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Idea Description
Supplementary Information
Detailed Submission Data
Innovation 'Elevator Pitch':

Kinesis lets clinicians (mostly GPs) request expert clinical advice from consultants at their provider trusts as an alternative to making a referral.

Find an expert – ask for patient related advice – receive a rapid reply – treat locally/refer
 

Overview of Innovation:

​Evidence shows that around 65% of referrals to outpatient clinics are 'inappropriate' [1. NHS Institute for Innovation and Improvement. Delivering Quality and Value – Focus on: Productivity and Efficiency. April 2009.], resulting in unnecessary delays to treatment and avoidable costs.

Kinesis is a browser-based application that allows clinicians to request expert clinical advice as an alternative to making a referral. It is most commonly used by GPs, who request advice from consultants at their provider trusts, though this can be extended to a wide range of healthcare professionals.
High level process:
Find an expert – ask for advice related to a patient – receive a rapid reply – treat locally/refer

Kinesis has a number of unique features that: drive rapid replies to requests for advice (typically within 24 hours), notify users of requests and responses, tracks outcomes, allows tariff payments, supports real-world work patterns.

Kinesis is fully encrypted, runs securely over N3, is very simple to set up and use.
Kinesis delivers improved clinical outcomes, fewer referrals (50% saved), improved primary-secondary engagement, referral cost reduction.


In practice, CCGs adopt Kinesis and set up all their GPs and engage consultants in specialties at their provider trusts in a phased approach to provide a responsive service. As adoption grows, more specialties and providers are added, often based on the demand from GPs.
Initial set up is rapid, requiring only a list of the names and email addresses (usually NHS email addresses) and their role (and optionally further profile information) to bulk add users, plus agreement on the configuration and preferred message text in the system. Typically, this takes around 2 weeks to complete, following which the system is announced as live to users and they can log in at the URL they are given, add further information to their profile (work days, mobile number, notification preferences, interests etc) and start using the system.

Administrators are similarly set up and have access to manage users, run reports, download data and provide general system management.
​The supplier runs all the servers etc. that make it work, help with set up, support &advice on getting the most from the system.
Kinesis is under active development and this is driven by the Steering Group, consisting of representatives from all the CCGS, providers and the supplier. New features are added on a rolling basis and made available to everyone.
 

Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
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Comments

There is a system already being marketed 'Consultant Connect' which some CCGs commission (not in my patch sadly). If this is better then you will be on to a winner.
There is a market for a tool to rapidly connect care homes/community nurses/paramedics to medics for real time decisions where there is potential to avoid inappropriate transportation to A+E and reduce admissions
Thanks for your comment.
We are well aware of Consultant Conenct and my personal view is that there is definiltey value in their approach. However our very first version of Kinesis (called Confer at that time) was very similar, providing instant voice contact with consultants. We quickly learned that this is perfect in maybe 5% of cases where clinical guidance is needed, but the rest doesn't ahve to be as immediate. We completely re-engineered Kinesis to it's current, near real time, typed experience. We still have the option to do voice, but none of our clients have chosen to use it.

We have also looked at the nursing home (and other advice setting options, including for prison services) and think there is a great need - but find a way to get those organsiations to look at the tools has proved challenging. We welcome any help!!

Let me know if you want a look - the brand new version (mobile friently, remote use, lots of other neat upgrades) is due later this year too.

Finally, we did an interesting ROI analysis against the eRS A&G tool. Our conservative estimate is tht Kinesis saves double the eRS based tool. Happy to share...
This sounds like a really thought through tool.  You have have already considered this but I was just wondering whether you had considered looking at adopting this into A&E.  I am sure you are aware of the challenges faced by the NHS around A&E waiting times and if we were to ensure that only those in need of A&E care were referred in then this could have a positive impact on A&E waiting times and resource. 
FYI, it is also being used successfully within Mental Health, though I think it should be adopted more strongly. There seems to be a strong desire for GPs to continue to interact witht the MH specialists during long term treatments, especialy around drug selection and outcomes.
Thanks for the kind words Tammy.
In all honesty, A&E is one of the few areas where we haven't really considered using Kinesis - my sense is that the need is for more real-time requests in this case. Kinesis does have a real-time mode (instant chat, with some intelligence around asking multiple advisors for help), though none of our CCG clients have elected to turn it on so far. I'd be very happy to have a chat to understand the 'use case' and see if it would likely work in practice.
I suspect there would need to be a fair bit of liaison between primary care and A&E to provide approriate cover and it may be difficult to carve this out from existing workloads.
I'd also be interested to know what proportion of A&E attendances are GP initiatiued rather than self referred.
Clearly there is a need to shift demand away from A&E, especially for the innaprorpiate attendances, so it bears further thoguht
This is great, I believe that you have you been in touch with Lucy Chatwin I will discuss with her and we will be in touch soon. 
 
Hi Tammy
it's been a while (but did anything come of your talk to Lucy?
Hi Simon, just to let you know i have seen your comment and im just chasing this up with my colleagues. 
 
I really like Kinesis, a great tool to help primary-secondary care professionals to communicate and work better together to reduce uncessary referrals, improve clinical outcomes and save the NHS money.  Add to that it's fully encrypted, runs securely over N3 and is simple to set up and use - a truly innovative solution.
Thanks Joanne - we have worked hard to make it such. And our user base really like it - we just need to get CCGs outside the London region to take a proper look. :-)
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