Growth presents as many challenges as it does opportunities – so having IT that evolves fast enough to keep pace is essential says PrivateDoc.
Suffolk-based online medical clinic PrivateDoc has just received a “good” rating from the Care Quality Commission – a fantastic result after having been told to improve after a previous inspection. The key to the change was evolving IT systems, with an agility that has lessons for every business.
“We’d had the growing pains of a scaling business,” admits founder Paul Marshall. “We had an excellent patient experience evolving, but some of the checking and the highlighting elements were on the edge – and those pulled us over... While 99pc of cases went through just fine, it was the 1pc of exceptions that caused us problems.”
These were, at root, caused by human error as the volume of orders increased – highlighting how the systems had to change to cope with the growth of the business. “You have to do it in a scaleable way, otherwise you just end up throwing bodies at it,” says Mr Marshall. “We’ve had to streamline the business, thinking about the needs of the clinicians and the safety features. We’ve had to automate a lot of the safety features.”
For the crucial identity checking and address verification stages, PrivateDoc wrote fresh algorithms capable of checking records far better than a human ever could. However, there were still stages requiring human intervention. “You can only plan for scale. What you can’t plan for is people’s mistakes,” cautions Mr Marshall. “But you can think around those issues and work out how you can help that person not make a mistake.” The solution was to build check and alert mechanisms into the system, to trigger the correct actions at the right moments. “It’s about bubbling information up to people in a need-to-know manner,” Mr Marshall says. The changes resulted in across-the-board Good ratings from the CQC, with the report noting: “The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.”
However, the reality is that the systems have been constantly and rapidly evolving – and the structure of PrivateDoc now is very different to how it looked when the business started in 2007. “If we tried to put the volume of patients we have today through PrivateDoc as it was then, it would have taken ten times as many people,” says Mr Marshall.
The key to the growth has been the rapid deployment of software to meet the needs of the expanding business. “When I started in IT 20 years ago, you could work on a project for six months and by the time we were ready for release, it was already out of date,” says Mr Marshall. “Now, at PrivateDoc we probably have two or three releases a day.”
This is possible because, rather than having an existing business with a web-capability bolted on, PrivateDoc has been engineered with the agile IT in mind. “We don’t need to release the whole system,” explains Mr Marshall. “We have the public facing website, the consultation journey, then the back office. It’s all broken down, so I can do release for any part of it – or for all of it. We have that agility.”
The key has been developing robots to do the deployments. “It might take a couple of hours if you did a release manually, but it can take a week to automate that process,” says Mr Marshall. “But having invested that time, you can just press the button and walk away. We’ve invested that time up front and now we’re reaping the benefits.”
It means every system can be improved – based not only on feedback from the regulator but also from the users. To satisfy the CQC PrivateDoc built in a callback dashboard to ensure patients were called back within an hour and records of the calls were properly logged; but when one of the clinicians noted that it would be good to be able to schedule calls for a future period, that was built into the system and released within a matter of hours.
It’s not only users within the business that can shape the system: customer feedback can be taken into account as well. “It means constantly engaging the user, because if they can steer the ship you can change direction very rapidly – like a speedboat rather than an oil tanker,” concludes Mr Marshall. “That’s what agile IT is all about.”
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