From GP practices to acute care, hospitals, diagnostics, and imaging, the UK healthcare system is complex for patients and professionals alike. Patient journeys are touched by a vast number of people, all with their own expertise and unique roles to play along the way. In many cases, journeys go beyond the boundaries of the NHS, moving into private healthcare or complementary services like social care.
As a result, there is significant pressure to maintain effective collaboration, eliminate bottlenecks, and streamline administrative processes wherever possible. Day-to-day, healthcare providers encounter three major challenges around the flow of information and, ultimately, the flow of patients from first contact to diagnosis, treatment, and recovery.
Integrated, effective technology has the ability to help overcome these challenges – and AI-powered, highly accurate speech recognition specifically provides a single holistic solution that results in improvements across the board.
#1 The unexpected is to be expected
The nature of healthcare is that things change fast. Few of us would have predicted a devastating pandemic at the end of 2019. Recent leaps forward in AI with the likes of ChatGPT have the potential to redefine how people, including medical professionals, interact with the world around them. The NHS is also undergoing its own transformation, from a strong digital roadmap to evolving models of care like Hospital at Home.
Meanwhile, Virtual Clinics are emerging as a significant way to reduce the Delayed Transfer of Care (DTOC). The NHS has begun to introduce virtual wards, allowing more people to get the care they need, in a home environment, not in hospital, which also helps to alleviate pressure. This now creates significant change in how care is delivered and how teams work with patient data.
The need for adaptability is significant. Taking radiology as an example, a study from February 2023 describes an urgent need to make radiology ‘antifragile’ – to increase resilience and adaptability, so we can thrive in an uncertain world. Some key considerations are building capacity, enabling new ways to collaborate, and prioritising information quickly and effectively.
Integrated speech recognition technology, like Augnito, helps with this challenge by empowering radiologists with more flexibility in the way they work – from transcribing reports on the go, to directly capturing information in clinical systems using speech. Speech also helps connect increasingly complex workflows across the patient journey, whether that’s in a clinical back-end, or, surfaced to other teams in different areas of the organisation. Beyond saving time for an individual healthcare professional, speech recognition transforms the availability and accuracy of clinical information. At the same time, the ability to capture information faster enables a greater degree of analysis, spotlighting the most critical information to anyone across the continuum of care.
#2 Incomplete information impairs decisions
If it wasn’t documented, it didn’t happen. That’s the reality of taking patients through journeys that are complex, often non-linear, and involve the work of multiple individuals, Trusts, private providers, and care partners. In this fast moving environment, information capture and sharing is pivotal.
- If it was just a thought, it wasn’t documented
- If it wasn’t signed off, it wasn’t documented
- It was misplaced, it wasn’t documented
- If it wasn’t saved, it wasn’t documented
- If the detail was lost, it wasn’t documented
- And if it wasn’t documented, it didn’t happen.
Wherever humans are involved in transcribing and capturing information, that information is at risk. Misplaced documents, typing errors, and incorrect data are a considerable challenge at every touchpoint. And, as information is shared across disciplines or among teams, this risk multiplies. With multiple single points of failure, a report that was accurate in the first instance misplaced or lost, affecting dozens of steps along the patient journey, with back tracking and retrieval a difficult, time-consuming task.
Healthcare has an economic and humanistic value. Gaps and failings come with financial and human impact—in some cases, irreversibly. Augnito is designed to close the gaps between medical professionals, multiple healthcare systems, the reporting technology, and their colleagues. Interoperability is key, with speech connecting disparate systems right along the patient journey and creating a single version of the truth. With highly accurate transcription available without the delays or risks of manual handling, only then can everyone make decisions based on the full, up-to-the-minute story – with complete confidence in its accuracy and validity.
#3 Harnessing collective experience and expertise
By definition, Multi-Disciplinary Teams (MDTs) are there to provide a breadth of expertise across distinct areas, each with an important role to play in patient outcomes. But close collaboration across these teams is made more difficult when ways of working and communicating aren’t unified.
A major challenge of any new technology in healthcare is adoption – especially when considering the differing budgets of those across the health and social care system. If a new technology isn’t within reach for under-funded mental health teams or understaffed GP surgeries, its impact will always be limited.
That’s why Augnito doesn’t just provide always-available, accurate speech recognition and transcription. It’s built to be widely accessible, from the low complexity nature of a cloud-hosted solution to a simple subscription model with no need for capital expenditure or complex infrastructure changes.
Holistic improvements to how people work
Technology alone isn’t lifesaving. It’s the unique expertise and talent of people across healthcare that make better patient outcomes possible. Voice-driven AI speech recognition influences outcomes in an integrated, holistic way by focusing on the needs of the people that deliver care every day.
