There’s plenty of variety in our ‘Supporting Healthcare Teams’ Response to COVID-19′ category at the HTN Awards 2022.
From planning solutions for vaccine delivery to helping speed up diagnosis – there are many ways health tech professionals have helped healthcare teams respond to the COVID-19 effort. Discover more about the submissions below…
Elsevier
The Elsevier Care Planning solution was adopted at Imperial College Healthcare NHS Trust.
Key drivers for purchase included: a strategic imperative to improve evidence-based practice at the point of care, and the absence of the hospitals own content/resource to develop and manage an in-house solution.
Elsevier’s Care Planning solution offered up-to-date, complete and trusted evidence-based content. This content was pre-built, then configured to the hospitals individual requirement and delivered via a structured, normalised database to ensure predictable and timely integration with the organisations’ EPR.
At last count, a total of 266 evidence-based, patient-centred care plans were made available to 4,000 nurses, across five sites, directly via the electronic patient record (EPR). Rapid integration was achieved through the collaborative efforts of Elsevier and the Imperial clinical informatics teams, supported by a strategic end-user education and go-live plan. The upload of all care plans into the EPR was achieved in just a two-day period.
Imperial College Healthcare NHS Trust foresees long-term benefits being:
- Research-based care plans that reduce variability and ensure the evidence-based practice is widely adopted.
- Increased operational efficiency as a consequence of seamless integration with standardized clinical workflows.
- Guaranteed interoperability for system-wide roll-out.
- An identified process through which the content is kept up to date with the latest evidence.
- It also allows having the latest content in the trust’s domain and knowing that the trust is doing the best evidence-based practice at the bedside.
- Elsevier Care plans solution helps to reduce the clinical variants to ensure clinicians provide the best patient care and enhance the outcome.
NHS Arden and Gem CSU
The National Immunisation and Vaccination System (NIVS) has played a key role the in safe and effective implementation of the COVID-19 vaccination programme, capturing real-time data at the point of delivery for more than 10 million vaccinations.
Developed by NHS Arden & GEM CSU, working in collaboration with the national programme team and hospital hubs, NIVS provides a cost effective, clinically assured, interoperable solution.
The Data and Systems Development team had already built a similar system to capture vaccinations for the flu immunisation programme, which had been used extensively in schools. Working in close partnership with the national programme team and hospitals designated as vaccination hubs, the team were able to scope, design and build a bespoke module within NIVS which evolved the system to deliver real-time data capture at the point of delivery.
This was achieved through a series of user discovery sessions with clinicians and vaccinators to ensure that the system offered a positive user experience and was easy to navigate within a live clinic environment. The NIVS module also enables:
- Use of the NHS number to automatically access an individual’s vaccination history.
- Vaccinators to be guided through a clinical decision support process to ensure the intended recipient is suitable for the vaccine.
- Batch information to be captured, by vaccine type and manufacturer, along with expiry dates.
- Assurance that patients are receiving vaccine doses within specified timeframes.
NIVS is hosted within Arden & GEM’s robust application and data warehouse environment to ensure system security and resilience. In addition to following a secure registration process, users are only assigned ‘vaccinator’ role status within NIVS once approval has been granted by organisational leads.
The system was rapidly deployed to the first hospital vaccination hubs in December 2020 and has since been rolled out to mass vaccination centres. The web-based application is now live in 457 vaccination settings and has captured over 11 million vaccination events. Users from 188 different organisations are supported via a dedicated help desk, web page, e-newsletter, user guides and manuals, and training videos. Users have also directly informed improvements in system functionality through contact with the helpdesk and liaison with their organisational leads.
Using the NHS Digital API framework, NIVS is able to automatically connect to the Personal Demographics Service (PDS), the national electronic database of NHS patient details, to help identify patients attending for vaccination and match them to their health records. Live reporting is available as a home screen dashboard within NIVS which allows users to monitor numbers vaccinated in the current day, previous day and a running total, by key cohorts.
Inhealthcare
Every weekday, City Health Care Partnership CIC (CHCP) receives around 1,000 patients at its clinics. Typically, it also arranges another 1,000 nurse visits in community settings across Hull. The onset of coronavirus in 2020 meant all patients needed to be screened to identify their symptomatic status prior to face-to-face contact with healthcare professionals. Anxiety levels about seeing patients face-to-face also increased amongst staff and it was important that their wellbeing was considered too.
