Revolutionising
Emergency Eye Care
Dr Andrea Jester, Clinical Lead Hand and Upper Limb Service at Birmingham Women’s and Children’s NHS Foundation Trust, explains how a new AI-powered triage system called TriVice has transformed plastic surgery services. This case study explores how automated triage is changing the game for clinicians and patients alike, offering a model for modernised triage across every NHS specialist department.
The Challenge: Triage Bottleneck
1. Pre-TriVice Situation Before the system was rolled out in 2022, trainees were fielding up to 80 phone calls during the 24 hours they might be on call. Instead of focusing on their patients, they were waiting on the phone, chasing information, or trying to identify and track down an appropriate specialist.
2. GMC Feedback When trainees started to raise red flags, the GMC fed back to us that we had to do something urgently to address the situation, says Dr Jester.
3. Analysis of Referrals When we looked at the types of referrals we were having, we saw that at least two-thirds could have been dealt with by an intelligent system rather than a human being.
The Solution: Automated Categorisation
1. Automated Categorisation
TriVice categorises the incoming information, tells the registrar what needs to happen next, and directs appropriate communications, guidance and assistance to the relevant healthcare professional, external services, and the patient themselves.
2. Comprehensive Communication
The system handles communications up to and including appointment reminders and outcome questionnaires.
3. EPR Integration
It is also fully integrated with the trust’s EPR (Electronic Patient Record) system, so that data including images is automatically fed in.
4. Peer-Reviewed Care Pathways
One of the most important aspects of TriVice is the creation of peer-reviewed care pathways by senior specialists– in this case Dr Jester, and as the system is extended across other departments, experienced clinicians in those areas.
Benefits for Clinicians
1. Time Efficiency:
“I’m too expensive a resource to sit at a computer and direct patients to whichever clinic is best” says Dr Jester. With TriVice, clinicians, health professionals, occupational therapists, physios– they can all do what they’re trained to do: treating the patient. No triaging referrals!
2. Widespread Adoption:
We now have over 12,000 clinical users across the region.
3. Flexible System:
Dr Jester praises the system’s flexibility, citing an example where they needed to quickly change patient messaging due to building work. Within 24 hours, the change was implemented, ensuring patients received accurate information.
Benefits for Patients
1. Reduced Travel:
Patients with less serious injuries can often be treated equally well in the primary care system. TriVice has signposted 36% of cases to be treated in local care settings, significantly reducing the amount of travel for patients.
2. Prioritised Care:
By directing less serious cases to local care settings, Emergency Department staff can prioritise their time triaging more serious injuries.
3. Clear Communication:
The system sends out notifications for surgery, providing clear instructions on what to do, what to wear, and where to go including directions.
4. Expert Guidance:
“The thing is, if you want platinum care by the best possible specialist, that person can give you the best advice and guidance” says Dr Jester. “With TriVice, you know that while the system is not a human being,
the guidance comes from top specialists.
Implementation Process
1. Development
It took around 18 months for Capri and Dr Jester’s team to develop and fine-tune TriVice for the department.
2. Onboarding
After development, the team focused on onboarding TriVice for the department, ensuring smooth integration with existing systems.
3. Continuous Improvement
Dr Jester emphasises the trust’s strong relationship with Capri as a critical factor in the implementation. As a system provider, Capri has always responded quickly to requests for fixes.
Implementation Process
10 Minutes per Referral Post-TriVice
60 Minutes Saved per Referral
82 Hours Saved per Clinician Monthly
£79k Cost Savings per Clinician Annually
x7 Faster Referral Processing Speed
1.13 Tonnes CO2 Reduced per Specialty per Year
Reduction in Referral to Treatment Time
The pilot case in Plastics clearly demonstrates the reduction in referral to treatment time (RTT) and enables centres to give equity in speciality specific evidence-based guidelines.
Conclusion: A Model for NHS Modernisation
Challenge:
Inefficient manual triage
Overwhelmed trainees
Limited specialist access
Solution:
TriVice automated system
AI-powered categorisation
Peer-reviewed care pathways
Outcome
Time and efficiency savings
Focus on patient care
Expert guidance for all
Greenfield opportunities for IT development are scarce in the NHS but where they do exist, the replacement of a legacy manual system with a digital platform built from scratch can deliver significant benefits for clinicians and patients. The success of TriVice in the Department of Plastic Surgery and Hand and Upper Limb Surgery at Birmingham Women’s and Children’s NHS Foundation Trust offers a model for modernised triage across every NHS specialist department.