In conversation with…Professor Jeremy Dale, Clinical Knowledge Unit Director, Health & Care

At OneAdvanced, we provide safe and high-quality healthcare solutions that empower our customers to deliver the best possible care to their patients. And that is achievable, if we have experienced professionals like Professor Jeremy Dale, Clinical Knowledge Unit Director of Health & Care division of OneAdvanced. His skills, in-depth research, and expertise are invaluable in shaping our software solutions and delivering the best to our customers. We spoke to him to learn more about his experience, the groundbreaking Odyssey project (which is now Clinical Decision Support), and his views on the challenges faced by clinicians today.

Can you tell us more about your career to date?

My career began in the early ‘80s after completing my studies in medicine. From the beginning, I had a keen interest in general practice, which led me to train as a General Practitioner (GP). After qualifying as a GP, I transitioned into academia as a clinical academic, where I spent part of the week doing research and other part doing general practice.

My research interests have always been varied, currently ranging from investigating how screening for obstructive sleep apnea in general practices can be enhanced to exploring better communications around palliative care needs when patients shift from hospice care back to general practice. One of the major projects I worked on was the development and evaluation of Odyssey, which is now known as Clinical Decision Support. It powers critical parts of the NHS urgent care system, including supporting how ambulance services and NHS 111 cope with patient demand.

Furthermore, I am also involved in a study focusing on how general practitioners are preparing for net zero, specifically looking into the initiatives general practitioners are taking to become more sustainable.

What is Clinical Decision Support and how can it help clinicians in their day-to-day role?

Clinical Decision Support is a decision-support tool developed to support triage and access to urgent care and primary care.? It was originally developed for use by clinicians, but we have now developed versions that can be used by non-clinically trained staff and patients themselves. Its prime function is to mimic the normal consultation process between a clinician and their patients. When a patient presents a problem, Clinical Decision Support’s job is to generate a series of questions, mimicking the usual inquiry process of a healthcare professional. It then gathers all the essential information, analyses it, and produces recommended outcomes. This might include the urgency for further action, together with tailored advice and guidance for the patient.

Clinicians often face overwhelming set of challenges, including increasing workload and high expectations from patients, health services, and society. One of the significant frustrations for clinicians is the gap between the technology available to them and what they need to support their roles effectively. They often feel that they are not sufficiently involved in the choice of technology, which can directly impact their ability to deliver care.?

Combining all that together, there is a huge opportunity for us to support clinicians in an effective way to empower them to deliver the best care for patients. And that’s where technology like Clinical Decision Support system comes into the picture. Clinical Decision Support offers efficient and safe knowledge, decision-making support, enhancing the capacity of clinicians, the urgent care, and primary care who they work for to meet the diverse needs of their patients at any hour of the day.

Today, the Clinical Decision Support tool is used internationally. It is employed by several ambulance services in Australia, the national helpline services in New Zealand, and out-of-hours services across Ireland.

What were the results from a recent research project on the outcomes of using Clinical Decision Support? ?

Last year, we published the findings of a research project that explored the outcomes of using Clinical Decision Support in urgent care settings in comparison to not using it. Our study examined around 200,000 calls, many of which were initially assessed by the 111 service before redirected to an urgent care provider. We performed a comparison between the outcomes determined by the 111 service and those arrived at by the urgent care provider through an assessment with Clinical Decision Support. Our findings were quite revealing.

Significantly, about 75% of the calls assessed with Clinical Decision Support were downgraded from their original urgency level determined by 111. This includes over 90% of cases that were initially triaged by 111 as requiring care within an hour. And about 30% of calls once assessed by Clinical Decision Support system, were considered not necessary for urgent care. These cases were advised to either follow self-care guidelines or to schedule a routine appointment with their GP.

In short, the result of this research highlighted that there is huge opportunity and benefit for the NHS of using Clinical Decision Support in an urgent care setting to re-triage calls that have been referred from 111. This significantly reduces the pressure and workload on urgent care services and helps patients to get the proper care as quickly as necessary.

How does your team ensure the clinical content of your product maintains its safety?

Ensuring the clinical content of our Clinical Decision Support system remains safe is a top priority for us. There have been around 35 million calls assessed using our Clinical Decision Support tool, and we are proud to say that we have not encountered a single case of serious clinical error. This achievement is recognised in our product’s content development process having been rigorously evaluated and approved by NICE, distinguishing Clinical Decision Support as a unique accredited system. Our approach involves a continuous, dynamic review cycle for all content within Clinical Decision Support system.

We listen to our customers – we value the feedback, suggestions, and insights they provide about our system. Whether it’s a recommendation for adjusting the wording in a question, enhancing an answer, or refining a piece of guidance, we take quick action to incorporate these improvements. By releasing latest content updates three to four times annually, we always ensure that users have access to the most current and accurate information available.

We would like to thank Jeremy for sharing valuable insights with us, and for the amazing work he is doing to support clinicians and the NHS deliver better patient outcomes. Learn more about how we support our customers to benefits from modern and tailored software solutions, in conversation with Rachel Gornall.