CHCP did not have the capacity to screen patients prior to appointments manually. Therefore, a solution was sought which could automate the collection of a patient/household members’ COVID-19 symptom status and alert staff so appropriate measures could be taken. This included making record and appointment changes within clinical records.
Inhealthcare worked with CHCP to develop an automated symptom checker for the daily screening of patients for signs of coronavirus before their routine outpatient appointments. The service also provided guidance for patients identified as being at risk.
The service was defined, designed and deployed at speed so it was ready for the first lockdown. It was launched In March 2020. Each day the CHCP Business Intelligence team generate a list of patients who are due visits at home or appointments in clinic. This information, along with patient contact details, is shared to the Inhealthcare platform APIs.
On the morning of the appointment, Inhealthcare’s technology connects with the patient either via an automated telephone call or an SMS text message and relays a request to complete a symptom questionnaire by submitting a simple response (for example, A, B or C), indicating either the household or their own symptom status with automated guidance provided back to the patient based upon their responses. If a citizen does not respond to the questionnaire request, they are sent reminders.
A dedicated group of staff were appointed by the CHCP Care Co-ordination Hub to oversee an alert dashboard on a daily basis, including analysing the response to the questionnaire. Warning signs are flagged on the dashboard by Inhealthcare to alert CHCP and allow healthcare professionals to escalate those requiring further action. Patient records in the CHCP Community SystmOne application are updated automatically through Inhealthcare’s integration with all major NHS systems.
Results included:
- A total of 311,557 outbound automated calls and SMS messages were sent to patients between March and November 2020.
- 19,836 individual patients were contacted across eight CHCP Services within this period. This equated to 1,000+ contacts per day.
- The service saved CCH NHS staff from making more than 350,000 outbound phone calls between late March and November. This allowed CHCP to direct staffing resource more effectively and focus on the patients who needed the care most.
- Between June and November 2020, 2,038 (2 per cent) patients informed CHCP that they and/or a household member felt unwell.
X-on
Surgery Connect was developed in collaboration with GPs and is currently deployed in 1,200 practices in England and Wales, serving an estimated 11.2 million patients. Responding to user feedback, Surgery Connect has been uniquely designed to meet the specific needs of UK general practice teams.
With the pandemic limiting to face-to-face appointments, GP appointments via telephone reached a record high with more than 130 million phone appointments taking place between March 2020 and March 2021 (NHS Digital). Growing patient demand and stretched practice resources have therefore underlined the need for telephony solutions which make life easier for practice staff and guide patients through the communication process in the most streamlined manner possible.
Surgery Connect provides practices with unlimited phone lines, call queuing and callback, and real-time management dashboards to help manage demand. The system also addresses the digital ambitions of the NHS set out in the GP Forward View, the policy that looks to reduce the burden on GPs and help make primary care more sustainable – increasingly relevant during the COVID pandemic. X-on has moved quickly to adapt or create services as the needs of GPs and PCNs change.
Surgery Connect X-flow provides administrators oversight and easy to use management of practice call flow. The browser-based graphical call flow creator uses blocks and connectors to provide a visual representation of calls, optimising both the caller experience and practice resource allocation. This minimises the amount of valuable administration time spent in setting up – useful when dealing with the pressures of the pandemic.
GP@Home, for example, was created at the start of the pandemic to enable doctors to deliver the same level of phone and video care from their own homes, when required to work remotely, as they would from their surgery. Free teleconferencing was also offered to CCGs and PCNs. It also enables GPs to quickly switch from phone to video consultation with one click, while images can also be requested and then easily attached to the patient record.
X-on has also developed a softphone function for Surgery Connect which has been used in vaccination hubs to help manage the call traffic generated by vaccine appointment bookings and queries, so that it could be managed smoothly without impacting regular day-to-day call traffic.
Vantage Health
At the height of COVID-19, Vantage Health helped Ipswich and East Suffolk CCG to reduce outpatient attendance for skin lesions by enabling GPs to get remote support from consultants. They were then asked to help the CCG and East Suffolk and North Essex Foundation Trust (ESNEFT) manage growing pressure on the ‘two week wait’ (2WW) skin cancer pathway.
To ensure they could meet the national requirements for triaging 2WW cases, they worked in close collaboration with the CCG’s Teledermatology Steering Group. This includes a GP, a lead consultant dermatologist, operational and IT staff and transformation leads from both elective and cancer services.
The team developed a new triage process, enabled by the integration of our Rego software with the GP referral system, eRS:
- GPs making 2WW referrals on the eRS system can now upload high-quality images of lesions for review by consultant dermatologists using Rego;
- Once reviewed, any suggestion to downgrade a case to a routine referral instantly alerts the relevant GP, who can then decide to accept or reject the advice;
- Cases which are triaged for a 2WW appointment are automatically booked in to the next available appointment at ESNEFT. If no response is received by the GP within seven days, the patient would remain on the 2WW pathway.
From January to May 2021, 93 per cent of the 96 cases were triaged in one day and 50 per cent of the total number were downgraded to either a routine referral or not requiring hospital treatment. A survey found that 78 per cent of respondents felt the system supported earlier detection and intervention for previously undetected cancerous lesions.
Graphnet Health
The Greater Manchester Care Record (GMCR) stepped up to support the COVID-19 response. A massive programme delivered at speed, work has included a COVID Oximetry @Home platform, remote monitoring to support pregnancies, informing valuable COVID-related research and integration with the world’s first COVID-19 management app for care homes.
At the start of the pandemic, development and use of the GMCR was accelerated to support the city-region’s response to the pandemic and to build on borough-based care records to create a single joined-up care record for all of GM and its 2.8m citizens. Rapid progress was made in weeks, rather than months, as part of the digital response plan and collaborative effort.
Since then, the GMCR has become a major digital resource for the area with almost 14k frontline users accessing the record to support care for almost 150k patients each month (Nov. 2021).
It is a partnership between the GM Health and Social Care Partnership, the 10 GM localities, Health Innovation Manchester and technology provider – Graphnet. The GM Care Record collates information held by over 500 different health and care organisations to ensure that GPs, doctors, nurses and care practitioners can see up to date medical records, care plans, medications and test results to inform the right care and treatment for each citizen.
In response to NHS England’s national COVID Oximetry @home and virtual ward models, Greater Manchester and Graphnet have also worked together to rapidly develop a COVID Oximetry @Home platform for patients on the programme, which has been rolled out to localities. The new platform allows clinicians to remotely monitor patients and detect the early signs of deterioration in patients with confirmed or suspected COVID-19 and support early discharge from hospital.
Graphnet’s CareCentric platform records the health status, including pulse oximeter readings for patients being supported on the virtual wards, and includes an app where patients can input their oximetry readings directly into their electronic record. This is monitored and reviewed by the clinical team on a secure internet connection. Clinical teams can also send tailored advice to patients using the app.
The GMCR is now also receiving information from the Safe Steps COVID Tracker – the world’s first COVID management app for care homes. A new, real-time view of the Safe Steps dashboard, which shows COVID data from 233 care homes, covering approximately 7,600 residents, is allowing the fast, easy identification of individuals who require advanced care planning by picking up early signs of deterioration.
Eva Health
Eva’s point-of-care vaccination platform, eVacc, powers a quicker, more efficient fight against COVID-19
eVacc is a rapidly-deployed, cloud-based and interoperable vaccination platform for PCNs to support vaccination delivery across settings. It has scaled to 60+ PCNs in less than six months and is delivering close to one million vaccinations. The platform saved the pilot site 20 seconds per jab and continues to experience 0% downtime.
In December 2020, NHS Digital invited Eva Health to tender for a point-of-care vaccination solution to provide an additional option. Having mobilised the team in just two weeks, Eva pivoted to focus on the vaccination effort to create eVacc. The team went from the first line of code in AWS to a fully assured solution, tested to take the full vaccination load of England without crashing, and available for the NHS to use in less than six months.
Owing to its internet-first and multi-device design, eVacc was able to support vaccine delivery across a range of care settings and pop-up locations – from GP surgeries and care homes, to mosques, gyms, nightclubs and even a bus.
A snapshot of its results to date include: delivered in just six months – from zero code, via NHSD assurance, to market; one day turnaround, five minute training; fortnightly upgrades, 20 to date; 6x active and assured NHS integrations ensuring updates of patient records and accurate and timely reimbursements and reporting; 20 seconds saving per encounter; over 50 PCNs use eVacc and have onboarded in less than six months; closing in on one million vaccinations.
