Engage Consult set-up guide for Total Triage€¦ · A guide to setting up Engage Consult to support Total Triage Engage Consult set-up guide for Total Triage. Total Triage-ready

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A guide to setting up Engage Consult to support Total Triage

Engage Consult set-up guide for Total Triage

engagehealth.ukTotal Triage-ready Engage Consult

Since the advent of the lock-down in response to Covid-19, practices have necessarily had to adopt a triage-first approach to all demand for medical help with a view to offering face to face consultations ONLY when all other options have been exhausted.

In the past, despite the best intentions of General Practice, patients have had to compete for face-to-face appointments or call-backs. This has always tended to favour the best organised and the most insistent, rather than those in most need. Many practices have, over recent years, adopted a degree of triage and found it extremely effective. However, for many, the moved to Total Triage – all demand managed in this way - has felt like a step too far.

Lockdown has changed all this. It has made the 8am rush largely a thing of the past. Practices have been learning quickly how best to manage ALL demand based on need rather than simply allow available appointment slots to be filled on a first-come, first-served basis. In the past, practices operating Total Triage have reported routinely managing up to 2/3 of demand remotely. During Lockdown many have found that between 70% and 90% of all medical demand may be managed remotely –by online message, by phone or by video call.

Introduction

page 2


How can Engage Consult help?

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This presentation explains how you can set-up Engage Consult to support Total Triage by providing a single platform to manage all your demand – both the digital and telephony channels - ensuring equity of access for all. For more in-depth support on the implementation of Total Triage please see: Making Engage Consult Total Triage Work for You & Engage Consult Online Consultations Checklist

Engage Consult provides:

• A single platform to manage all your demand (clinical and admin) irrespective ofwhere the demand comes from – the digital or the telephony channel – ensuringequity of access for all.

• A single practice application that lets you send digital responses to patients andlaunch video consultations – both as video NOW consultations or for pre-bookedvideo appointments

• Simple, intuitive workflow allowing requests to be moved to the RIGHT person (orgroup) FIRST time

• Easy integration with your principal clinical system allowing patient matching,adding information to the patient record and opening of the patient record –ALL at the click of a button


Setting up Engage Consult for Total Triage


What’s the plan of action?

page 5

1. Change the banner link for the Engage Consult service on your homepage (and elsewhere) so that it opens up the SIGN-UP or LOG-IN screen. This way, a patient can only access the PORTAL VIEW as an Account Holder.

2. Configure your customisable Ideas, Concerns and Expectation (ICE) questions to reflect your Total Triage access environment

3. Provide contact options that will allow people to indicate the nature of their query at the outset in a way that aligns to your Total Triage capabilities

4. Configure your “same day response window” to ensure equity of access for both the digital and telephony channels

5. Decide on and indicate your Total Triage response policy

6. Create workflow Groups in EnCompass LT to mirror how you intend to manage your daily demand

7. Set-up “Proxy accounts” for staff to use to manage telephone demand

8. Manage Total Triage demand (telephone and online) in EnCompass LT workflow

9. Manage telephone episodes in EnCompass LT workflow


1. Changing your banner link


Your existing Engage Consult service link

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On your website you will have a banner with an embedded hyperlink that points to you Engage Consult patient portal. The link you most likely have

used looks like this: https://wsp.psf-live.co.uk/YOURSITECODE/#/portal

You can find this link in your control panel (https://my.wiggly-amps.com)

• Add in your ODS code and password

• Choose the Engage Connect menu option, “Links” sub-option (either from

the main screen or the menu bar)

• The link you are most likely using at present as the service hyperlink is

the SECOND blue link down ending in the word “portal”. You can see

what your site code is here.

• THE LINK TO USE NOW is the FIRST blue link:

Patient Login:

https://wsp.psf-live.co.uk/YOURSITECODE/#/welcome

https://wsp.psf-live.co.uk/81351/#/portal

https://my.wiggly-amps.com


After the banner link change, it will point to this page:

page 8


Only after the user has logged in or signed up can they access the patient portal view:

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2. Setting Ideas, Concerns and Expectations questions in the Control Panel -> Engage Consult -> settings


Setting your Total Triage ICE questions

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You can find this link in your control panel (https://my.wiggly-amps.com)

• Add in your ODS code and

password

• Choose the Engage Consult

settings option (either from the

main screen or the menu bar)

• Scroll down to ICE and/or Custom Questions

• Select New Problem

• Select “After selecting complaint”

• ALWAYS SAVE YOUR CHANGES



Setting your Total Triage ICE questions

page 12

• Overwrite /add to existing questions for New Problem, click Save Changes

• See slide 16 for examples

• Repeat for both “Existing Condition” (see slide 17 for examples) & “Get back in touch” (see slide 18 for examples)


Example ICE and/or custom questions for Total Triage - new problem

page 13

It’s important that these questions should be as succinct and as clear as possible as they will need to be read out over the phone to non-digital users as well as read on screen by digital users. Naturally, the statements about the questionnaires will not be read out to phone users - these users will ONLY be answering these free-text questions

• Your standard statement/advice about what a patient should do if they are concerned they have Coronavirus

• Can you give a brief description of your problem - what’s concerning you the most? Just an overview, there is a questionnaire to follow.

• Have you got any issues with your medication? Have you changed your medication recently?

• Do you have in mind anything you’d like from us specifically today?


Example ICE and/or custom questions for Total Triage - existing condition

page 14


• Whats is concerning or worrying you about your problem today? Just an overview, you will get the chance to give us all the detail you feel is necessary in the following questionnaire.




Example ICE and/or custom questions for Total Triage - get back in touch

page 15


• How have you been since your last consultation? Just an overview, you will get the chance to give us all the detail you feel is necessary in the following questionnaire.




3. Setting contact response options in Control Panel -> Engage Consult -> settings


Setting your Contact Response Options

page 17

You can find this link in your control panel (https://my.wiggly-amps.com)• Add in your ODS code and password• Choose the Engage Consult settings option (either from the main screen

or the menu bar)

• Scroll down to Available Staff



Examples of useful contact options

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• Doctor - for an adult

• Doctor - for a child

• Doctor - for frail elderly

• Practice Nurse

Other options could be:

• Contraception Service

• Practice Physio

• Social Prescriber

• Practice Councillor

• Smoking Cessation Service

• Practice Pharmacist

ALWAYS REMEMBER TO SAVE YOUR ADDITIONS OR CHANGES


4. Deciding on and setting your Total Triage same day response window: Control Panel -> Engage Consult -> settings


Your Total Triage “same-day” response window

page 20

1. Total Triage using both digital and telephony channels requires equity of access. There is usually a cut-off point in the day after which, if the Practice receives a telephone request for help, the response will be that someone will be in contact on the next usual working day. Of course, there will always be requests that are very concerning, even potential emergencies, where this response will be overridden.

2. Whatever this “window” of time is going to be for trying to offer a same-day response, it’s important that it is the same for requests received online and by telephone.

3. Engage Consult allows the Practice to configure a “same-day” response window for online users. Please bear in mind, though, that your messaging should indicate that you will make every reasonable effort to respond on the day, for requests received within that window of time. You are NOT making an absolute commitment.

4. The 2-way messaging channel in any event will allow you to update the patient if a medical response is not available that day, either because demand has been particularly high or capacity has been otherwise affected, or because the request has been triaged as non-urgent. Research has shown that this simple action increases patient satisfaction considerably.


Example of an effective “same-day” response window

page 21

Always

remember

to Save

Changes


5. Deciding on and setting your Total Triage response policy: Control Panel -> Engage Consult -> Settings-> Messages to Users


Examples of effective Total Triage Messaging: on screen message

page 23

Email message sent to Engage Consult users WITHIN Engage Consult request hours:

Thank you for using Engage Consult to request help from the practice today.

Within working hours we usually respond within two hours to both online and phone requests. Sometimes demand may mean this takes longer, so please don’t call us before three hours have passed, unless you are getting worse.

You can keep up to date with the latest information about Coronavirus here:

https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response



Examples of effective Total Triage Messaging: on screen message

page 24

Message for users when submitting the Engage Consult request OUTSIDE Engage Consult request hours:


You have requested help outside of our same day response hours and we will respond on our next usual working day.

If you are feeling worse or are at all concerned about your condition, please contact NHS 111 (111.nhs.uk).

In an emergency, call 999.

You can keep up to date with the latest information about Coronavirus here:




Examples of effective Total Triage Messaging: emails

page 25

Email message sent to Engage Consult users WITHIN Engage Consult request hours:


Within working hours we usually respond within two hours to both online and phone requests. Sometimes demand may mean this takes longer, so please don’t call us before three hours have passed, unless you are getting worse.

You can keep up to date with the latest information about Coronavirus here: https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response



Examples of effective Total Triage Messaging: emails

page 26

Email message sent to Engage Consult users OUTSIDE Engage Consult request hours (usually for Admin):

Thank you for using Engage Consult to request admin help from the practice today.

You’ve sent a request outside of our same day response window for online and phone requests and therefore we won’t look at this, or respond to it, until our next working day.

