{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:26:00Z","timestamp":1793759160767,"version":"4.6.1"},"reference-count":30,"publisher":"Royal College of General Practitioners","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"accepted":{"date-parts":[[2025,12,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ineffective care planning at the end of life carries high rates of unscheduled hospitalisation and avoidable deaths in hospital. Palliative care registration (PCR) and, crucially, care planning helps improve adverse outcomes. However, identification for registration often occurs late or not at all.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To improve PCR accuracy and uptake by developing an automated digital tool, utilising palliative care process markers, combined with clinical judgement, to identify those with palliative care needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design &amp; setting<\/jats:title>\n                    <jats:p>A primary care-based prospective cohort study in eight general practices in Wolverhampton, the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      All adults on the practice list for the general practices (\n                      <jats:italic>n<\/jats:italic>\n                      = 39 079) were included. A robotic process tool (BOT) identified those not on the PCR and with any of five palliative care process markers. BOT-positive patients were assessed by GPs for the PCR. Performance metrics for prediction of subsequent 1-year mortality were determined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 546 patients were BOT-positive, of which GPs validated 131 patients (24.0%). This subset had the highest mortality rate (48.1%) compared with: those already on the PCR (37.2%); BOT-positive patients who were not added to the palliative care register (PCR) (19.5%); and those who were non-registered and BOT-negative (0.8%) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). The new combined PCR captured 220 (35.5%) deaths, compared with 157 deaths (25.4%) in the original PCR. A \u2018digital safety-net\u2019 group, comprising those initially on the PCR and all BOT-positive patients, captured 301 (48.6%) deaths.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We developed a robotic process technique combined with GP assessment that yielded higher PCR uptake and accuracy, identifying at-risk individuals for ongoing surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgpo.2025.0174","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T16:10:11Z","timestamp":1769530211000},"page":"BJGPO.2025.0174","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing palliative care registration using an automated robotic process with clinician validation: a PRADA prospective cohort study"],"prefix":"10.3399","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2681-2877","authenticated-orcid":false,"given":"Emily","family":"Heyting","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3460-6759","authenticated-orcid":false,"given":"Baldev","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4361-9685","authenticated-orcid":false,"given":"Vijay","family":"Klaire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3030-006X","authenticated-orcid":false,"given":"Nisha","family":"Kumari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9767-2971","authenticated-orcid":false,"given":"Kamran","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5551-9561","authenticated-orcid":false,"given":"John","family":"Burrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Guest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdool","family":"Koodaruth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasadika","family":"Labutale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Mahmood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Pickavance","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2110-3411","authenticated-orcid":false,"given":"Mona","family":"Sidhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurjeet","family":"Malhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0278-6898","authenticated-orcid":false,"given":"Emma","family":"Parry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"2026110317501697000_BJGPO.2025.0174v2.1","unstructured":"Normand C May P Johnston B Cylus J (2021) Health and social care near the end of life: can policies reduce costs and improve outcomes? 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