scholarly journals The Future of Health Care: Protocol for Measuring the Potential of Task Automation Grounded in the National Health Service Primary Care System

10.2196/11232 ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. e11232 ◽  
Author(s):  
Matthew Willis ◽  
Paul Duckworth ◽  
Angela Coulter ◽  
Eric T Meyer ◽  
Michael Osborne
Keyword(s):  
Primary Care ◽  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Primary Care System ◽  
Care Protocol ◽  
The Future ◽  
Care System

scholarly journals The Future of Health Care: Protocol for Measuring the Potential of Task Automation Grounded in the National Health Service Primary Care System (Preprint)

2018 ◽  
Author(s):  
Matthew Willis ◽  
Paul Duckworth ◽  
Angela Coulter ◽  
Eric T Meyer ◽  
Michael Osborne
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Care Staff ◽  
Primary Health ◽  
The Future

BACKGROUND Recent advances in technology have reopened an old debate on which sectors will be most affected by automation. This debate is ill served by the current lack of detailed data on the exact capabilities of new machines and how they are influencing work. Although recent debates about the future of jobs have focused on whether they are at risk of automation, our research focuses on a more fine-grained and transparent method to model task automation and specifically focus on the domain of primary health care. OBJECTIVE This protocol describes a new wave of intelligent automation, focusing on the specific pressures faced by primary care within the National Health Service (NHS) in England. These pressures include staff shortages, increased service demand, and reduced budgets. A critical part of the problem we propose to address is a formal framework for measuring automation, which is lacking in the literature. The health care domain offers a further challenge in measuring automation because of a general lack of detailed, health care–specific occupation and task observational data to provide good insights on this misunderstood topic. METHODS This project utilizes a multimethod research design comprising two phases: a qualitative observational phase and a quantitative data analysis phase; each phase addresses one of the two project aims. Our first aim is to address the lack of task data by collecting high-quality, detailed task-specific data from UK primary health care practices. This phase employs ethnography, observation, interviews, document collection, and focus groups. The second aim is to propose a formal machine learning approach for probabilistic inference of task- and occupation-level automation to gain valuable insights. Sensitivity analysis is then used to present the occupational attributes that increase/decrease automatability most, which is vital for establishing effective training and staffing policy. RESULTS Our detailed fieldwork includes observing and documenting 16 unique occupations and performing over 130 tasks across six primary care centers. Preliminary results on the current state of automation and the potential for further automation in primary care are discussed. Our initial findings are that tasks are often shared amongst staff and can include convoluted workflows that often vary between practices. The single most used technology in primary health care is the desktop computer. In addition, we have conducted a large-scale survey of over 156 machine learning and robotics experts to assess what tasks are susceptible to automation, given the state-of-the-art technology available today. Further results and detailed analysis will be published toward the end of the project in early 2019. CONCLUSIONS We believe our analysis will identify many tasks currently performed manually within primary care that can be automated using currently available technology. Given the proper implementation of such automating technologies, we expect considerable staff resources to be saved, alleviating some pressures on the NHS primary care staff. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11232

scholarly journals Primary care-led commissioning and public involvement in the English National Health Service. Lessons from the past

2014 ◽  
Vol 16 (03) ◽  
pp. 289-303 ◽  
Author(s):  
Christina Petsoulas ◽  
Stephen Peckham ◽  
Jane Smiddy ◽  
Patricia Wilson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Services ◽  
Public Involvement ◽  
Negative Impact ◽  
Central Place ◽  
Patient And Public Involvement

BackgroundPatient and Public involvement (PPI) in health care occupies a central place in Western democracies. In England, this theme has been continuously prominent since the introduction of market reforms in the early 1990s. The health care reforms implemented by the current Coalition Government are making primary care practitioners the main commissioners of health care services in the National Health Service, and a duty is placed on them to involve the public in commissioning decisions and strategies. Since implementation of PPI initiatives in primary care commissioning is not new, we asked how likely it is that the new reforms will make a difference. We scanned the main literature related to primary care-led commissioning and found little evidence of effective PPI thus far. We suggest that unless the scope and intended objectives of PPI are clarified and appropriate resources are devoted to it, PPI will continue to remain empty rhetoric and box ticking.AimTo examine the effect of previous PPI initiatives on health care commissioning and draw lessons for future development.MethodWe scanned the literature reporting on previous PPI initiatives in primary care-led commissioning since the introduction of the internal market in 1991. In particular, we looked for specific contexts, methods and outcomes of such initiatives.Findings1. PPI in commissioning has been constantly encouraged by policy makers in England. 2. Research shows limited evidence of effective methods and outcomes so far. 3. Constant reconfiguration of health care structures has had a negative impact on PPI. 4. The new structures look hardly better poised to bring about effective public and patient involvement.

