics, they are unable to relay any information regarding delays or cancellations to the patients. They do not have access to their records so are unable to telephone them to re arrange an appointment. This negatively impacts both the organisation and the patients. DILO02 expressed that taking on these extra clinics would not negatively impact the workload. A further challenge is the workload variety. Some days there is limited work to be completed and others the day consists fully of contacting patients and clinicians. This is dependent on the number of clinics running during the day. Additionally, the set-up of the VR role within the hospital does not allow for any working from home opportunities as the role works best within the contact centre to allow efficient flow of information throughout the contact team. Calls for the VR goes through to the contact centre generally, so it is important that the whole team is aware of delays in clinics to be able to correctly advise patients who ring regarding an appointment.
In addition, there is a lack of communication with clinicians themselves. If a clinic is running late, DILO02 must contact the secretaries to establish the reasons, the secretaries then contact the clinician to establish the problem. Direct contact with clinicians was expressed as desirable as the current process inhibits smooth and efficient communication which results in patients waiting for answers longer. Additionally, there tends to be one way communication in which the VR contacts clinician staff if there is a delay, which further delays communication with patients and would be beneficial if the VR was readily informed and updated on late running clinics.
What is needed to improve the service?
Potential improvements to the system identified by DILO02 were limited. A key element that was identified to improve the efficiency of the role for both the VR and the organisation was increasing access to all clinics throughout the health board. Additionally stronger communication with clinicians and their secretaries was seen as highly desirable to improve the service of a VR, including the encouragement of two-way communication between clinician secretaires and the role of VR. This would allow VR to be aware of delays in clinics and relay this information to patients prior to them waiting >30 minutes in the AA Waiting Areas.