Developed in partnership with medical professionals, Augnito is tailored to the biggest challenges our healthcare system is facing, from rising backlogs to surging DTOC figures and a widespread bed shortage. Delivering incremental improvements to the speed, accuracy and quality of reporting and communication, Augnito brings new efficiency to everyone who touches the patient journey.
Learn more about Augnito
Augnito is already impacting the patient journey through our growing list of UK resellers and technology partners. Request an Augnito Spectra evaluation version to see its benefits first-hand.
[London, 29 March 2023] – With the NHS struggling to meet the demands of an ageing population, complex discharge processes, and widespread bed shortages, new technology has an important role to play in safeguarding patient outcomes.
The past few years have been incredibly challenging for the NHS, with the pandemic and heightened demand bringing longstanding problems into sharp, urgent focus. Bed shortages continue to be a major issue, with British Medical Association data from December 2022 reporting that occupancy rates consistently exceed safe levels. Meanwhile, Delayed Transfers of Care (DTOCs) create unnecessary bottlenecks, with patients occupying beds when they are clinically ready to be discharged or transferred.
For NHS Trusts, this creates a significant, largely unnecessary cost – one that’s hard to immediately address by adding new bed stocks. That’s why Scribetech, the co-creators of AI speech recognition solution Augnito, are working to help Trusts understand the potential of innovative new technology.
“For decades, the NHS has tried to address bed stock and occupancy issues by adding more beds, but we have consistently seen that it’s almost impossible to keep up with demand” stated Shiraz Austin, Managing Director at Scribetech and Co-Founder of Augnito. “Technology and changes in ways of working have the potential to reduce occupancy rates and improve care in a way that’s more sustainable. But this transformation is only possible if it makes financial sense.”
Estimating the financial cost of DTOCs and the bed shortage is difficult. Department of Health figures put the cost of a DTOC bed at £400/day, while Age UK report 2019 costs of £346/day. Using a forgiving cost of £350/day, this implies a bill in excess of £54 million just for the delayed days in February 2020, when DTOC metrics were last reported.
Speech recognition technology like Augnito can’t immediately eliminate all DTOCs, but it can deliver consistent, incremental improvements to the workflows of multidisciplinary teams (MDTs). With real time dictation and transcription in any platform or dedicated desktop and smartphone applications, healthcare professionals can reduce the risk of delays arising from inaccurate records, lost records, and breakdowns in communication.
Austin continued: “The financial outlook is clear: the cost of new technology is significantly less than the cost of delays and low bed stocks. The cost of a single extra bed per day is 10 times the cost of an Augnito licence for a month. But that commercial reality is just one part of the picture. There’s a human cost that must also be considered.”
While delays and occupied beds affect every patient – and, indeed, the entire healthcare system including social care – some particularly vulnerable groups are disproportionately affected. December 2021 saw intensive care beds for children reach record occupancy of 89% across the country. Meanwhile, older patients are particularly at risk given the typical complexity of their discharge or transfer to other providers.
When paediatric beds simply aren’t available or elderly patients are kept on wards for weeks, even months after they’re ready to be transferred, their experience is resoundingly negative. They’re unable to receive the care that is appropriate, when it is required, in the right setting. In some cases, this comes with a very real and measurable impact on outcomes.
Austin concluded: “Augnito is designed to work for NHS Trusts – a cloud-hosted technology that’s significantly lower in cost than unnecessary delays and can be implemented quickly and easily. But it’s also designed to empower healthcare professionals and multidisciplinary teams to work efficiently, so they can act based on what patients need, without being limited by processes and old, outdated workflows.”
Notes to editors
Full blog posts referenced in this media alert:
For further information, interview opportunities or accompanying graphics please contact: [email protected]
About Scribetech and the Augnito solution – visit https://www.scribetech.co.uk/ for details and follow us on Linked-In.
Augnito is a secure, cloud-based, AI-driven clinical speech recognition product suite. It offers fast, easy ways to capture live clinical data on any device with 99.3% accuracy, support for multiple medical specialities, and no need for voice profile training. Augnito brings seamless speech recognition to daily workflows and third-party clinical systems, turning medical information into clinical documentation and making healthcare intelligence securely accessible wherever it’s needed. Augnito was co-developed by Scribetech, a clinical voice solutions innovator, fusing 20 years of transcription and digital dictation services to the NHS, speech-to-text, and clinical coding solutions for the healthcare sector, and its own speech recognition engine with advanced voice AI technology.
While Delayed Transfers of Care (DTOCs), bed shortages, and needless hospital stays negatively affect every patient, the NHS still has a responsibility to pay special attention to the most vulnerable people in our society. But, given the nature of acute hospital beds and potential transfers to social care, the frail elderly and sick children make up a considerable part of the pressure that the NHS faces in handling its current backlog of more than 7 million people waiting for treatment.
In an effort to improve collaboration between disciplinary teams, the NHS has been taking steps to rectify the specific challenge focussed on the vulnerable and . Between 2013 and 2015, 25 integrated care pioneer sites were selected by the NHS to develop and test new ways of joining up health and social care services across England. In 2015, 50 vanguards were chosen to lead the development of new care models, becoming blueprints for the wider NHS moving forward and the inspiration to the rest of the health and care system moving forward.
Through the new care models programme, a complete redesign of whole health and care systems was being considered. That care model was to take into account improving care not simply for older people, but with a focus on frailty vs. age and the differing needs of our ageing population. An ageing population that is living longer and presenting with more complex illnesses that require complicated care. At the same time, similar complexity can be found in a vulnerable group at the other end of the patient age spectrum – the young (children). These factors compound today’s NHS bed shortages, understaffing, burdened workflows, bottlenecks and burned-out clinicians and nurses. They also add to the DTOC problem.
While DTOCs can occur for a wide variety of reasons in the patient journeys of the above two mentioned vulnerable groups, data shows significant challenges in bed capacity, particularly for children. For older patients, awaiting care packages in their own home or nursing home availability are among the most common causes. Meanwhile, Multidisciplinary Teams (MDTs) have a pivotal role to play in enabling seamless journeys, without being limited by inaccurate patient reports, loss of reports, and delays in information sharing (a topic we’ll go into more detail in our next blog post).
In this post, we focus on how DTOCs affect the vulnerable most frequently and how speech recognition technology could help improve this situation to deliver a more consistently available level of care and, ultimately, improve outcomes.
Treating severely ill children
Recent data from Nuffield Trust examined the impact of NHS pressure on children, looking specifically at intensive care beds across the challenging winter period.
According to the report, December 2021 saw just 314 beds per day across the whole of England. While this was marginally higher than availability in previous winters, occupancy was higher too. On average, 89% of these beds were occupied, leaving just 35 beds available to new admissions.
This is by no means the direct consequence of DTOCs and patients failing to be transferred or discharged appropriately. But, it is a sign of a healthcare system in crisis, dealing with peak demand and increased instances of flu, scarlet fever and Strep A with little room to manoeuvre. Bed stocks have been reduced to an extent where any unexpected demand – or delay – could have disastrous consequences.
DTOCs and older patients
For older frail patients, effective care takes a seamless approach between the NHS, community services, and social care providers. It is often these cases where the discharge and transfer process is most complex, requiring collaboration between multiple parties and effectively prioritising what are often multifaceted, intricate needs.
According to a study in Age and Ageing, Volume 50, Issue 4, the average cost to the NHS of DTOCs in older patients was £820 million each year. However, the study highlights the importance of keeping patients central, even where most data gathering is focused on wasted costs.
The reality is that DTOCs aren’t just a cost centre. They create a ripple effect across our entire healthcare system – and out into the lives of patients and our wider communities. Reducing wasted costs is simple: discharge patients faster and more effectively – that’s just one part of the story.
For older patients – and patients of any age – the discharge and transfer process is a key part of their experience. Delays create distress and negatively impact healthcare outcomes. And the knock-on implications of bed shortages, soaring occupancy, and unavailability of care, tend to lower standards across the entire system.
The human cost of DTOCs and bed shortages
At the end of 2022, Landmark Chambers reported on a specific judicial review of an individual Integrated Care Board (ICB). A patient with complex physical needs and autism was stuck on a ward for 8 months when the NHS and social care bodies failed to agree on a discharge plan.
The ICB was ordered to pay the patient’s legal fees as well as their own costs – a legal bill estimated at more than £100,000. The real cost in this, and sadly many similar DTOCs isn’t financial. The real cost is to the patient: a vulnerable individual, already in a challenging environment, needlessly kept waiting for almost a year.
Look behind the scenes, and there’s also a human cost to the overworked, under-pressure MDTs based on the disjointed transfer of care process itself, providing these teams with unwieldy, often outdated reporting platforms and slow, manual processes that make efficient discharge and transfer more difficult than they need to be.
How can technology help?
Augnito’s AI speech recognition empowers all healthcare professionals to save time, increase productivity and, ultimately, reduce costs. It was created to play a part in rethinking models and workflows in healthcare, to actively improve the patient journey by making accurate, agile technology available to entire MDTs across Trusts and across primary care. The challenges the NHS continues to face are sizable, constantly evolving, and not easily solved. We believe a way for professionals to work more flexibly, cope with considerable workloads, and focus their efforts on delivering exceptional patient care will be key steps towards a solution.