If you are worried you may have Coronavirus, or may have been in contact with someone who has Coronavirus do not come to the surgery. Continue to use our online services or the NHS111 online service (111.nhs.uk), or call 111.


Email message sent to Engage Consult users OUTSIDE Engage Consult request hours but overridden:

Thank you for using Engage Consult to request medical help from the practice today.

You’ve sent a request outside of our same day response window for online and phone requests and therefore we won’t look at this, or respond to it, until our next working day.

If you are worried you may have Coronavirus, or may have been in contact with someone who has Coronavirus do not come to the surgery. Continue to use our online services or the NHS111 online service (111.nhs.uk), or call 111.


engagehealth.ukTotal Triage-ready Engage Consultpage 27

Always

remember

to Save

Changes

after

writing

your

messages


6. Configuring Total Triage Groups in: Control Panel -> EnCompass LT -> settings


EnCompass LT->Groups

page 29

• Go to:https://my.wiggly-amps.com

• Add in your ODS code and password

• Choose the EnCompass LT -> Groups menu option (either from the main screen or the menu bar)



Naming Groups for Total Triage

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• “GROUPS” are essentially in-boxes for messages which individuals or teams within the practice have access to

• You may choose to name groups to indicate levels of urgency once an episode has been triaged

• You may also wish to name groups based on who a medical enquiry is for - e.g. paediatric, frail elderly

• A combination of both will assist effective Total Triage

• Simply enter the name of the group and click “Create”

• Other groups will reflect team functions

• Using “!” before the name will give the group priority when viewed in the Practice application, EnCompass LT



7. Setting-up “Proxy accounts” for staff to use to manage telephone demand


Setting-up “Proxy accounts” for staff to use to manage telephone demand.

page 33

• Each staff member who takes phone calls can create an Engage Consult user account which can be used to take request for help over the phone; effectively your staff member will act as a proxy for the person ringing in with a request for help

• The accounts can be registered as “Telephone Triage 1”, “Telephone Triage 2,” etc. Each staff member can use the same email set-up for this purpose, to allow them to complete a request (e.g. [email protected]). Each staff member can use the SAME password they use for their EnCompass LT account they use to see and action messages, so there are no more passwords to be remembered. Each staff member taking telephone calls can then log in to this user account the beginning of the day to take in telephone requests for help. adding each new caller as a patient on their poxy account.

• The proxy function allows for up to 250 patient accounts to be associated with it. Patient accounts can be deleted at any time - as the patient has NOT created an account, secure online 2-way will not be used and the information provided at each request episode will remain visible in LT and in the patient record.

mailto:[email protected]


Creating an email to be used with a Proxy account

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A simple gmail account for exmple can be created to be used for all proxy accounts that will be used for taking requests for help over the telephone. NB do not use an nhs.net email address - these can not be used currently for user accounts of any type in Engage Consult, e.g.:

[email protected]

All staff taking requests for help over the phone can then use this simple email when they send in a proxy request.

The email is only used in this instance to send information about response times for request, which staff will relay over the phone


Accessing the link to set-up a Proxy account

page 35

Your Staff need to save this link to their browser favourites or as shortcut by the desktop - the link behind Consult Online NOW option

https://wsp.psf-live.co.uk/YOURSITECODE/#/welcome

To create the Proxy account, click on Sign Up

https://wsp.psf-live.co.uk/81351/#/portal


Setting up the Proxy account

page 36

Create a name that will be clear in the practice workflow that the request has

been taken over the phone - make sure there each such user name is

assigned to 1 person ONLY and you have a log of this, kept up to date.



page 37



page 38



page 39

3 pieces of memorable

information are

required - needed in

case account details

are changed at a later

date. Each person

setting up a telephone

triage proxy account

will need to do these

for themselves. Once

this is done, the

account is good to go.


Taking telephone requests for help with Proxy Account

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Choose “Add Someone Else” for each patient


Get the key demographic info - and ask other questions

required by your IG policy to establish their identity

page 41


Choose “Carer”

page 42

Choose “Carer”


Choose the patient whose details you have just taken from the list

page 43


Choose “Consult Online NOW”

page 44


Complete the disclaimers -these need to read these out to patient

page 45


Completing the GDPR screen

page 46

Its OK for staff members to tick

the first option - this does not

imply that the patient has. The

staff member can read out the

other 2 options - having these

ticked is NOT mandatory to

continue.


