Understanding desp pain points (#313)

Create understanding-desp-pain-points

Author: HarleenKDhillon

app/diabetic-eye-screening/2025/12/understanding-desp-pain-points/index.md

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+---
+title: Understanding Diabetic Eye Screening providers (DESP) pain points 
+description: What we learned from two co-design workshops with Cohorting as a service (CaaS)
+date: 2025-12-12
+author: Harleen Kaur Dhillon
+tags:
+  - discovery
+  - cohort manager diabetic eye screening
+---
+
+To ensure our evolving ideas were grounded in operational reality and reflected the needs of those delivering diabetic eye screening on the ground, we worked with cohorting as a service (CaaS) to host two focused workshops with diabetic eye screening providers (DESPs). These conversations helped validate current assumptions, illuminate the challenges providers face day-to-day, and highlight opportunities for more sustainable and scalable improvements.
+
+Across both sessions, we centred the discussion around three core themes:
+
+1.	Understanding DESP operational pain points
+2.	Exploring barriers to efficient data flow and reporting
+3.	Identifying solution directions that could meaningfully reduce burden
+
+## Key themes from DESP engagement
+
+### 1.	Operational pain points and workflow friction
+
+### Disconnect and unreliable systems
+
+-	The disconnection leads to unnecessary duplication, higher administrative burden, and increased risk of error, especially when data must be transferred manually. In addition, DESPs noted that the data within these systems cannot always be fully trusted. Providers often find inconsistencies in patient demographics, diabetes status, GP registration details, and screening history. As a result, staff must spend additional time cross-checking information, chasing missing details, and confirming whether the data reflects the patient's current situation.
+- The unreliability of information has further downstream effects: incorrect or outdated patient records may trigger inappropriate invitations, missed screenings, or delays in contacting patients who genuinely need intervention. DESPs described this as a source of daily friction, forcing teams to compensate for system shortcomings through manual workarounds and repeated validation steps that divert time away from clinical and patient-facing priorities.
+
+### 2. Data flow, quality, and integration gaps
+
+- DESPs consistently raised concerns about incomplete or inconsistent data coming from GP systems, particularly where coding practices vary widely.
+-	Some programmes expressed uncertainty around the "source of truth" for key patient information-diagnosis dates, activity status, and clinical exemptions.
+-	Several DESPs emphasised that data lag-such as delayed updates to patient records or GP handover processes-undermines cohort accuracy and results in misaligned patient lists.
+
+### 3. Opportunities for potential solutions
+
+-	DESPs welcomed the idea of a clearer, standardised mechanism for validating patient eligibility, reducing the need for ad-hoc confirmation processes with GPs.
+-	There was support for exploring a shared or centralised data view, enabling DESPs to access near-real-time information on patient status without relying on multiple systems.
+-	DESPs expressed strong interest in automated prompts or guidance to help flag inconsistencies (e.g., mismatched diagnosis data, missing identifiers, incorrect activity status).
+-	Participants emphasised that improvements must be practical and lightweight, avoiding any solution that adds steps or additional administrative burden.
+-	Pain points varied between programmes, but many agreed that standardisation across regions-whether for data formats, codes, or update pathways-would reduce variation and improve accuracy.
+-	DESPs suggested the value of applying pregnancy flags to pregnant participants to support more frequent and appropriate screening.
+
+## Additional insights from the workshops
+
+-	The concept of a feedback loop between DESPs and GP systems was widely supported, provided it reduces rather than increases workload.
+-	DESPs emphasised the importance of capturing contextual information such as mobility issues, language needs, pregnancy status, and safeguarding considerations, all of which affect screening pathways.
+-	DESPs highlighted any new coding or admin requirements unless they are accompanied by clear national guidance and consistent GP engagement.
+-	Many DESPs felt that technology alone will not fix underlying issues without aligned incentives and shared accountability across the pathway.
+
+## How this is informing our next steps
+
+-	We are incorporating DESP feedback into our option development, ensuring that any proposed solution directly addresses the operational pain points raised in the workshops.
+-	We are assessing the feasibility of a centralised or semi-centralised repository, with the potential for DESPs to access and contribute to accurate, up-to-date patient data.
+-	We are exploring the potential design of a bi-directional data flow model, enabling cleaner, more consistent updates between GP systems and DESPs.
+-	We are prioritising opportunities for workflow simplification, particularly where automation or standardisation could meaningfully reduce manual administrative work.
+-	Insights from the workshops will inform the refinement of potential MVP scope, ensuring it remains both desirable to DESPs and operationally deliverable within existing constraints.