Somerset NHS Foundation Trust - Case Study

Somerset NHS Foundation Trust (SFT) shares a mission to deliver outstanding care to its patients, carer-givers, colleagues and communities through a culture of listening and learning. It provides joined-up community, mental health, and acute hospital services. Managing outpatient appointments for multiple services is an integral part of this work. 

Working together with Microsoft Partner EBO and The Access Group, the Trust deployed the Virtual Assistant built on Microsoft Azure Cognitive Services and part of the Rio electronic patient record (EPR) solution. 

Somerset NHS Foundation Trust, like all NHS organisations, has been tackling appointment backlogs caused by the Covid-19 pandemic and its impact to services. This has meant patients are waiting longer to be seen – even for phone appointments.  

The phone lines were jammed, patients were waiting in long queues trying to get through and sometimes even miss their appointments

explains Kim Hale, Digital Change Lead at Somerset FT. 

SFT needed to find a way to improve response times and reduce the pressure on booking officers, and to do this quickly. This meant finding a solution that would work with its existing IT infrastructure, but that was also easy to use to avoid major delays with the onboarding process and teaching staff. 

They wanted a digital solution that was easy to use, yet still felt personal, empathic and engaging, and that improved access by being available 24 hours a day, every day.   

Somerset had three goals: 

• Onboard a digital alternative to telephone booking for appointments. 

• Reduce staff workload through this alternative option. 

• Reduce temporary booking workforce costs. 

Somerset FT reached out to The Access Group, who provide their Rio electronic patient record system, and EBO, a Microsoft partner that helps organisations to have conversations with patients. EBO leverages Azure Cognitive Services to bring human capabilities to AI-based Virtual Assistants (VA).  Since EBO and The Access Group shared a collaborative working relationship, the Rio Virtual Assistant works seamlessly as part of the Rio EPR used by the Trust right from the start. 

Rio Virtual Assistant offers patients around-clock-accessibility to manage appointments without speaking to a human agent and increases employee efficiency via automated workflows, so in 2022 EBO and The Access Group deployed this solution to the booking teams for three of the Foundation Trust’s outpatient services: 

• Podiatry 
• Musculoskeletal Physiotherapy 
• Trauma and Orthopaedics 

 This was done as part of a 12-week pilot scheme and targeted three high-volume services to properly assess the levels of engagement and benefits. Patients were engaged by the Virtual Assistant on the SFT website and were automatically sent a text, email, or letter to confirm appointments. They were also invited to use the Virtual Assistant if they needed to reschedule or cancel their appointment. 

The experience of working with The Access Group has been very positive. They heard our concerns and helped design AI solutions that benefit our patients by providing an alternate way they interact with the Trust.

James Marriott, Digital Change Manager at Somerset NHS Foundation Trust 

Today, the Rio Virtual Assistant solution conducts over 1000 fully-automated conversations each month. Over 80% of interactions with Rio Virtual Assistant lead to completed conversations with patients. Since over 40% of these conversations take place outside office hours, patients now have more flexibility to engage with hospital services when it suits them.  

“We wanted to make it easy for patients to call in and either confirm appointments or cancel if they can’t make it, without limiting them to a 9 to 5 window. We’re not wasting patients’ time or appointment slots since it is assigned to someone else” explains Hale. 

According to Hale, Rio Virtual Assistant has smoothly integrated and automated multiple workflows within the Trust, leading to more flexibility over employee workloads. “Our booking officers absolutely love Rio Virtual Assistant as it helps collect useful information in advance and they can focus on the patient needs,” she says. 

Deploying Rio Virtual Assistant entirely on Azure also means the workload is easier on the in-house IT team. They now have continuous monitoring and capacity management, as well as high availability and simple management of the environment. 

Over the last six months, Rio Virtual Assistant has helped save 24 hours of staff time per week.

Kim Hale, Digital Change Lead - Somerset NHS Foundation Trust 

Ensuring human-like interactions

For Somerset FT, language was a key factor when developing Rio Virtual Assistant. EBO and The Access Group worked with the Trust to ensure patients could use their natural language when speaking to the Virtual Assistant “Our callers come from diverse cultural and linguistic backgrounds, so we ensured Rio Virtual Assistant could understand all our patients and the different ways they communicate,” explains Hale.  

Unlike most solutions in the market, Rio Virtual Assistant can have human-like interactions with patients. Its unique conversational skills and understanding of context allow the Virtual Assistant to convey empathy. It can also detect sentiment and determine when a call should transfer to an agent.  

Rio Virtual Assistant is friendly and approachable, so patients feel comfortable interacting with it, even though they know it’s not a real person.

Kim Hale, Digital Change Lead - Somerset NHS Foundation Trust 

Rio Virtual Assistant’s ability to learn and adapt is what sets it apart. It integrates with the Rio EPR, to extract relevant patient data for use during conversations. It also updates patient electronic files with any new information and collates patient history so that booking agents have more of the data they need during callbacks. 

After six months of deployment, Somerset NHS Foundation Trust reported over 700 conversations per month were being held via the Virtual Assistant; 80% of the total interactions with the VA. This is an adoption rate of 14.6% based on the partial rollout, and 40% of these conversations were had outside of the normal ‘office hours’ that patients could typically engage with clinical services. Importantly, of the people who interacted with the Virtual Assistant, 86% of patients either liked or were neutral about their experience.  

The bigger gains were the savings to time and money though. Approximately 24 hours of staff time was saved each week thanks to the work of Access and EBO, meaning 615 hours saved in the six month period.

Then there’s the money: based on the 14.6% adoption rate of users interacting with the VA, this would equate to £159,900 saved each year for Somerset Foundation Trust, but with better awareness and patient confidence interacting with the VA this could jump up to a targeted 30% adoption rate, which would save a potential £456,000 per year instead. 

We received approximately 4 to 5 Virtual Assistant notifications a day for MSK, reducing the number of cancellations via telephone.

- Service manager for MSK/Podiatry Somerset FT 

Due to the resounding success, Somerset FT plans to introduce improvements in the next phase by adding more features, functionality, and automation. This will empower the staff to provide patients with the quality of care they need and deserve while helping to manage employee workloads more efficiently.  

Patients are at the centre of it all. Our goal is to make things easier for our patients and improve how we communicate with them, both on the phone and in person.

- says Hale. 

 
The next rollout phase for the Virtual Assistant is to add notifications as specific points of the treatment pathway, to help patients stay abreast of each next step. There will also be new functionality to view the appointment letters when seeing an appointment, and to cancel appointments outright – without having to be then referred to a receptionist to confirm. 

The goal is to increase patient usage from 14.6% to 30%, in order to increase the level of savings for Somerset FT. Please note however that the data provided here will have a lag time attached to it, as it takes time for the NHS to analyse and present technical information before it can be made public, but more statistics and evidence should be released in 2024 for us to update this feature with and to showcase just how beneficial our partnerships with EBO and SFT have been.