The Manor Surgery/AccuRx

Developing a successful messaging app

Context

The Manor Surgery, a GP practice in Oxford, had a strategy to improve its business and to include the use of technology to improve care and efficiency.

In February 2017, AccuRx, a start-up company that had developed decision-support software to improve antibiotic prescribing accuracy, was piloting their product in 19 GP practices across Oxfordshire and Haringey.

The software used existing guidelines and integration with primary care electronic medical records to inform decisions. It also allowed clinicians to print a personalised patient advice leaflet or send this to someone using services via SMS message.

In the pilot sites, AccuRx struggled to get adoption with staff because the software did not address an existing ‘pain point’. It also struggled to find clinical commissioning groups willing to invest in this area. However, during this time, some practices were starting to shift appointments for minor ailments from GPs to nurses and pharmacists who were using the software. Clinicians were excited by the ability to send tailored text messages to patients.

Approach

In September 2017, AccuRx stopped working on antibiotic prescribing and spent four months working at the Manor Surgery, understanding the day-to-day job of clinicians, receptionists and administrators, as well as what people using services needed. They worked with the Manor Surgery and other practices to develop and test over 20 different software prototypes to improve people’s experience and to improve efficiency.

Research included the AccuRx team shadowing clinical, reception and admin teams, running extensive analysis on practice data and running workshops on the practice away day. This close relationship allowed innovations to be prototyped and tested rapidly. For example, capacity and skill-mix planning was developed in a spreadsheet, staff training needs were collected in an online form and knowledge management for the reception team was developed in an ‘off-the-shelf’ website. With each prototype, extensive feedback was gathered from user research interviews, innovation huddles, practice meetings and data analysis.

Through the partnership, AccuRx was able to learn what was useful and usable for GPs. Most of these solutions required extensive change management in individual practices. However, one solution, allowing GP practices to compose and send SMS messages to patients, could be deployed quickly. AccuRx focused on honing this solution, so that it could be deployed in minutes anywhere across the country.

Success

One of the solutions that scaled is Chain SMS. This is self-service software in primary care that in just two years has been adopted by GP practices so they can send messages to their patients. Through their partnership with AccuRx, the Manor Surgery was able to retain several tools that have been used to improve the efficiency, experience and outcomes of their care.

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