Get the patient’s telephone number

page 47

Take the patient’s phone number


Now complete the request

page 48

NB for a medical request, DO NOT try and complete a questionnaire - just ask

the “Ideas, Concerns and Expectations” questions


Using the Engage Consult Total Triage telephony page - admin queries

page 49

• Ask them first if this is a medical problem or an admin query

• If admin, choose that option on screen, choose help from anyone

• Ask them what the issue is; choose the most appropriate option displayed and complete a free text entry, click continue when completed, read back what you have written to be sure that they agree that you have captured their request accurately, then click send

• You could ask the patient if they would like to set-up an account at this point, but they will need access to an internet enabled device - and their email account - to complete the process. They can use their email address as their username and will need to set up a password and create answers to security questions. You can explain the benefits at this point of being able to receive replies in future online rather than worrying about missing a call, and also login quicky, rather than having to wait in a queue on the phone.

• Tell the patient when they might expect a reply - always be sure that it is caveated by “We will do our best to respond by…”


Using the Engage Consult Total Triage telephony page - medical problems

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• Ask them first if this is a medical problem or an admin query

• If medical, choose that option on screen, and then read out your Total Triage “like help from” options and ask them to choose the most appropriate

• Ask them if they need to specify times when they will be able to receive a call back; choose and complete that option if they do

• Ask them if this is a new problem, a problem with an existing condition, or if the doctor has asked them to get back in touch. choose the option

• Ask them to state the problem briefly - tell them you’ll ask a few more questions in a moment, but for now just give a summary. They are likely to be conversational rather than succinct, so at the first sensible opportunity say “shall we say it’s about a (e.g.) sore throat?”

• Read out any alerts displayed and ask the patient if they understand and are happy to continue


Using the Engage Consult Total Triage telephony page - medical problems

page 51

• Provide any signposting information appropriate to the condition at this point, if that is your practice policy, if not, then continue with your Total Triage ideas concerns and expectations questions - read out to the patient and record their replies.

• Having completed these, DO NOT attempt to complete a questionnaire. Simply choose the “send my request as it is” option

• As before with admin queries you can at this point then ask the patient if they would like to set up an account

• When the episode has been completed, the Patient Portal view will be displayed. Click on the “Practice use only” link if you have that in the Patient Portal view to return to demographics screen for the next call, or if not, go to your bookmark or desktop shortcut.


If the user chooses a medical problem and the problem entered triggers an alert, the staff member will need to read this out to the user before continuing

page 52


Ask the user to respond to the ICE questions, leaving out references to the full questionnaire (they won’t be asked these questions!)

page 53


Simply choose “No send my request as it is”

page 54


Read back the report and ask if they want to add or change anything

Click “Accept and Continue”

page 55


UNTICK Secure online message option - this patient will need a call back

Click “Send”


Choose “not this time” for the survey and return to your account screen, ready for next patient


A staff telephone triage Proxy account can take up to 250 patients, however you can DELETE a patient at any time. Simply choose the patient you wish to delete….


Select the BOTTOM option “Patient Info”


And choose “Delete Patient”….and select “Yes”


Staff will return to the screen ready to add next patient calling in


8. Managing all Total Triage demand in EnCompass LT workflow


Using “!” before the Group name brings that group to the top of the list -prioritise the inbox and the top priority triage groups


If your role is to triage demand

Remember to “Click to cover” the !INCOMING MESSAGES box so that you can look at and assign messages to the correct group based on your assessment of the urgency of response required. Choose the Groups and/or Colleagues menu options in EnCompass LT to “Click to cover”.

In a Total Triage environment it often will make sense to ensure that a clinician - a GP or experienced nurse has the role of triaging incoming demand.Clinicians can also opt to “Take” messages directly from any Triage Group.


9. Managing telephone demand in EnCompass LT workflow


A completed telephone request is identified in EnCompass LT as coming from: Carer: Telephone Triage 1 .


When verifying patient identity, by definition, the first option should be chosen - of course the patient called IN, but otherwise, a conversation took place during which the staff member would have assured themselves of the patients identity.


NOTE that there is no “Send message to patient” option - this person will needed to be called back


After the patient has been matched and verified, the request episode can then be triaged to the most appropriate Group for a response - in this case, the Practice Nurse Group


Practice Nurse can see straight away that this is a Telephone Triage episode and they will need to call the patient back...


When placing in the record, the clinician (or administrator) will need to identify this as a Telephone Triage episode, and can also place a note they have added to the episode in the Detail field


Shows clearly in Consultations that this is a total triage episode

Will similarly show up in the SystmOne Journal and

the Vision Consultation Manager


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Engage Consult set-up guide for Total Triage€¦ · A guide to setting up Engage Consult to support Total Triage Engage Consult set-up guide for Total Triage. Total Triage-ready