During our HTN Now series 2021, we heard from Dr Jonathan Behar, Consultant Cardiologist and Electrophysiologist at Royal Brompton & Harefield NHS Foundation Trust. The talk was to highlight digital innovation at the Trust, with a particular focus on digital pathways for pre-operative consent.
In his live session, Dr Behar explained, “I primarily deal with heart rhythm disturbances – so kind of like a heart electrician.
“I’ve been leading on a piece of work surrounding pre-operative consent and digitising those pathways that existed pre-COVID, to try and optimise the way that patients obtain information; how they utilise that information in the shared decision-making process.”
Discussing how the regular, face-to-face pre-operative consent pathways have been disrupted since COVID, and how patients can be better informed through access to more and clearer information, he stressed that consent does not “constitute a signature solely…it’s very much a dialogue that’s part of that doctor-patient relationship”.
He added that: “We as clinicians really need to make sure we engage with patients to ensure that they understand the material risk and how they apply to them, specifically and individually.”
He chose to highlight the well-known Montgomery v Lanarkshire case in 2015, which saw the UK Supreme Court rule in favour of a woman who gave birth to a child with cerebral palsy and said she had not been informed of the risks linking diabetes, large babies and small mothers.
Speaking of a collaboration between Royal Brompton & Harefield with the company Explain My Procedure, Dr Behar illustrated how the Trust has been harnessing the digital platforms as part of wide variety of digital and electronic strategies for improving patient understanding. For example, he explained the use of the company’s animations to show patients what will happen during procedures. Using cardio-related animations as an example, he was able to demonstrate the technology to us briefly through his presentation.
Going on to speak of a new, wider electronic consent pathway at Royal Brompton and Harefield, Dr Behar also guided us through the process, outlining features including live video consultations and links to further information, as well as confirmation of understanding at the bottom of each section, digital signatures, pre-procedural checklists and smart tablets that patients can use to watch Explain My Procedure animations ahead of procedures.
Dr Behar was also able to provide us with feedback from 51 forms, from patients that had used the video animations. He told us that:
- 92% understood what procedure would involve
- 90% understood the possible benefits of the procedure
- 90% of patients understood the risks of the procedure
- 70% of patients watched the video
- 89% felt the video helped their understanding of the procedure.
The live chat also then went on to cover the potential next steps with the technology and the wider pathway, what needs to be improved on in terms of issues such as access and inclusion, and what its limitations are and could be. This was then followed by a live Q&A session that saw Dr Behar field questions from the audience.
Check out the full video, including useful slides, below: