At our one-day Digital ICS event, Richard Wyatt-Haines, founder and chairman of HCI (Health and Care Innovations) , provided an insightful presentation on how ICSs can use digitally connected care pathways to educate and engage patients in their own care and maximise delivery of care closer to home, when equipped with the right tools and information.
Richard began by outlining his plan to share case study examples that translate to many different scenarios, applicable to “challenges that you or your ICS are facing, in terms of things like backlogs, too many outpatient appointments, and the need to move people to be able to care for them closer to home.”
To kick off the session and provide some background context into the operations of HCI, Richard said: “Traditionally, we started off using video to help patients through their pathways of care, and in doing so, we’ve identified that not only could we improve the patient journey – and ensure they are less anxious – but also that we could improve those pathways of care, and bring about significant savings in the number of appointments, length of appointments, and the cost of appointments. We’ve got some CCGs in Cornwall, Dorset, Blackpool, Sheffield, and Torbay who are really heavy users of the library and are driving the benefits out of that.”
HCI’s early beginnings, Richard stated, led to more “precise” thinking in providing effective care for patients: “From there, we created CONNECTPlus, which is a multi-condition app that really supports remote care across a patient’s full conditions, wherever they might be.”
Richard divided his discussion into four key themes:
- Why change is required at system-level and the context of the care landscape in the here-and-now
- What the challenges are that stand in the way of ICSs within their early years;
- The principles and functionalities that need to be established in preparation for ICSs to go live;
- and the possibilities and technological opportunities that are out there and available for the taking; exploring some examples from HCI’s own work.
Richard illustrated some of the problems clinicians and healthcare teams are currently facing within the management of their pathways. Using diabetic podiatry care as an example, Richard shared a short video from a podiatry care team featuring Richard Collins, Podiatry Team Lead, and Jen Williams, Diabetes Podiatrist, who cited a lack of patient responsibility in self-caring for their condition as significant challenge.
Building on the growing pressures placed on the diabetic pathway, Richard discussed the findings of National Diabetes Footcare Report: “Minor amputations are growing. We have a growing pressure that we have to do something about. We can’t have people going into hospital; we can’t be operating; it’s not right for the system and, fundamentally, it is not right for the patient. None of us want a minor foot amputation, I have got to say.
The report, Richard asserted, highlights that “many foot-related complications are preventable if identified and treated early. NICE (National Institute for Health and Care Excellence) says speed up the care pathways, minimise the delay for first expert assessment, do annual foot checks, and educate patients and their family members on foot problems and care pathways.”
Moving onto problems faced within the paediatric neurodiversity pathway, Richard discussed the barriers in the way of children and families in receiving acceptance for assessment by paediatric teams: “What we know is that we’ve got these referrals coming: a mixture of ASD, ADHD, and other things. We know that over half of the families that are presenting have previous safeguarding issues. This is a really challenging area.”
Significant challenges, Richard noted, can also be observed within overflowing waiting lists. “If you look at an average paediatric neurodiversity team, there are over 40 referrals a week, they are all handling waiting lists over 1,550, there are trusts around the country where they have exceeded 2,500.” For the few families that do manage to see a paediatric team, however, “26 percent of them are turned down almost immediately because they are outside of the criteria.”
Richard then placed the obstacles faced by specific clinical pathways into the broader context of pressures affecting the wider healthcare system, namely the “healthcare capacity” challenge. “Demand for healthcare outstrips supply. That is going to be thus for a good while yet. You might be able to change it in your ICS, but long-term that’s not going away. So, we have to find new ways of operating. We live in a different era: we know we have an ageing population, who are living less healthy lifestyles, and fundamentally, these people have more multi-morbidities,” Richard said.
“15 million people, a quarter of the population,” Richard explained, “have two or more multi morbidities. 4.7 million have four or more, and the exponential cost of each condition you add on there is massive.”
Richard moved on to highlight the importance of digital remote care in supporting ICS teams to address the rising complexities of capacity challenges by removing patients from “the most expensive acute care” settings. Richard said: “It’s about getting people living at home independently, self-managing as much as possible, even if it’s supported at home. The cost is lower, but the truth is and the quality of life for the patient is better.”
Focusing his discussion on the art of the possible, Richard discussed the need for digital remote care and its functionalities to be built with the requirements of the patient in mind.
Richard spoke of the importance of providing patients with relevant and engaging information to support with self-care: “What we know is that they need information to help them self-manage. The concept of handing out some dreadful old leaflets that repeats itself is not tenable in a digital age. It’s just not acceptable in that way. They need information. if we can give them information in an effective way, in an accessible way they will get on and self-manage. They will be empowered.”
Other essential functionalities, Richard stated, include symptom tracking so that healthcare professionals can intervene with precision: “when we give patients access to that information, they self-manage more effectively because they can see what’s going on with their disease, and they can correlate the concept between a change in diet, or drinking habit, or activity.”
Rounding up his presentation, Richard said, “Hopefully what I’ve done is to show ways in which you can do [this] as an ICS, ways in which to think about it, ways in which you can think about the key issues that you need to address, and you can pull that together… there are solutions out there that can happen, and that I’ve shown some of the features and functionalities of those tools that you need to consider to make this a practical reality.”
Finally, Richard took questions from the webinar. The question and answer session starts from 40:00 on the video below.
Many thanks to Richard for his time. The webinar can be viewed in full here: