Financial benefits of Personal Health Records

The PHR community has lacked a single place to find PHR benefits.

We have gathered research on PHR financial benefits for you and will add more once we have it.

Each is published: 

• as a brief introduction 

• with agreement from its source 

• with best efforts to confirm its accuracy

• with source contact details, for you to find out more 

Bear in mind that we: 

• do not own the benefits, they are owned by each source

• are not responsible for the benefits happening 

• do not know how calculations have been made 

Some benefits terms might differ locally. Our understanding is that:  

• cash-releasing benefits are where money can be reallocated, or value removed from budgets 

• non cash-releasing benefits are efficiency savings, but don’t release money back to budgets 

• non cash-releasing benefits are opportunity costs, like staff time saved, which have a value, but don’t release money back to budgets 

1. Photocopying and postage of subject access requests

Source

Care Information Exchange.

Summary

The Care Information Exchange is a PHR system available across north London.

It can offer patients a copy of their records, after subject access requests.

This offers the potential to save on photocopying costs and postage, or CDs and DVDs if scanning.

Estimated value

The figures below show potential savings at sites where this has been implemented.

Benefit category

Provider efficiency.

Find out more

Email [email protected] from Imperial College Healthcare NHS Trust.

2. Printing and postage of clinic outcome letters

Source

Care Information Exchange.

Summary

Postage costs could be saved where patients opt to receive clinic outcome letters through the Care Information Exchange (CIE).

Evidence since the introduction of emailed appointment letters suggests that at least 20 per cent of patients prefer to receive letters electronically.

An estimated 500,000 patients are seen by acute trusts per year. There could be considerable savings if 20 per cent opted to receive their letters via the CIE.

The benefit to patients is that the clinic letter will be:

• accessible to them anywhere and anytime, through their wider CIE record
• immediately shareable with anyone else they want to see it

A PDF of the record could be added to the email and this also saves on postage.

The CIE also offers a way to fulfil subject access requests, where patients ask to see their records. 

Estimated value

An acute trust receiving over 5,500 requests each month would save over £80,000 per year.

Benefit category

Provider efficiency.

Find out more

Email [email protected] from Imperial College Healthcare NHS Trust.

3. Reduced booking admin and support costs

Source

University Hospital Southampton (UHS) NHS Foundation Trust, Patient Online Service.

Summary

Admin and support staff currently help patients to use appointment booking services.

Patients will be able to do this directly themselves, using My Medical Record (MyMR). This will free staff to work more on MyMR.

Staff using the existing UHS patient administration system currently take: 

• 43 seconds to cancel an appointment
• 143 seconds rebook an appointment
• 52 seconds to attend an appointment
• 99 seconds to outcome an appointment

Around 8% of outpatient appointments are not attended.

Estimated non-cash saving

It was estimated that there would be £1,823 non-cash savings in the financial year 2018/19, based on savings in quarter one to quarter three. This is based on the number of MyMR users during this period.

MyMR usage is planned to reach 100,000 users by the end of 2019.

That means an estimated non-cash releasing benefits saving over 5 years of £565,000. This assumes a 20% reduction in face-to-face attendances that need admin team support.

Benefit category

Provider efficiency.

Find out more

Email the My Medical Record team at [email protected]. 

4. Reduction in paper and postage costs

Source

University Hospital Southampton (UHS) NHS Foundation Trust, Patient Online Service.

Summary

UHS are working to save further money on paper letters and stamps by sending letters electronically.

Patients using MyMR can sign up to receive these paper-free communications.

Estimated cash saving

Savings based on an estimate of two letters per appointment are:

• an ambitious saving over 5 years of £891,058.07
• a moderate saving over 5 years of £702,637.82
• a conservative saving over 5 years of £376,709.38

Benefit category

Provider efficiency.

Find out more

Email the My Medical Record team at [email protected]. 

Source 

East Surrey Hospital (ESH).

Summary 

ESH has introduced a Personal Health Record that allows its inflammatory bowel disease service to save approximately £232,320 a year, by avoiding hospital admissions and appointments.   

The PHR also allows ESH to monitor patients remotely at home. This has led to the use of a different drug treatment, low dose azathioprine with allopurinol (LDAA). 

LDAA has 

• reduced the use of expensive monoclonal therapy

• led to a 90% reduction in admissions

• led to an 80% reduction in operations 

As a result: 

• there were 28 admissions in 2015, compared with 280 in 2008

• there were 20 operations in 2015, compared with 113 in 2008 

Estimated value 

This means potential savings of approximately £1.5 million per year on operations alone, based on an average of £16,226.23 per operation for ulcerative colitis. 

Learn more through our case study into how East Surrey Hospital achieved service redesign through its PHR. 

Benefit category

Reduction in demand. 

Find out more

Email [email protected] from East Surrey Hospital.

Saving on maintenance costs for systems 

Source 

University Hospital Southampton (UHS) NHS Foundation Trust, Patient Online Service.

Summary 

If you have a PHR in place, like My Medical Record (MyMR), you save on maintenance costs for systems that you don’t need anymore.

This can be recorded as cost avoidance, as the system would be needed if a PHR like MyMR was not being used. 

Realised value 

This benefit is already happening. It is expected to offer a conservative non-cash releasing saving of £80,000 over 5 years.

Benefit category 

Provider efficiency. 

Find out more

Email the My Medical Record team at [email protected]. 

Source

University Hospital Southampton (UHS) NHS Foundation Trust, Patient Online Service.

Summary

Nurses can save time during face-to-face pre-operative assessments, as patients can use MyMR to provide some information beforehand. 

This will also provide more accurate data for patient administration systems. 

Estimated cash saving

The comparison of non-cash releasing benefits are:

• ambitious saving over 5 years of £136,000
• moderate saving over 5 years of £136,000
• conservative saving over 5 years of £136,000

Benefit category

Provider efficiency.

Find out more

Email the My Medical Record team at [email protected]. 

Cut costs of physical outpatient appointments

Source

University Hospital Southampton (UHS) NHS Foundation Trust, Patient Online Service.

Summary

Costs of holding physical outpatient appointments can be cut by holding them online instead.

The cost of providing a face-to-face follow-up appointment in Urology for example is £84.

This is a loss-making service for UHS, as the tariffs were reduced to £74 for 2019/20.  

This cost is made up of:

• admin support time, including reception, house-keeping services time, facilities management and clinical support
• admin to book an appointment
• car parking maintenance
• nurses' and consultants' time
• space in clinic

Assumption

There will be a 20 per cent reduction in the number of appointments held physically, as patients transfer to a digital appointment.

Estimated and realised cash savings

There would be an estimated cash saving of £7,488,000 across 5 years, if:

• the same cash saving profile is assumed across all services
• it reaches a 20 per cent saving in the number of outpatients

UHS have negotiated a tariff with their Clinical Commissioning Groups (CCGs) for their My Medical Record outpatient replacement reviews. This provides additional income to the trust.

CCGs would save £14,911,889 over five years if they adopt the same approach of using MyMR that the Prostate Cancer Service uses for its service, based on the current tariff and cost savings achieved. This is calculated using a 20 per cent saving on outpatient appointments.

UHS has released cash savings of £40,000 for the trust in the financial year 2018/19 and £31,000 for the CCGs.

Benefit categories

Provider efficiency and reduction in demand.

Find out more

Email the My Medical Record team at [email protected].