We are pleased to share the Health Tech Awards 2022 finalists in the category of ‘digitising patient services’ are…
Alder Hey Children’s NHS Foundation Trust
Overview: Alder Hey Children’s NHS Foundation Trust designed an online Symptom Checker to support children and their families, so that families can determine which service is suitable for their needs.
Why? Following the pandemic, Alder Hey noted a rise in emergency department attendances, with figures rising to over 113 percent of those seen in 2019.
What happened? Alder Hey began a programme of work to analyse this data and to implement changes in how patients were managed upon presenting in the emergency department. The analysis showed a clear pattern in the increase in attendances, with a disproportionate number of patients triaged as ‘green’, indicating that many could be seen by services other than the emergency department. Alder Hey built an online Symptom Checker to reduce unnecessary attendances, with the aim of reducing the number of green triages by 10 percent and improving family experience by 20 percent. The initiative has been hugely successful, with over 81,000 views of the web-based tool since the launch. Feedback shows that parents and carers rated the tool at an average of four out of five in usefulness, and over 92 percent said that they were likely to use it again.
Looking ahead. The Symptom Checker was recently showcased in a national urgent care visit, and as a continuous development, it can be adapted to reflect patient responses.
Midlands Partnership NHS Foundation Trust
Overview: Midlands Partnership NHS Foundation Trust (MPFT) piloted an electronic prescription system (EPS) with NHS Digital and CLEO Systems, digitising the paper process of sending prescriptions to pharmacies.
Why? The digitisation enables improved patient choice, increases patient safety and contributes to sustainability.
What happened? MPFT worked with NHS Digital and CLEO Systems to implement the EPS; before the EPS, clinicians were handwriting prescriptions and patients often had to travel to collect them. MPFT received feedback asking for a solution and used continual communications with clinicians and patient feedback to shape the direction of the EPR pilot. The pilot consisted of 24 prescribers using the system, which generated 1073 electronic prescriptions, avoiding postage and travel costs. Other services within MPFT were encouraged to see the EPS system and its benefits and these services were added to the deployment list to be on-boarded due to recognition of positive benefits. The pilot has resulted in reduction of time for clinicians in prescribing, travelling time, increased patient safety and removed potential risks such as lost or stolen prescriptions, or illegibility of handwriting.
Looking ahead. An interface is being created between EPS and the main clinical system following the pilot, to allow clinicians to have access to one record that will show all prescribing history.
Royal Cornwall Hospitals NHS Trust
Overview: Royal Cornwall Hospitals NHS Trust has undertaken digital transformation to improve conditions and outcomes for patients, staff and the trust as a whole.
Why? The trust aim to deliver a unified and value-driven approach to outpatient care across the trust, with focus on reducing referral routes, simplifying outpatient pathways and promoting equity with a structured Planned Care Inequalities Plan.
What happened? The team focused on five key projects: remote consultations; patient initiated follow-up (putting patients in control of their follow-up to reduce unnecessary appointments); advice and guidance services offered by all specialities receiving GP referrals, to provide an alternative to the previous default of face-to-face appointments; request management to provide a single point of entry for all GP referrals; and patient portal, to allow electronic management of outpatient appointments for patients. The team is data-led with regular monitoring and achievements so far include restructuring the outpatient model to simplify and standardise ways of working and developing framework guidance around the Planned Care Inequalities Plan to embed methodology to support specific cohorts.
Looking ahead. The trust has captured learning from their programme to share with other NHS peers in the NHS Personalised Outpatient Programme, and uses examples and successes to encourage other departments to participate in growing transformation efforts.
Lancashire Teaching Hospitals
Overview: Lancashire Teaching Hospitals’ Patient Pass is a secure platform for secondary to tertiary consultation and referral management that improves communication between clinical staff in different locations.
Why? The trust noted a pressing need to reform acute tertiary referral processes in selected sub-specialist areas covering their area as there was too much variability in communication and issues with manual processes.
What happened? The scope of the project was to implement and enable the new patient referral system to six acute tertiaries, to significantly increase positive outcomes of patient care and deliver a robust audit trail. The system was purpose-built and versatile, allowing documentation from the referrer and the opinion/advice of the receiving unit to be amalgamated in one resource. This allowed an audit trail in most of the trust’s acute sub-specialist areas. Ultimately, the entry stated it enables the trust to better use data for reporting on patient care in line with their paper-lite strategy. Key benefits have included improved patient safety due to greater control over referral tracking and management, reduced litigation and improved appointments with fewer missed and fewer inappropriate referrals.
Looking ahead. The system continues to improve patient experience, with the trust seeing a reduction in complaints and better patient outcomes.
Rotherham Integrated Care Partnership
Overview: Rotherham Integrated Care Partnership developed the Rotherham Health App, an innovative place-based digital solution empowering patients to take more control over their health.
Why? The vision was to provide easy access to health and care services across the local area within one digital platform, so that navigation is streamlined and improved from a patient perspective.
What happened? The app provides complementary services to the NHS App and is tailored to local pathway needs, interfacing with a range of local systems across Rotherham and providing access to a range of local services consolidated in one place. Services include symptom checking and care navigation, direct booking to primary care, community and IAPT mental health services, a local directory of voluntary services and more. The app has maintained a continuous upward trend in registrations since its implementation in March 2019 and as of May 2022 there are over 41,000 registered patients. Use of the app means that patients can quickly and easily book appointments or order repeat prescriptions 24 hours a day, and of those booked appointments, around 40 percent are with non-medical staff, ensuring that patients are seen by the right person first time.
Looking ahead. Having established a strong integration model at place, the delivery team is now sharing learning with South Yorkshire ICS partners.
Apira Limited
Overview: London North West University Healthcare NHS Trust (LNWH), supported by Apira Limited, Restore and IMMJ Systems, digitised their entire active caseload of records during the pandemic.
Why? The pandemic highlighted that operating using paper records was not going to be feasible, as records being handled and moved around the organisation was increasing infection risk and they were only available where clinical staff were physically located.
What happened? An earlier business case by Apira had identified significant savings in moving away from paper, including reducing overloads, the ability to reuse library space and the ability to free up staff. The trust set a goal that no new medical records would be created or added to, and that any paper still generated or received would be digitised and added to the patients’ record. A solution was deployed that resulted in 155,000 records scanned and accessible via MediViewer. All legacy notes are now available to clinicians across the organisation 24/7, multiple clinicians can access a record at the same time in any location, and patients experience no delays from missing notes.
Looking ahead. Feedback shows happier, less stressed staff, redeployed staff and resources, reassured patients and higher quality care as the trust continues its work.
Definition Health
Overview: Definition Health offer an end-to-end digital pathway that supports patients from referral through surgery to post-discharge at home through its web-based apps.
Why? Definition Health note the challenge of increasing surgery waiting lists which are often hindered by outdated, paper-heavy systems, and the role technology can play in making care simpler, safer and more efficient.
What happened? Definition LifeBox is a digital pre-operative assessment tool facilitating the collection and validation of critical health information prior to admission. It is an intuitive patient-centred health questionnaire which allows the patient to submit a comprehensive medical history to the hospital from the comfort of their own home. LifeBox can quickly adapt to the needs of hospitals, for example by adding COVID question screening at the beginning of the pandemic. An ‘assisted digital’ profile is available to support people who cannot fill in the questionnaire themselves, and patients have access to informative audio-visual media describing their condition and surgery. Patients also have a two-way file sharing system so the hospital can share important documents before their surgery.
Looking ahead. As Definition Health continues to respond for the growing need to digitise patient services, more patients will have access to this solution along with continuing innovation and development of the product.
Sidqam Limited
Overview: Direcht Restore from Sidqam Limited is a new digital version of the popular paper RESTORE2, a deterioration and escalation monitoring solution designed for use in care homes, nursing homes and domiciliary care.
Why? Direcht Restore was designed to solve the problems inherent with paper-based solutions such as potential loss and inaccurate information and data handling.
What happened? It provides a secure, seamless and flexible way for care home workers to monitor the physical health of their residents in one easy-to-use application on iOS, Android or web app. Direcht Restore captures clinical history and the normal reference range of the resident, along with critical paraments and features such as soft signs, vital signs, medical emergency and analytics. Sidqam say that implementing Direcht Restore can significantly increase the quality of care to residents as a result of the increased accuracy and empowerment it provides to care home workers, with the application allowing ease of use and compatibility across all devices to ensure seamless day-to-day operations.
Looking ahead. Sidqam offers continual training and support and by empowering care home teams with critical information to ensure accuracy and appropriate response time, residents can continue to be provided with higher quality of care.
Leeds Teaching Hospitals
Overview: Leeds Teaching Hospitals NHS Trust (LTHT) approached technology partner Aire Logic in 2021 for support in continuing a programme to increase hospital capacity for planned operations.
Why? The solution was designed to tackle NHS waiting lists and rapidly enable patients to complete vital pre-assessment documentation digitally from their own homes.
What happened? Aire Logic worked with LTHT clinicians to develop a pre-operative workflow solution that digitises the end-to-end effective patient POA process, including patient-facing assessments and other processes like the coordination of pre-operative tests or anaesthetic reviews. Development of the solution was completed in less than six weeks and went live in May 2021. The process is being used across four hospital sites serving over 10,000 patients a year. Since introducing the new process, the team has received over 75 percent of digital forms back within 24 hours and have noted benefits such as earlier completion of clinical tests in the pathway, patients reporting that they get more value from the solution than they previously did from a phone call, and a significant reduction in administrative workload.
Looking ahead. The trust report that the solution is a ‘win win’ for them going forward, with improved patient experience, improved efficiency and improved clinical quality.
