Case study: BEMS harnesses RIVIAM's secure digital technology for new Primary Care community service

A case study on how RIVIAM is used for delivery of a Focused Weekend Working service

Bath and North East Somerset Enhanced Medical Services (BEMS) selected RIVIAM’s Pathway Hub secure digital service to enable their Focused Weekend Working community service for a population of 200,000 patients.

BEMS is a progressive and forward-thinking not-for-profit GP Federation organisation. It brings together a federated network of GPs from 26 local practices to deliver timely and targeted clinical services that transform care in the local community.

The organisation is always looking at ways to foster collaboration across the GP practices, improve workflow and provide better services to patients in a local environment.

The challenge

In 2015 BEMS set about improving weekend access to GPs for those patients who are most vulnerable and at greatest need, for example those needing palliative care or suffering with multiple, long-term clinical conditions.

This was part of GP practices’ wider preparations for a more challenging future of escalating patient clinical need, patients living longer and the transfer of services from Bath’s Royal United Hospital into the community.

To solve 7 day access for patients to their GPs required a review of workflows and a flexible approach to GPs’ access to patient records and information across the community.

From the outset of the project the BEMS team decided better use of data and technology would provide an innovative answer for their new Focused Weekend Working (FWW) service.

“We faced a stark choice between implementing a paper-based system or putting in place the technical architecture that would give us more transparency, control and speed for FWW, as well as support our broader vision for building capabilities that enable community Primary Care to flourish.” Amanda Simpson, Project Director, BEMS

BEMS were looking for an organisation with a deep understanding of current trends in the health and social care industry, providing a secure digital platform and services. They started working with RIVIAM in January 2015 to deploy their Pathway Hub.

This is a secure web and mobile pathway service for health and social care organisations supporting referral, session and discharge management.

Our solution

RIVIAM uses an innovative approach to extract referral information from GP clinical systems in the 26 GP practices and import this directly into RIVIAM using generated templates. Approximately 40 referrals each week were proactively selected to be referred to FWW by the GP practices and each owed into the system in this way.

BEMS administrators use a simple digital interface to set up weekend appointment GP sessions and, as referrals come into the RIVIAM system on a Friday afternoon, they are allocated to a session, and then to the clinicians who will be working, with a click of the mouse.

Clinicians receive an appointment on their tablet within minutes with a full set of supporting information from the referral form and the history of consultations and contacts.

They are able to add notes, manage outcomes, request new appointments or discharge a patient wherever they are. Discharges are then sent digitally directly to one of the 26 referring GP practices for delivery into their GP systems using MESH message API.

Regarding the process, Amanda explained: “Working closely with RIVIAM we have created a clever system that really simplifies the process for FWW. It enables mobile working and delivers the outcomes we were looking for in terms of speed of transaction, transparency of information and responsive care.”


Having managed 2,162 referrals for the FWW service over the last 15 months (from January 2015 to April 2016) the bene ts to BEMS of using RIVIAM’s Pathway Hub are clear.

For vulnerable patients and their families who have been able to receive care out of hours, it has improved the responsiveness and quality of their care, as well as the whole experience.

They don’t need to repeat their story to clinicians who are armed with knowledge about the patient’s referral and care plan. A recent Patient Satisfaction Survey regarding the FWW service has highlighted positive patient feedback:

“I’m confident that a doctor gave a thorough examination of my condition. Her manner was professional and friendly. I am impressed and pleased that my needs have been carefully monitored!”

“I found visit and phone calls from the doctors, who were able to read my daughter’s notes very helpful. They did their best to make my daughter comfortable as she felt so sick.”

For the 26 GP practices making referrals, it has increased efficiencies by reducing the time spent completing referral information, printing and sending paper, and reducing the associated administration costs.

Feedback from clinicians delivering care has been positive and many were surprised how easy the RIVIAM FWW service was to use. They can easily manage their diaries, appointments, rebooking and discharging patients while they are out and about.

“RIVIAM’s flexible approach has meant we have been able to incorporate user feedback into the design of FWW from the outset. Working together we carefully customised the intelligent referral, outcome and discharge forms to optimise benefits and to help us collect the right data so we can report on the success of the service.” Amanda Simpson, Project Director, BEMS

BEMS is able to monitor the Key Performance Indicators of the FWW service on a regular basis using RIVIAM's customised reports. When additional information is required for audit purposes, BEMS is able to access the Digital Care Record about a person and view a full history of referrals and outcomes.

If BEMS had deployed a paper-based system rather than RIVIAM's this would have created costs for administration time spend completing and managing information. RIVIAM's secure Pathway Hub provides a cost-effective mitigation of risk where security is a core component and all patient data is encrypted meeting strict NHS requirements. Use of RIVIAM has meant medical indemnity for each clinician has been reduced by two thirds.

The FWW service has had significant positive impact on pressures at the Royal United Hospital through reducing admissions of vulnerable patients and supporting earlier discharge for patients.

“RIVIAM has helped BEMS deliver a progressive new community service. Our investment in their secure technology has reduced the costs and improved the delivery and value of our FWW service. It's also enabled us to test and understand how secure technology can be a springboard for innovation in the way Primary Care community services are delivered.” Amanda Simpson, Project Director, BEMS

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