The final session of our latest HTN Now Focus event, which tackled a number of topics related to electronic patient records, saw Vijay Magon of CCube Solutions conclude the day with a presentation on empowering patients to help with the growing NHS backlog.
The webcast explored challenges such as managing patient flow, ensuring that patient information is available at the point of need, supporting remote consultations and virtual clinics, and improving patient engagement in the delivery of care through Patient Initiated Follow Up (PIFU).
“We have a long and established record in secondary care, within the NHS. We help trusts and health workers to manage and deliver patient information at the point of care,” explained Vijay, Managing Director at CCube.
Focusing on the growing NHS care backlog, he added, “we’ve all seen the headlines…about the NHS waiting list…those alarm bells are further compounded by depictions of the numbers of patients actually waiting to be treated. That’s the kind of problem that’s facing the NHS and there are many issues that need to be looked at, in terms of tackling that backlog.”
On the session, he explained: “Today we’re going to be focusing on the waiting list problem, which is increasingly in the public domain. How do we achieve the management of outpatient flow? We’ve been looking at this very closely over the last several months.
“There are, essentially, three key players that we want to address and who need to be brought together, to address this issue. The first one is data – you may have a lot of data sitting in different active systems, maybe not talking to each other, but it’s there. The second one is the customer, or the patient, who wants to help with their care. The third key player is, of course, the carer – the health carer who wants to be able to find a way of quickly getting information to the right patient.”
“Keeping in mind that the patient is home-based, the clinician is home-based, and the data may be sitting somewhere else. How do we actually connect of all these in a seamless fashion?”, Vijay asked.
“The patient now has access to applications, particularly smartphone-based apps – how do we make it easier for them to connect with the complex dynamics between IT systems and healthcare service providers, who are busy connecting their day-to-day tasks with the available IT data, within a trust or health board?”
“We have access to APIs [Application Programme Interfaces] that can be used to now connect the patient, who is outside both of those firewalls,” he said, “and the clinician may be outside of those firewalls and working from home [too].”
“The point really,” he continued, “is that we have a lot of data, we have systems, we have the players who need to use data to help them effectively get through the backlog.”
On CCube’s vision and application regarding this, Vijay commented: “We’ve been looking at a lot of apps and the distinction, really, is that you can go to a laptop or desktop and open up a page, and the patient can use an application to connect with their service provider, and manage their appointment. A patient can view the appointment and use the application to submit request changes to the appointment, cancel an appointment, and so on.
“Those requests, once submitted, then have to be tracked through the application to make sure that the right action is taken, and the outcome is communicated back to the patient. Given the fact we’re all now used to using smartphone apps to do all kinds of things in our daily lives, it’s quickly moved on to allowing the patient to make changes and set up PIFU – what we call Patient Initiated Follow Up Pathways.
“If I want to request a change and deal with the processes to do with my care, I can actually initiate a PIFU pathway to the app and make sure that the care team at the other end are connected through it. I want to be able to communicate but also record information – weight, blood pressure – and be able to submit that to the team while I’m stuck at home.”
“With these kinds of tools that are now being made available,” Vijay stated, “we think there are a lot of potential benefits…we want to make sure patients are able to have two-way access to be able to provide relevant information…a lot can be gleaned between opening up the data gateways between the patient and trust.”
On back end processes that can also be of use, Vijay continued: “Talking to a district general hospital, for example, we’ve estimated that it costs around £1 in postage, stationery or labelling to send a letter to a patient in the UK. The average hospital is going to be sending out close to 1 million outpatient appointment letters per year. It takes two or three letters to chase and confirm and progress. So the actual number of letters is a lot more.”
To tackle this, Vijay added: “Once you have a patient connected to a portal using a smartphone app, there’s potential for getting rid of that cost very quickly. Patients can be kept notified about the appointment and any delays, as well as the journey to the appointment, to avoid patients waiting outside clinical areas. By keeping the patient informed through communication, the patient can actually help in the delivery of their care.”
“Some of this is not new,” Vijay said, “we’ve been working with a lot of trusts and health boards in secondary care, up and down the country, making sure their patient information can be captured, managed and delivered at the point of need, in a timely fashion. Regardless of the geographical location of the user and patient.”
“We’re now looking at how we can improve the engagement of the patient in the delivery of their care…we’re currently looking at managing 490 million patient records for about 33 million patients,” he said.
“The key point is that the average daily use is 16,500 users of our systems every day…use of digital patient information is not new. Currently it is being widely used but [the question is] how can we now connect the patient to their own data and make it easier for them to engage?”, he concluded, adding that a number of projects are currently being trialled and could be ready by the start of 2022.
Catch up on the full session with Vijay below: