Case Study for RPA in Berkshire Healthcare NHS Foundation Trust’s Health Visiting Team
Background
An automation was commissioned to establish digital contact with parents associated with the Berkshire Healthcare NHS Foundation Trust’s Health Visiting team at the 3-month and 6-month points post-birth. This contact will occur through email, inviting parents to visit dedicated pages on the BHFT Health Visiting website for each milestone.
The aim is to enable parents to address any concerns about their child earlier and access support from the teams. Intelligent automation is being employed to facilitate this process. Additionally, as part of commissioning the Health Visiting service in Berkshire, there is a new requirement for increased contact with parents at these milestones, utilising digital methods to enhance information provision and improve the patient experience.
What Was The Problem
The challenge of meeting the new commissioning requirements lay in the lack of available options to expand the Health-visiting team's workforce to effectively engage with parents, distribute informational materials, or communicate efficiently. It was essential to find a solution without requiring substantial investment of resources or time, nor compromising the quality of clinical care provided by the service.
This is where the concept of leveraging technology to establish a digital communication platform, coupled with the implementation of Intelligent Automation to disseminate information across the Health-visiting caseload, emerged.
Robot Solution
An email is sent to parents based on Informatics reports provided monthly for 3- and 6-month contacts. A digital form on Rio is updated to accurately report the number of digital contacts sent. Progress notes are updated to reflect digital contacts sent. An exception email is sent to the service if no contact method is achieved or if the process cannot be completed for other reasons.
The system interacts with the current RIO system (Electronic Patient Record), identify failures, notify the service, and attempt to send contact via email. An email is automatically sent to parents based on monthly Informatics reports for the 3- and 6-month contacts. Concurrently, a digital form on RIO is updated to document the number of digital communications transmitted.
Progress notes are then revised to reflect the execution of digital contacts. In cases where contact cannot be established due to various reasons or if the process encounters any obstacles, an exception email is sent to the service. The system seamlessly integrates with the existing RIO system, promptly identifies any failures, notifies the service, and endeavours to initiate contact via email as an alternative measure.
Technology
The Robot was built using the Microsoft Power Platform, this included:
Power Automate
Power Automate Desktop
Dataverse
Keyvault
Azure AVD Virtual machines
The robot operates with unattended licenses, enabling it to initiate and execute tasks autonomously without the need for human intervention. Reports concerning business exceptions are automatically forwarded directly to the respective service team, while notifications regarding system exceptions are routed to the Intelligent Automation team via email.
Microsoft BI reports provide comprehensive access to key activity metrics, including run time, the frequency of runs, tasks accomplished, and exception rates. These insights facilitate a thorough understanding of the robot's performance and allow for informed decision-making regarding optimisation and troubleshooting efforts.
Governance
Covered within its dedicated Data Protection Impact Assessment (DPIA), this process underwent scrutiny in accordance with the ISO:27001 standards and controls when transitioning into the production phase. Following that, collaborative efforts have been initiated with Berkshire Healthcare Information Governance (IG) to formulate comprehensive DPIAs that will encompass multiple automations.
This approach facilitates the inclusion of several automations under the purview of a unified DPIA. Each subsequent automation will require approval from Berkshire Healthcare Information Governance.
Delivery Time
The automation build spanned two sprints: one dedicated to Business Analytics and the other to development. The project complexity arose from the integration with third-party systems devoid of APIs. Additionally, its classification as 'high risk' stemmed from the handling of patient data. From the initial start-up meetings with clinical services, through user testing, to production, the development cycle took approximately 10 weeks.
Benefits
Implementation of digital automation has resulted in significant time savings, estimated to be at least 10 hours per month in Wokingham alone, with similar savings expected in West Berkshire and Bracknell, and even more in Reading. This has been particularly beneficial in areas where there were admin vacancies, alleviating pressure on staff.
In Wokingham, administrative staff have been able to take on additional tasks such as rostering, leading to improved responsiveness and more effective use of clinic appointment slots. The time saved has allowed for the organisation of additional drop-in clinics and breastfeeding support sessions for parents. Feedback from parents regarding the usefulness of the digital platform and resources has been positive, which has been communicated to the Commissioners and Early Years Best Start in Life groups.
Parents-to-be have expressed appreciation for the availability of digital contact options, indicating a positive response to the initiative. In Q2 and Q3 (2023), Robot Elle contacted 3,449 parents to provide access to resources, saving significant time for the admin teams, eliminating the need to individually email or send letters to families, including tasks such as printing, addressing, mailing, and documenting on Rio.
Outcome
The implementation of the project has led to more effective utilisation of staff resources, particularly in addressing vacancies and supporting health visitors. By delegating rostering tasks, time has been freed up for clinical support.
Key Performance Indicators (KPIs) have improved due to better planning, leading to earlier client appointments and reduced rescheduling times within KPI timeframes. Planning improvements have enabled staff to focus on data management, resulting in more consistent record checking and demographic updates, reducing the need for exception emails.
The presence of Robot Elle in records is a source of pride for the team, contributing to a more professional image through digitalisation. The team is actively exploring further opportunities for process improvement and streamlining.
Return On Investment
This automation is releasing upwards of 1.33 WTE within a single admin team. Based on the calculation of 10 minutes per task, 1100 per month, 12 months a year, 1st and 2nd contact 1200, 2200 hours are being released annually.
Lessons Learnt
The importance of fostering collaborative partnerships with service leads in each respective area during the automation planning phase was crucial. This collaborative approach facilitated the early identification and mitigation of potential issues, ensuring that concerns were addressed proactively before the automation was rolled out into production.
Additionally, it ensured that all services could reap the benefits of the solution, fostering a culture of inclusivity and maximising the impact of automation across the organisation. From a development standpoint, a significant lesson learned was the necessity of isolating Power Automate Desktop (PAD) flows when automating processes involving the Rio Patient record.
This isolation helped minimise potential conflicts and streamline the automation workflow, thereby reducing the likelihood of errors and enhancing overall efficiency. Furthermore, it underscored the importance of evenly distributing the workload to optimise performance and maintain system stability.