Evaluating the Efficiency of an Automated Pathway for Obstructive Sleep Apnoea Therapy Through a Digitally Enabled Workflow: An Observational Research Study

OBJECTIVES: This study assesses the efficiency gains from implementing clinician-facing digital software that enables remote therapy initiation and management for patients with Obstructive Sleep Apnoea (OSA). It evaluates the effectiveness of this intervention in reducing administrative burden, improving clinical workflow, and enhancing overall efficiency at both the service- and system-levels within England’s Integrated Care Systems (ICS).

METHODS: An observational design was used to compare pre- and post-implementation metrics of the digitally enabled pathway using time and motion studies. Clinicians were observed during routine tasks such as telephone consultations, ordering patient kits, answering inquiries, and updating software, including 30-day follow-ups. A total of 139 patients were referred by England's Southwest Integrated Care Board (ICB). The findings were analysed using a Student's t-test.

RESULTS: Operational Efficiency: Pre-intervention, clinicians required 40 minutes per patient for administrative tasks over 8 weeks. Post-implementation, this reduced to 1.3 minutes per patient over 4 weeks, saving 38.7 minutes per patient, a significant 97% reduction (p<0.001). This equates to an annual savings of £87,000 and 2.6 FTEs, thereby enhancing efficiency and workforce management. Service Performance: The pathway significantly improved access to care, with 20 patients being set up over 8 weeks pre-implementation, compared to 119 patients over 4 weeks post-implementation, representing a sixfold increase in the number of patients seen in half the time (p<0.001). This improved service performance and reduced therapy initiation backlogs. Sustainability: The digitally enabled solution for remote patient setup saved more than 470 patient journeys, equivalent to reducing CO2 emissions by 1.5 tonnes, demonstrating environmental benefits.

CONCLUSIONS: This study provides robust evidence of the benefits of integrating automated, digitally enabled workflows in OSA therapy initiation. Key outcomes include:

- Enhancing access to care by reducing waiting time from diagnosis to treatment initiation

- Optimising clinic capacity by reducing time spent on administrative tasks

- Improving environmental sustainability by minimising unnecessary travel