PHO CEOs Meeting Financial modelling of ePortals in general practices 17 April 2015 Introduction • The National Health IT Board seeks to promote the use of electronic patient portals in general practices • Portals have the potential to streamline a number of clinical processes and improve practice communication with patients • Stakeholder uncertainty regarding the financial and workload impacts of implementing portals is thought to be a barrier to uptake of portals. 2 Approach • Three step approach: – Step One: Background research – Step Two: Design and assumptions – Step Three: Financial modelling 3 Background Research • Several themes emerged including: – Pre-installation concerns (e.g. increased workload, legal liability, persistent emailers) generally weren’t realised; – Imposing a financial cost to patient was a significant barrier to uptake; – Scale of uptake important for benefits to be realised; – Benefits primarily realised through improving the efficiency of low-level tasks; – Potential for substitution of doctor workload. 4 Design and Assumptions • Output at this stage was: – Design parameters for which there was relatively little uncertainty, and formed the core of the model – Design parameters which there was uncertainty, and were subject to more detailed exploration with different scenarios during the modelling phase 5 Financial Modelling • Modelling focussed on the release of resources from ePortal implementation rather than net savings; • General practices will vary in how they wish to realise the value of released resources; • Analysis of net savings useful to explore design parameter relationships and trends. 6 Changes in FTE - GP GP FTE 0.45 0.4 0.35 ∆ FTE 0.3 0.25 0.2 0.15 0.1 0.05 0 0% 5% 10% 15% 20% 25% 30% 5000 7 35% 40% 45% Percent 2500 10000 50% 55% 60% 65% 70% 75% 80% Change in FTE – Nurse and admin staff Nurse FTE Admin Staff FTE 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% -0.05 0 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% 0 -0.5 -0.1 -1 -1.5 -0.2 ∆ FTE ∆ FTE -0.15 -0.25 -2.5 -0.3 -3 -0.35 -3.5 -0.4 -0.45 -4 Percent 5000 8 -2 2500 10000 Percent 5000 2500 10000 Summary of Results Practice Size 9 GP FTE Nurse FTE Admin FTE Net Gains ($) 2500 0.105 -0.100 -0.947 14,143 5000 0.210 -0.200 -1.893 28,278 10000 0.420 -0.400 -3.788 56,577 Sapere Report The written report explores in detail the effect of: • • • • 10 Substitution between in-person and e-consults Number of emails per person Scale effect from increasing practice size The interrelationships between the design parameters Dr Tom Love & Rohan Boyle +64 4 915 5358 www.srgexpert.com Our core values are independence, integrity and objectivity Sapere aude – dare to be wise 11