Learn more about Augnito
Augnito is already impacting the patient journey through a growing list of UK resellers, distributors and technology partners.
Request an Augnito evaluation version to see its benefits first-hand.
With the NHS under immense pressure, bed stocks are infamously limited. However, this pressure shows no signs of slowing – and the number of beds across the NHS shows no sign of growing in a way that’s substantially impactful. What other approaches can we take to address this major challenge and, crucially, how can technology help?
From healthcare professionals to the general public, most of us are intimately familiar with the continued lack of beds in our healthcare system. Even pre-pandemic, few health experts felt we were well equipped with beds and ample resources. Now, the BMA continue to stress the severity of this problem: data from December 2022 reports occupancy rates consistently exceeding safe levels and call capacity a ‘critical limiting factor’ for the NHS.
Beyond those early adopter areas like radiology and pathology, speech recognition technology has the potential to reduce costs across entire Trusts – potentially freeing up resources to invest in new ways to grow capacity and bring occupancy down to reasonable levels.
The impact of DTOC on bed capacity
Recently, in our previous blog post, we wrote about the significant challenge of Delayed Transfers of Care (DTOCs) – those periods when a patient is ready to be discharged from an acute care bed but remains in the bed regardless. Typical bottlenecks and obstacles to discharge/transfer include:
- Awaiting completion of assessment, including incomplete documentation
- Awaiting care packages
- Awaiting nursing home placement
- Awaiting community equipment and adaptations
- Awaiting further non-acute NHS care
- Awaiting care packages in own home
- Disputes and legal challenges
Across all these areas, faster documentation and reporting time can help keep people moving along the patient journey. If not, DTOC dramatically worsens the problem of poor bed stocks and low capacity.
Every day a patient stays in an acute care bed unnecessarily, beds remain unavailable to those who need them. While this is obviously a barrier to delivering timely, effective treatment and care, it also creates unnecessary cost.
The costs of a widespread bed shortage
Bed shortages, driven by needlessly extended hospital stays and DTOCs, lead to significant costs to the NHS. This is a wasted expense that does nothing to improve patient journeys, experiences, and outcomes.
In February 2020, DTOC metrics reported by the GSS show on average 5370 people were delayed per day. The actual cost of these delays is significant by any measure. According to Age UK, in 2019, the cost of a DTOC bed per day was £346. whereas Department of Health figures from 2017 put the cost at £400 per day. Even if we assume the NHS’ own £350/day cost was accurate in February 2020, this means that month’s cost for 155,700 days was over a staggering £54 million.
An effective, accurate speech recognition technology like Augnito can reduce this cost and deliver a considerable saving by enabling clinicians and healthcare professionals to work and report more efficiently, removing some of the above mentioned common obstacles to prompt discharge or transfer. And the cost of adopting Augnito is significantly less than the cost of adding and maintaining more beds.
Repurposing even just 5% of February 2020’s estimated DTOC cost into Augnito licences could empower tens of thousands of clinicians to work more efficiently, reduce reporting time, and focus their energy on patients. Even a seemingly small 1% efficiency gain could dramatically improve both staff workloads and, more importantly, patient journeys overall.
Addressing the consistent fall in NHS beds
Over the past three decades, the total number of NHS hospital beds in England has more than halved. In part, this reflects changes to the ways patients are treated and is a trend we can see reflected in other advanced healthcare systems. For example, an increase in day surgery and long-term policies to move patients into care in the community have partly driven this ongoing reduction in capacity.
Of course, we all know that demand hasn’t followed this proposed downward trajectory. While the number of beds may have decreased, the number of patients treated has continued to rise sharply. Today, the UK has fewer acute beds relative to its population than most other European countries.
Worse, the longer-term outlook is bleak. The Health Foundation’s REAL Centre analysed bed stocks against best-case demand and found a significant gap. According to the report, 35% more beds will be required by 2030 – even if NHS initiatives to reduce hospital stay durations succeed. Apply the estimated DTOC rates we’ve shown above and the cost skyrockets.
The impact of speech recognition on efficiency and cost
As the NHS has consistently found for more than three decades, expanding bed stocks isn’t a simple task. Capacity is a complex issue and, as demand continues to surge, occupancy rates of 99% and above aren’t likely to improve without significant change.
It’s not that technology like Augnito AI powered speech recognition can solve the DTOC challenge overnight. It’s that incremental improvements to the way healthcare professionals work, collaborate, and share information creates consistent improvements over time. Eliminating the slow reporting and typing into cumbersome, often outdated systems saves time, reduces costs, and enables budgets to be repurposed into wider, systemic changes.
Augnito is already used widely across healthcare, helping those in diagnostic and reporting roles capture clinical data quickly, securely, accurately, and more cost-effectively. Crucially, Augnito’s flexible licensing means it’s available to Trusts for a fraction of the cost of adding capacity or keeping patients in beds for longer than they need them.
For Trusts, this creates time and money savings with a compound effect. The ease of implementing Augnito across multiple individuals, departments and parts of the patient journey means even small efficiency gains for healthcare professionals create a significant, meaningful saving overall. The facts speak for themselves: the cost of a single extra bed per day is close to if not 10 times more than the cost of a single Augnito licence for a month.
See how you could save time and money
Augnito is already quietly and positively impacting the patient journey and the continuum of care in primary and secondary care. Talk to us to find out more or request an evaluation version / Augnito app to see how it could help you.
[London, 10 February 2023] – As the NHS continues to address and reduce Delayed Transfer of Care (DTOC) incidents – and their associated costs – speech recognition has the potential to deliver transformative efficiency gains.
With the healthcare system under unprecedented pressure, NHS Trusts are reflecting on key metrics associated with performance, cost, and quality of patient care. Delayed Transfers of Care (DTOCs) see patients continue to occupy beds when they are clinically ready to be transferred or discharged. This results in significant expense to the NHS, a lack of available bed stocks, and disrupted journeys for both the patients waiting for transfer and those waiting for beds.
According to Scribetech, UK distributors of Augnito, a cloud-based, AI-powered speech recognition solution, new technology and workflow transformation have the potential to significantly improve how DTOC is managed.
“DTOCs are an indicator of how healthy the health and social care systems are,” stated Shiraz Austin, Managing Director at Scribetech (UK) Ltd and Co-Founder of Augnito.ai. “When patients continue to occupy beds they don’t clinically need, there’s a ripple effect that stretches across the patient journey. This includes delays to treatment for new patients, as well as a considerable amount of distress for those needlessly held in hospital.”
The scale of the DTOC problem is significant. In February 2020, reports show, there were an average of 5370 people delayed per day across the NHS in England – some attributable to the NHS, some attributable to social care, and some with joint responsibility. Based on the Department of Health’s reported costs of an excess bed per day (£350 – £400), the estimated cost of DTOC was as high as £2,148,000 per day for that month alone.
However, this immediate financial impact is just one consequence of DTOCs. With bed stocks at an all-time low and occupancy at an all-time high, DTOCs directly affect the availability of treatment, making acute care when a bed is finally available even more costly and negatively affecting patient outcomes.
Innovative new technology has the potential to positively influence these outcomes – but Austin remains realistic about the results.
Austin continued: “It’s not that technology like Augnito can solve the DTOC challenge overnight. It’s that incremental improvements to the way healthcare professionals work, collaborate, and share information eliminate the low-hanging fruit of slow reporting and typing into cumbersome, often outdated, systems. And time saved leads to reduced cost, where budgets can be repurposed into wider, systemic changes.”
Augnito was designed in partnership with healthcare professionals to address their biggest challenges. This includes bringing real-time SR to the clinical systems used as part of the discharge and transfer process, allowing people to work faster and more flexibly.
Adopted widely, Augnito can deliver:
– Faster reporting time and fewer internal delays to patient discharge or transfer
– Reduced costs, which can be repurposed into growing bed stocks and community nursing
– Increased bed availability with less waste and lower occupancy
– A way to offset the removal of the Government’s Covid-19 DTOC funding
As standard, Augnito empowers healthcare professionals with advanced SR on any device – desktops, web browsers, and mobiles. With a flexible SDK and API, Augnito can also be integrated into existing systems for accurate, immediate capture into an Electronic Patient Record.
Based on February 2020 DTOC data, just a small reduction in turnaround time, inaccuracies and errors could save the NHS hundreds of thousands per month. Austin concluded: “Augnito creates a more seamless way of working for healthcare professionals, helping with considerable workloads and backlogs. But its real impact is on the NHS as a whole, improving financial drainage and removing the bottlenecks that become obstacles to outstanding patient care and the best possible outcomes.”
Notes to editors
Read the full blog post here www.scribetech.co.uk/2023/01/31/can-the-advantages-of-clinical-voice-ai-sr-technology-help-reduce-dtoc
For further information, interview opportunities or accompanying graphics please contact: [email protected]
About Augnito India Private Limited – visit Augnito.ai.