Here we take a look at all of the entries for the Health Tech Awards 2023 category of ‘Digitising Patient Services’.
Oxleas NHS Foundation Trust
Overview: An electronic consent portal was developed for school-based immunisations for COVID 19, replacing paper forms, and managing consent and other data to help manage the immunisation campaign.
Why? In response to the coronavirus pandemic, School Age Immunisation Services (SAIS) were commissioned by NHSE/I to deliver COVID-19 vaccines to healthy children aged 12-15 years within schools.
What happened? An electronic consent portal for school-based immunisations was developed at-speed, where parents could record decisions, and nurses could access data to help with the management of the campaign. The vision was to have an accessible portal, bearing in mind the link between poverty, digital exclusion and digital inequality. The SAIS made adoptions in the offer to ensure that above mentioned challenges were mitigated for an equitable offer. The weblinks were disseminated to parents was coordinated by schools via e-mail accounts and/or text messages to all parents or legal guardians of children within the relevant cohort to complete the consent documentation. There was also a follow up via telephone to parents during this period as a prompt or reminder. NHSE described the roll out as ‘exemplar’ and the trust was used as blueprint for digital consent for childhood immunisations to other providers. Through this work the trust has been able secure funding to expand the digital offer, with focus on vulnerable groups such as children with special educational needs and disabilities (SEND). For our clinical staff, triaging the health of child for eligibility to a vaccine was much simpler, with nurses following up on medical history in advance. The use of an electronic consent portal was of great help in pulling through data for measuring uptake and performance against targets.
Looking ahead. Through engagement work with the schools, there was feedback on developing viewing access to them, for their school cohorts only, which will support in chasing families where there is delay in submission.
Royal Papworth Hospital and DrDoctor
Overview: Royal Papworth Hospital, in collaboration with DrDoctor, digitised patient communications in their outpatient department with the use of a digital patient engagement portal.
Why? The team were printing and posting patient letters in-house, resulting in additional time spent preparing these letters, risking missed appointments, impacting patient experience and having an environmental impact.
What happened? The RPH project team collaborated with DrDoctor, ensuring all letter correspondence throughout the patient journey at Royal Papworth could be effectively digitised. Once a member of the outpatients team triggers a letter to be sent, an automatic SMS message or email is sent to the patient, dependent on their communication preferences. The message provides a URL link to click to view the contents. Patients are then directed to the patient engagement portal on their native internet browser. There is no app to download which could create barriers for some patients. Patients see the contents of their letter in the form of a PDF, allowing them to zoom, scroll and download the correspondence to their device should they wish. Previous letters can easily be accessed through the engagement platform at any time, and patients will be notified of future correspondence. Accessibility for patients with specific needs has been improved. DNA rates have fallen across outpatient clinics, and environmental benefits include saving 108,000g of carbon emissions so far. 74 hours of Admin time has been saved, and 75 percent of patients have been viewing their letters online. Over the next year, forecasted benefits include 1,008,000g of CO2 saved or the equivalent of planting 45 trees; an equivalent of 81 working days’ time savings through automating communications; and huge cost savings for the trust with 280 percent ROI.
Looking ahead. The team are currently in the process of rolling out digital correspondence throughout the remainder of the outpatients’ department, with scope to extend this to include inpatient letters.
Hanley Consulting
Overview: In partnership with Maple PCN, Hanley Consulting completed a pilot programme and created an automated digital solution to support patients and practices to access services digitally and improve digital literacy across the registered population.
Why? Data suggested that low uptake of digital tools, due to lack of awareness and poor digital literacy, is impacting surgeries’ ability to meet demand with the capacity they have.
What happened? At the time of entering the awards, EDATT has been launched across two of the three surgeries at Maple PCN with the third set to launch in July 2023; and has now been commissioned across five PCNs and one Federation. 12 percent of digital triages have been signposted to self-care, freeing up clinical capacity. EDATT has relieved pressure on reception staff by moving 15 percent of calls onto a digital route, seeing an improvement in their wellbeing with a 25% increase in those that would recommend their workplace. Where patients still require assistance via the telephone, EDATT has reduced call wait times by two minutes on average. By increasing use of digital triage by 300 percent in six months, GP time saved has gone from 12 hours to 56.7 hours per month by signposting self-care, pharmacy and ARRS physio. By surfacing directly bookable slots within the bot and offering this from the telephone system, cervical smear bookings have increased sixfold, with 86 smears booked digitally in a single practice in May 2023 (up from 14 in January 2023). The pilot has achieved full scoring against quality improvement activities, including sharing across the network and also capacity and access improvement funding by improving access and patient experience.
Looking ahead. Hanley Consulting will be using patient feedback to make continuous improvements to the solution.
PATCHS
Overview: PATCHS is a next generation online consultation system powered by artificial intelligence triage and workflows, helping practices manage rising demand whilst improving patient access.
Why? PATCHS helps tackle key issues in primary care, including workload management, health inequalities, and long waiting times.
What happened? PATCHS Online Consultation solution, supports over 1,000+ GP practices and 10m+ patients. It enables easy two-way communication between patients and their GP practice, helping patients get help when they need it and practices increase productivity. It has been implemented at-scale across multiple regions including North West London (2.2m patients), Cheshire and Merseyside (2.7m patients), West Yorkshire (2.7m patients) and North Central London (400k patients). Results have shown improvements in workload management including 85 percent of all requests being dealt with fully online, a 20 percent reduction in self-care patients submitting requests, and only 22 percent of health requests requiring a face-to-face appointment. Telephone calls reduced by 50 percent, clinical safety improved thanks to PATCHS AI which is estimated to detect 94 percent of all urgent and emergency patient requests, and waiting times were reduced with an average resolution time for a high usage PATCHS region of 5.6 hours. On an inclusivity basis, UoM research found that many older patients found PATCHS easier to navigate than expected and it was their preferred method for contacting the GP practice, whilst patients who struggle with telephone or in-person appointments find it easier to use PATCHS. This includes patients with hearing loss, anxiety, and autistic spectrum disorders.
Looking ahead. The PATCHS team plans on continuing to develop the system and to roll it out across more regions to enable even more benefits for primary care.
Maldaba Ltd
Overview: A new approach to Annual Health Checks (AHC) focused on overcoming the barriers identified by stakeholder groups across primary care staff, community staff and families/people with learning disabilities.
Why? The pilot aims to support people with a learning disability by identifying risks earlier and preventing ill health, given that people with LD die on average 20 years earlier than the general population.
What happened? Through co-design, a new approach to Annual Health Checks (AHC) was produced, including a web-based system for primary care staff to manage the 12-month AHC cycle including Health Action Plans (HAPs); a mobile-based solution for people with LD and their families/carers to respond to questionnaires, see and track activities related to their HAPs throughout the year; technical designs for EMIS interoperability; and a standard operating procedure for primary care staff. This work was a partnership between Symphony Healthcare Services Ltd and Maldaba Ltd, who were the technology partner. With this solution, trackable documents will be sent out to patients, completed and returned electronically, using. HAPs are more likely to be produced, shared and used with their wider support network e.g. day staff. The estimated time saving per AHC is 113 minutes, constituting reduced time for admin, completion and analysis. This totals over £57 just for the completion of the process, without accounting for broader savings from reduced engagement episodes and reduced paper/postage activities. Scaling this £57 to the estimated 250,000 people on the Learning Disability register in England, the procedural saving alone could reach £14.2m.
Looking ahead. Key inputs from PPI recommendations will be developed in the full solution, such as suggesting gamification methods to improve engagement with the software.
Alvie Health
Overview: A hybrid human and digital personalised cancer care partnership for greater equity of access and better patient outcomes.
Why? One in two people diagnosed with cancer will not start or complete cancer treatment due to poor health or complications. An affordable prehabilitation solution could help reduce these complications for cancer patients.
What happened? ESNEFT and Alvie co-created the first hybrid digital plus local service in the NHS, with an AI-driven 3600 health profile and risk-stratification algorithm/dashboard stratifying patients to different levels of support. High-risk patients are sign-posted to hospital-based specialist AHPs, with low-moderate risk groups receiving technology-enabled guidance and support. Seamless referrals to Alvie are made through a simple online referral portal. Contrary to published research, where step count deteriorates by 15% in chemo patients; weekly step count increased from 19,000 steps to 40,000 steps in the first two weeks and plateaued. Distress and anxiety measured on the validated emotional distress scale also fell significantly, from median 5 to 3 and 5 to 4 respectively. Contrary to published research indicating that quality of life falls by 11 percent in patients on chemotherapy, patient’s EQ5D5L health utility improved by 7 percent and EQ-Visual analogue scale by 17 percent. The median post-op hospital stay in colorectal patients is five days – one day less than the national average). Finally, the partnership calculates cost savings of £971 per patient, delivering an ROI to ESNEFT of 320 percent.
Looking ahead. The Alvie-ESNEFT partnership provides a blueprint for improving access to personalised care across the NHS. Alvie is replicating the ESNEFT model, to become the digital solution for patient choice and equitable access.
Better and Hereford and Worcestershire Health and Care NHS FT
Overview: Implementing the Better Meds EPMA project in a record 2.5 months.
Why? The partnership enabled the incredibly rapid implementation within the Trust, which is of significance due to the risks associated with operating a dual digital and paper system.
What happened? The Better Meds EPMA was implemented in a record 2.5 months, despite an earlier, unrelated, setback due to a significant EPR and PAS outage. H&W and Better identified a pilot ward – a small six-bed ward that provided specialised end-of-life care. This allowed rigorous testing of the prescribing regimes and software capabilities. The project expanded to a 28-bed rehabilitation ward, catering to a different set of requirements and providing further opportunities for testing. The collaborative nature of the project was evident throughout training and staff engagement. A core team of “super-users” were trained, with Better staff visible on site to provide support. Engagement sessions and “roadshows” were held prior to implementation, allowing staff to raise queries and understand the impact of the roll-out. Comprehensive mandatory online training was then provided to all staff members, resulting in an impressive 90 percent completion rate and face-to-face drop-in sessions were arranged to address any questions. The combined effect of having behind-the-scenes support and visible presence meant that all staff felt confident in the new EPMA and could see the benefits it held. Following this, and due to the high level of engagement from staff, the trust decided to expedite the phased roll-out to include all seven community hospitals and mental health facilities.
Looking ahead. The successful practices that enabled the collaborative working during this partnership, and the implementation model that has been used, can act as a blueprint for other trusts.
