Dem Dx 

NHS problem

Growing staff shortages are forcing our health systems to change. There is a shortfall of approximately 84,000 staff in primary care, resulting in patients struggling to get GP appointments. Some are resorting to attending A&E departments. The NHS is funding 26,000 new allied health professionals (AHPs) within primary care networks by 2023/24; and AHP roles (nurse practitioners, nurse prescribers, physiotherapists) are expanding to see patients in GP clinics, taking on assessment and referral decision-making. These practitioners will require support to deliver high-quality service efficiently and safely.

The solution

Dem Dx is pioneering a world where AHPs in primary care and community services can provide clinically accurate and consistent triaging through the use of a medically certified Clinical Reasoning Platform digital application (CRP). With CRP, nurses, paramedics and other front-line clinicians are able to assess patients, order tests and make referrals before the patient sees a doctor. The platform guides the AHPs from a presenting complaint through associated symptoms to a list of differentials at every step, supported by media, national guidelines and offers tailored clinic-specific actions. Dem Dx helps improve overall clinical care, reduce healthcare delivery costs and use doctors’ time more efficiently and effectively.

Impact

  • In primary and community care, CRP is implemented in The Hall GP practice (10,800 patients/registered), part of the Buckinghamshire ICS (48 member GP serving a 500,000 population) – and in Bury and Rochdale Rapid Response Team (RRRT) (servicing a community of 380,000 patients), a leading urgent care centre specialised in AP-driven intermediary and community care.
    • CRP has been shown to improve clinical assessment in over 60% of cases, more appropriate patient referral in over 15% of cases, and a potential reduction in unnecessary A&E visits (study including 192 patients).
  • In secondary care, Moorfields Eye Hospital NHS Trusts paediatric nurse practitioners are using CRP for all emergency patients (12,000 patients per annum).
    • CRP implementation has resulted in a 15% saving in senior consultant time as nurse practitioners take on more clinical responsibility and ask for more relevant investigations (study including 741 appointments before and 529 appointments after CRP implementation). Patients’ time to treatment has also been reduced by 10% since implementation.
  • CRP is also being implemented in the Mater University Hospital (Ireland, 6,400 patients per year) and Guys and St Thomas’ Urology services (85,000 patients per year).
  • Evaluation of CRP has also demonstrated:
    • Improved adherence to local guidelines in 66% of cases.
    • Increased confidence, reported by 86% of AHPs.
    • CPD support, saving an AHP 60 hours per year