Over the past nine or so months, staff from King’s College Hospital (KCH) NHS Foundation Trust have been working with industry partners to redesign patient journeys, deliver more personalised care experiences and improve access to services.
In this live HTN Now webcast, the team explained their journey towards implementing scalable technologies which provide patients with communications at every care touchpoint, their exploration of patient-centric solutions and the overall aim to ensure nobody is left behind by digital enhancements.
Topics covered included integrated patient flow, patient load balancing, how to avoid digital exclusion of patient groups, and the importance of patient follow-ups for future capacity.
The four speakers for this session were: Jonathan Lofthouse, Site Chief Executive at KCH, Charlotte English, Senior Improvement Lead for KCH, Kenny Bloxham, Managing Director at Healthcare Communications, and Peter Beaumont, the Sales Director for Intouch With Health.
Jonathan kicked-off by introducing the audience to the trust, which stretches from the main hospital site at Denmark Hill across much of south London and beyond, including St Guy’s and St Thomas’ University Hospitals.
“I look after the south part of our group – and five hospitals within that sector, as part of King’s College,” he explained, “we’re one of the largest university teaching institutions in the UK and operate for a number of sites – six sites across the south and south east London peninsula. We also have a substantial overseas interest.”
Speaking to us from the Princess Royal University Hospital, Jonathan sketched out the size of the trust’s coverage, which encompasses 1.5 to 1.6 million outpatient attendees per year and 32,000 patients for 36 theatres across the organisation, and serves a local population over just over 1 million, as well as up to 4 million of the South East of England population for some specific services.
Charlotte then took over the reins to guide the audience through the project timeline for the organisation’s Reset and Recovery programme, which was the main focus of the talk.
“We set up a Reset and Recovery programme across King’s,” she began, “and [our] outpatient transformation programme feeds into that overarching programme of work.”
“Our main ambition was to move to a digital by default outpatient pathway and improve our communications via digital means with our patients, and look at ways of working with third parties which could integrate together to serve a blended flow of work,” she said.
February 202o was the start-point, after the initial implementation of Attend Anywhere, to help with the continuation of outpatient activity during the pandemic, with phone appointments offered to those patients for whom it was not appropriate. This was followed by the expansion of the use of the Intouch With Health platform to add to their existing kiosks across King’s sites and offer all patients an option to be able to check-in through those or via their smartphones.
By July, Charlotte explained, they were ready to do a ‘beauty parade’ of third party suppliers and selected Healthcare Communications due to its ability to work closely with Intouch to provide the end-to-end pathway they were “striving to achieve”, with the project then getting underway properly in August.
Kenny of Healthcare Communications and Peter of Intouch With Health then jumped in to provide more detail about the pathway that the two companies collaborated on with King’s.
Kenny said they were “looking to bring together our ‘best of breed’ platforms” and created a “patient-first, blended digital and non-digital pathway”.
Visualising the digital pathway on his slides, which was working in parallel and joining up with the physical care pathway, Kenny walked the audience through the different steps, which began with an “integrated approach” that “takes the patient from referral to discharge, seamlessly, whether they are on a face-to-face or virtual pathway”.
Step one began at a familiar point – a referral and initial appointment letter, with Kenny outlining that the patient portal creates “a digital front door” for users to register all appointments in one place or utilise as they go along. He was keen to emphasise that this should be “patient choice” with forced registration often impacting adoption negatively.
“Patients can now read the hospital correspondence digitally, with a host of inclusivity tools,” Kenny added, with options including text and voice conversions in up to 99 languages, as well as the sending of letters through the post.
App scheduling and app reminders were also part of the pathway, with a bot “empowering patients to choose a slot which is more suitable for them” and either SMS or voice messages acting as reminders.
To support patients through the pathway, a remote virtual assistant that offers 24/7 access has already been deployed on the King’s website, soon to be joined by assistants on social media channels and Google Search, as well as a virtual arrival assistant with video and sound, to allow patients to speak with a professional who may be elsewhere.
Peter stepped in at this point, to add: “through our eco-system, we’ve built the ability for patients to self check-in digitally, whether that’s a face-to-face attendance or virtual appointment.”
The patient is prepped for a virtual appointment, but even face-to-face patients benefit from barcode scanners and the ability to use smart devices to check-in from outside of the hospital until socially distanced waiting is available inside the building. The technology can also ask whether patients have COVID-19 symptoms and update wait times.
“Once successfully checked-in,” he continued, “the patient can then be held in either a virtual waiting room or a physical waiting room”, with clinicians automatically notified. They were even exploring the idea of offering patients “digital magazines” while in the virtual waiting rooms, Peter said.
The benefit of Intouch and Healthcare Communications working together on this, he added, was “delivering a joined-up solution that benefits both clinician and patients alike.”
“All outpatient appointments should be managed in a similar way; whether the engagement is face-to-face, video or even phone, and by bringing all of those attendances together on a single dashboard, we can offer busy clinicians a simple and intuitive view of all of their appointments and the appointment time,” he said, before giving a brief demo of how the tech works.
The discussion then moved on to functionalities for consultations – such as camera control, screen shares, document sharing, chat functions and text to speech translation, with room and resource booking, and pre-op questionnaires through Synopsis, also part of the process.
Kenny then returned to cover patient initiated follow-ups, including advice and guidance, appointment scheduling or patient-clinician chat, as well as the availability of remote monitoring tools – such as e-forms and virtual assistants.
“We are, and fully expect, to be interopable with other remote monitoring platforms,” he said, before handing back over to KCH’s Charlotte to discuss how the project is progressing in the present.
“Despite COVID,” she said, “we’ve managed to achieve an awful lot in a relatively short space of time – at the back end of last year we did go live with our appointment reminders.”
She revealed that they had also gone live with the instant patient messaging platform, which had been used for COVID vaccinations, as well as pharmacy mediation alerts. Some sites had also deployed the patient portals and chat bots, with e-clinics starting in April.
To sum up, Charlotte said they’d had “very positive feedback from the clinicians” on the functionality of e-clinic, with 94% of patients providing positive feedback, as well. Around 113 hours of phone admin time had been saved by the chatbots on certain sites, while 96% of patients attending face-to-face pre-op went through Synopsis for the healthcare questionnaire, and over 340,000 patient messages had been sent since December.
In terms of next steps, Charlotte added that they were looking at platform expansion for Intouch so that everyone who wants to has the option to use a kiosk and that King’s was in the testing phase for the mobile application, to give patients another check-in option from their cars, as well as other initiatives such as automating appointment scheduling and AI for a patient follow-up tool.
“Everything that we’re trying to do here, we’re trying to push for what’s the art of the possible…working closely with third parties…[at] how can we use technology and push the boundaries there to really, truly provide that digital end-to-end outpatient pathway,” Charlotte concluded, before the team fielded a range of questions from both industry professionals and patients in the audience.
Watch the session below: