Dr Satya Raghuvanshi, VP of Clinical, Accurx
A recent poll by HTN asked readers which challenge in health and care they thought should be the biggest priority – 60% said “revolutionising patient flow”. Clearly it’s a hot topic, and for good reason. Patient flow, i.e. the speed and efficiency in which a patient moves through the healthcare system, has become incredibly challenging and fragmented in recent years. This is contributing to some of the biggest challenges faced by the NHS today, like the elective backlog.
If we take one of the final steps in a patient’s journey through the system as an example – discharge out of hospital – there are lots of different steps and activities involved. A discharge coordinator needs to be able to access patient information and quickly communicate the patient’s next steps – to the patient themself but also any carers, family members and other healthcare professionals involved in their care. The ward pharmacist may need to verify the patient’s take-home medications, and referrals to community or social care may be required for continued treatment and ongoing support after discharge. The medical team will also need to inform the patient’s GP of the discharge and the treatment plan, and the patient may need to be given a way to get in touch with the hospital in case anything with their condition changes, for example through Patient-Initiated Follow-Up (PIFU).
But discharging a patient from hospital is just one small part of a patient’s journey of care, and despite appearing to be a linear pathway, we know the reality of discharging patients into the community is often complex. Fragmented and poor communication both with patients and their families or between healthcare professionals can exacerbate these pathways, making ‘patient flow’ feel even more broken.
We’ve seen that simple tech like SMS messaging with patients and improved healthcare professional to healthcare professional communication can be easy to implement and simple for both healthcare teams and patients to use for coordinating care – even when resources and capacity are limited. Of course it’s not a silver bullet and bigger interventions like investment in social care and plans to retain and support overstretched staff are desperately needed. However, better, faster communication methods that make patient flow easier can make a world of difference during resource strapped times and limited bandwidth for innovation.
So how do we think patient flow can be revolutionised, using Accurx across the system?
Once a patient is ready to be discharged, a text message can be sent to their carer or family members including NHS advice and care plans in a secure digital attachment. This means patients and carers can easily refer back to advice and information in one place. Two-way messaging can also be used to easily contact a patient’s carer and plan for a patient’s care. At Accurx, we’ve seen occupational health teams request photos of the home environment and descriptions of equipment available. This helps to determine what equipment the team needs to take for home assessments, or whether the patient will have everything they need to support their recovery outside of hospital. If photos aren’t enough, video consultations can be used to make quick assessments of home environments.
Follow-up reviews can be done through two-way messaging with patients or their care teams, for example through requesting patient responses to messages so they can send text or photos. Alternatively, clinically validated structured data capture via questionnaires can be sent, to monitor a patient’s ongoing symptoms and recovery. Clinicians can also share links to Patient-Initiated Follow-Up (PIFU) with patients via SMS, to help support them to initiate their own care with hospital teams when they need it.
Clinicians can further monitor patients by requesting information about their condition through questionnaires and monitoring forms, which allow them to triage and manage requests quickly and seamlessly, often without the need for a face-to-face appointment.
This is just one example of thousands of patient stories that could be different if we truly start to harness the power of technology and introduce these simple tools across the system that power better communication.
But what do system leaders think?
At Accurx, we believe in working closely with patients, frontline healthcare staff and customers, to understand their views so that our software genuinely works. That’s why at ConfedExpo in June in Manchester, our Partnerships Leads, Polly Platts and Rosie Watson, ran a workshop on patient flow, in partnership with our customers at South Yorkshire ICS; CCIO and Innovation Lead Richard Cullen and Director of Digital Katie Dowson.
In the workshop we asked participants to reimagine the four different stages of a fictional patient pathway, thinking big about how technology can move them through the system more effectively. We were grateful to be joined by nearly 200 colleagues from across the system, including Directors of Strategy & Planning, Digital Transformation Clinical Leads, Service Managers and CIOs, who came up with some fantastic ideas to help improve patient flow through the system, for example:
- Tech to enable more proactive care so conditions are picked up earlier
- A patient facing app that would inform a patient of their progress along the referral journey so they feel informed on the entire process and can view standard timelines for getting an appointment, as well as surface information on who to contact about appointments
- A dashboard for GP practices, so they can see how their patients are moving across the pathway, who is involved in each stage and what has happened, so all healthcare professionals involved in care are up to date and can communicate with each other
- Prompts that could connect a patient to services like volunteer drivers or carers, so they can make arrangements in advance for hospital appointments
- Appointment reminders to ensure that patients are more likely to attend their hospital appointments and are given any information to prepare, to reduce the risk of DNAs
It was fantastic to hear all of these suggestions from the room, from complex interventions to relatively simple fixes that could be put in place quickly. Taking a step back, the clear thing that connects these answers, and Accurx’s thinking, is that good patient flow demands easy collaboration, communication and information sharing between and within multiple care settings, and to patients and their families. Of course, there are other pieces of the puzzle, like workforce planning, population modelling and transforming operational processes. But tech can and should be an incredibly strong lever in improving and supporting the system to remove blockages for staff, so that they can genuinely revolutionise patient flow.