Symptom Checker Healthdirect Australia's latest service offering for consumers Maureen Robinson
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Symptom Checker
Healthdirect Australia’s latest service offering for
consumers
Maureen Robinson
Background
• Long time requirement of funding agreement
• Researched various options
• Study tour to UK to review NHS Direct HaSCs
• Licenced – early 2013
• 41 HaSCs
• Undertaking an “English to Australian” translation
• Went live with 19 in early July
• Remainder over following 9 months
• (Plus one!)
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Objectives
To provide, safe, effective, appropriate, consumer focussed, accessible advice to
the general public about health and symptom management.
“Empowering Australians with trusted answers to their health questions”
• Guide people to an appropriate level of care
• Provide reassurance for users
• Improve health literacy by providing a clinically robust, web based service
• Add value to people’s efforts to manage their health and health problems
• Provide some assistance to people who are geographically isolated.
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Adaptation to Australian Context
• Evidence Review and Gap Analysis
• Undertaken by NHS Direct
• Based on list of Australian authoritative sites
• Eg: NHRMC, NICS, DOHA and Content Partners, eg Cancer Council, Heart Foundation,
Professional Colleges
• Focus on guidelines rather than underlying evidence – basis of healthcare professional advice
Simple Moderate Complex
Monitor head Different care advice to UK. Significant research AU
injured patient for AU research into local standards / guidelines.
2 days - UK guidelines and standards. Significant discussion with UK re
1 day - AU Discussion with UK re inclusion inclusions in Gap
in Gap and content. eg Bites and stings – multiple
eg Hydration advice for adults inclusions
and infants eg Mental Health – completely
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rewritten.
Adaptation to Australian Context
Clinical Assessment Panel
• Currently 30 members
• Every panel consists of – ED physician, GP, ED nurse, Pharmacist, Paediatrician, Ambulance
rep,
• Some panels also include SME’s. Some SME’s include
• Sexual health nurse * Midwife * Obstetrician
• Urologist * Psychiatrist * Mental Health Nurse
• UK review - Some acceptance of risk
Disposition review
• Dispositions are the end point – the recommendation of appropriate care.
• UK -120 – so far 30 in AU
• Expect to have more as we progress through to specialist dispositions.
• Reduced due to context of AU health system
• 9 UK call backs reduced to 1 in AU (ring - healthdirect)
• Speak to your GP
44Clinical Governance
• Content development – clinical expertise
• Editorial to ensure consumer readability and useability
• Clinical Integrity Checking
• Logic flows
• Clinical content accuracy
• Endpoint/dispositions
• Correct self care advice attached to disposition
• Ongoing
• Documentation and control
• Evidence updates
• Continuous clinical review
45First release
• Head injury • Breathing problems
• Abdominal Pain - Adult • Limb injury
• Abdominal Pain – Paeds • Leg pain
• Chest and Back Pain • Burns scalds and electric shock
• Colds and Flu • Back injury
• Joint pain and swelling • Bites and stings
• Diarrhoea and Vomiting –Adult • Chest injury
• Diarrhoea and Vomiting –Paeds • Pregnancy problems
• Hay fever and minor allergies • Rashes and skin problems
• Wounds
46Remainder
• Collapse • General illness in adults
• Confusion • General illness in children
• Contraception enquiry • Headache
• Dental problems • Male sexual health
• Diabetes • Mental health
• Dizziness and light-headedness • Mouth problems
• Earache • Neck pain
• Eye problems • Nosebleed
• Facial injury • Rectal bleeding
• Female sexual health • Swallowed/inhaled object or substance
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• Foreign body • Urinary problems……………………………plus
Fever
48Usability Testing
Testing with prototype semi-functional designs
Objective test usability of the online interface
Scope both desktop and mobile interfaces
Method professional UX testing organisation
participants set tasks by facilitator to be performed using prototype Symptom Checker tool
user screen interactions and eye movements were recorded
Sample 18 participants mix of males and females (7 males, 11 females)
some being parents of children under 8-10 (4 mothers, 5 fathers)
some Aboriginal/Torres Straight Islander-origin (3)
some from a mix of cultural backgrounds (including Chinese, Belgian, Indonesian,
Romanian, Indian, Russian, Aboriginal, Uruguayan)
mix of age ranges (3 aged 18-29, 8 aged 30-50, 7 aged 51-80)
from CBD, suburban and regional locations
Results grouped: Conceptual, Content, Feedback, Goal-based Issues, Navigation/Interaction, Terminology, Visibility,
Performance Support
Score issues identified: 7 high priority; 15 medium priority; 22 low priority
overall this test was positive: concept was very well received, and generally worked well for everyone; however
issues identified showed design needed some design refinements 49Entry Point
The host healthdirect website
50Screen One
Landing page
Before After
51Key points
• Not a diagnostic tool
• Not a replacement for face-to-face consultation
• Does not undermine or compete with relationship a GP has with their patients; aimed at enhancing
this.
• Good clinical information, that will safely direct patients where they need to go
• User friendly and with assurance that the information they get from the internet is accurate, safe
and clinically sound
• Works with the principal of a patient's “medical home”
• Encourages a person to help themselves where appropriate, but also to discuss and involve their
"usual GP" where ever possible and appropriate
• Aimed to work with GPs, not as a substitute to GPs
• Encourages consumers to take responsibility for their health and improve health literacy 52www.healthdirect.gov.au
53Thank You
Symptom Checker: Healthdirect Australia’s latest service offering for consumers
Maureen Robinson
General Manager Clinical Governance, Healthdirect Australia
Email: maureen.robinson@healthdirect.org.au
Phone: 02 9263 9011
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