Pricing, Insurance and the National Health Service

1979 ◽  
Vol 8 (2) ◽  
pp. 157-176 ◽  
Author(s):  
Alan Maynard
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Health Care System ◽  
National Health ◽  
Potential Role ◽  
The United Kingdom ◽  
The Cost ◽  
Care System

ABSTRACTSince the birth of the National Health Service in 1948 there have been periodic discussions of the potential role of pricing and insurance in the United Kingdom health care system. This article is concerned with discussing the problems inherent in these mechanisms and it advocates more careful articulation of the cost and benefits of such policies. The first section gives a description of some quite recent proposals to extend the role of the pricing and insurance mechanisms which have been made by the British Medical Association and the McKinsey consultancy company. The second section uses economic analysis to show that both the pricing and the insurance mechanisms have inherent problems which may vitiate their efficiency in many western health care markets. The third section is concerned with the mechanisms by which the efficiency of the health care system can be improved, and radical experimentation is advocated. Without radical experimentation and the implementation of suitable incentive systems, inefficiency and inequality will continue in the National Health Service.

Increasing Patient Charges in the National Health Service: A Method of Privatizing Primary Care

1986 ◽  
Vol 15 (2) ◽  
pp. 163-184 ◽  
Author(s):  
S. Birch
Keyword(s):  
Primary Care ◽  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Substantial Reduction ◽  
The Real ◽  
Real Value ◽  
The Government ◽  
The Cost

ABSTRACTFrequent increases in the real value of National Health Service (NHS) patient charges have been made since the Conservative Party's return to office in 1979. For those patients subject to these charges the increases have led to a substantial reduction in the level of subsidization of the cost of the service. The rationale for the subsidization of health care is shown to be unrelated to ‘ability to pay’ considerations. Consequently the ‘backdoor privatization’ of these services is inconsistent with the objectives of the NHS even though the Government has continually committed itself to these objectives. Alternative policies to increasing patient charges are suggested which would encourage the efficient use of NHS resources without compromising NHS objectives.

Accountability for Rationing — Theory into Practice

2005 ◽  
Vol 33 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Christopher Newdick
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Systems ◽  
The Public ◽  
Modern Health Care ◽  
Concept Of Health ◽  
Care Systems ◽  
Health Need

Most now recognize the inevitability of rationing in modern health care systems. The elastic nature of the concept of “health need,” our natural human sympathy for those in distress, the increased range of conditions for which treatment is available, the “greying” of the population; all expand demand for care in ways that exceed the supply of resources to provide it. UK governments, however, have found this truth difficult to present and have not encouraged open and candid public debate about choices in health care. Indeed, successive governments have presented the opposite view, that “if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.” And they have been rightly criticized for misleading the public and then blaming clinical and managerial staffin the National Health Service (NHS) when expectations have been disappointed.

scholarly journals Postcode lottery? Hospital transfers from one London prison and responsible catchment area

2010 ◽  
Vol 34 (4) ◽  
pp. 140-142 ◽  
Author(s):  
Simon Wilson ◽  
Katrina Chiu ◽  
Janet Parrott ◽  
Andrew Forrester
Keyword(s):  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Catchment Area ◽  
Clinical Implications ◽  
Hospital Unit ◽  
Transfer Data ◽  
Hospital Transfer

Aims and methodTo consider the link between responsible commissioner and delayed prison transfers. All hospital transfers from one London prison in 2006 were audited and reviewed by the prisoner's borough of origin.ResultsOverall, 80 prisoners were transferred from the audited prison to a National Health Service (NHS) facility in 2006: 26% had to wait for more than 1 month for assessment by the receiving hospital unit and 24% had to wait longer than 3 months to be transferred. These 80 individuals were the responsibility of 16 different primary care trusts. Of the delayed transfer cases (n=19), the services commissioned by three primary care trusts were responsible for the delays.Clinical implicationsThere are significant differences in performance between different primary care trusts related to hospital transfers of prisoners, with most hospitals able to admit urgent cases within 3 months. This suggests that a postcode lottery operates for prisoners requiring hospital transfer. Data from prison services may be useful in monitoring and improving the performance of local NHS services.

The Education of Pediatricians for Primary Care: The Score After Two Score Years

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 270-272
Author(s):  
Evan Charney
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Medical Profession ◽  
Primary Care System ◽  
Educational Structure ◽  
Task Forces ◽  
Do So ◽  
Care System

In a 1973 monograph on the education of physicians for primary care, Joel Alpert and I wrote, "There are two interrelated and serious problems in our present educational structure—not enough physicians enter primary care and those who do so are not adequately prepared for the job."1 Twenty years and many task forces and exhortatory editorials later, much the same could be said. But that conclusion would not be entirely fair: changes have indeed occurred in the subsequent two score years. There is now clear consensus that a strong primary care system should be the linchpin of our nation's health care system, with 50 to 60% of physicians as generalists, 2,3 and the medical profession has at least professed to agree with that strategy.4

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