Symptom Checker Healthdirect Australia’s latest service offering for

consumers

Maureen Robinson

Background

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• 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!)

Objectives

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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.

Adaptation to Australian Context

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• 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

Monitor head

injured patient for

2 days - UK

1 day - AU

Complex

Significant research AU

standards / guidelines.

Significant discussion with UK re

inclusions in Gap

eg Bites and stings – multiple

inclusions

eg Mental Health – completely

rewritten.

Moderate

Different care advice to UK.

AU research into local

guidelines and standards.

Discussion with UK re inclusion

in Gap and content.

eg Hydration advice for adults

and infants

Adaptation to Australian Context

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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

Clinical Governance

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• 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

First release

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• Head injury

• Abdominal Pain - Adult

• Abdominal Pain – Paeds

• Chest and Back Pain

• Colds and Flu

• Joint pain and swelling

• Diarrhoea and Vomiting –Adult

• Diarrhoea and Vomiting –Paeds

• Hay fever and minor allergies

• Wounds

• Breathing problems

• Limb injury

• Leg pain

• Burns scalds and electric shock

• Back injury

• Bites and stings

• Chest injury

• Pregnancy problems

• Rashes and skin problems

Remainder

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• Collapse

• Confusion

• Contraception enquiry

• Dental problems

• Diabetes

• Dizziness and light-headedness

• Earache

• Eye problems

• Facial injury

• Female sexual health

• Foreign body

• General illness in adults

• General illness in children

• Headache

• Male sexual health

• Mental health

• Mouth problems

• Neck pain

• Nosebleed

• Rectal bleeding

• Swallowed/inhaled object or substance

• Urinary problems

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……………………………plus

Fever

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Usability 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

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Entry Point The host healthdirect website

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Screen One Landing page

Before After

Key points

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• 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

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www.healthdirect.gov.au

Thank You

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Maureen Robinson General Manager Clinical Governance, Healthdirect Australia

Email: maureen.robinson@healthdirect.org.au

Phone: 02 9263 9011

Symptom Checker: Healthdirect Australia’s latest service offering for consumers