There are also: 3,000+ registered users onboarded and using the platform; 700+ GP Practices receiving data from Eva system; 500,000+ patient records stored.
Spirit Health
CliniTouch Vie is Spirit Health’s patient-centric, digital health platform, designed to connect patients and clinical teams using remote monitoring technology. Helping to make healthcare safer, smarter, and more efficient, the platform enables the digitisation of multiple pathways, including COPD, chronic heart failure, frailty, and more recently, COVID-19 virtual wards. The remote monitoring solution is currently supporting teams across the NHS to provide virtual care.
The company worked closely with Leicestershire Partnership NHS Trust (LPT) and University Hospitals of Leicester NHS Trust (UHL) to deliver COVID remote monitoring services across the region. CliniTouch Vie was first used in the fight against COVID-19 in April 2020, when LPT deployed the technology for use by the community respiratory and heart failure teams, as well as supporting those who had been discharged into the community earlier than usual.
Recognising the need for a rapid response in the first lockdown, the team from Spirit Health worked around the clock with the trust to expedite the delivery of the service, ensuring continuity of care for those considered most at-risk, and therefore shielding at home. This rapid deployment included delivering tablet computers and peripherals to patients, as well as training and support for the teams on the front-line delivering care.
The remote monitoring technology enabled patients with COPD and heart failure to remain in the comfort of their own home, whilst still providing them with access to their clinical teams via the CliniTouch Vie platform. They would answer bespoke question sets tailored to their conditions, as well as taking vital sign readings, like blood pressure and pulse rate. The data would then be sent in real-time to their clinical teams to review, with a prioritised caseload coded red, amber, or green for each patient.
Crucially, the community teams were able to intensively monitor for signs of deterioration without needing to see the patient face-to-face, only escalating their care when truly necessary. With messaging and video call functionality embedded within the platform, clinicians were able to connect with their patients virtually to offer health and wellbeing advice, reassurance, and consultations throughout the pandemic.
In late 2020 as hospital admissions began to rise, LPT also introduced the COVID Virtual Ward service, facilitating the early-supported discharge of symptomatic patients into the community to continue their recovery at home. Using the bespoke COVID-19 pathway constructed by the expert clinical team, the service was available to all patients being discharged after a positive diagnosis – monitoring for signs of deterioration that could indicate a need for re-admission.
A study, recently published in the British Journal of Healthcare Management, revealed the following results:
- Reduced mean length of stay in hospital, from 5.5 days to 3.3 days (40.3 per cent decrease).
- Red days, where an urgent response was required, decreased from 33.8 per cent of patients in their first three days at the virtual ward to 10.8 per cent in their final three days (P=0.002).
- Overall savings of £68,052.
ORCHA
The ORCHA team created a free formulary of top flight, vetted COVID-19 support apps for frontline staff, and developed bespoke app libraries for many healthcare providers.
At the start of the pandemic there was an explosion in digital health adoption as people looked for remote ways to manage their health and wellbeing. National Government COVID-19 strategies, local authorities and consumers, all turned to health apps.
Since its inception, ORCHA’s principal objective has been to uphold quality in digital health, in the face of a tsunami of poor-quality health apps being launched daily on unregulated app stores.
ORCHA’s response was to launch a COVID-19 health app formulary to help healthcare professionals and consumers know which health apps they could trust. The site included reviews of health apps across a range of health conditions relevant to the COVID-19 pandemic, including reviews of COVID-19 apps launched to date. ORCHA also offered free professional accounts to all NHS staff for a three-month period, giving them gratis access to the formulary.
Along with its formulary, ORCHA actively promoted specific lists of top-flight apps to support different cohorts. For example, apps to help support the elderly through the pandemic. These included Tab Care, an app that incorporates a panic alarm, Moves4Me, which encourages resistance exercise training, and Elevate, a brain training programme.
Throughout the pandemic, ORCHA produced a quarterly COVID trends report to encourage healthcare professionals by sharing data on what their peers were doing. Meanwhile, ORCHA’s implantation team was in overdrive, in just one month creating COVID-response app libraries for: The Chartered Society of Physiotherapy, Lancashire & South Cumbria NHS Foundation Trust, Cheshire & Merseyside HCP’s App Library, East Berkshire CCG, Staffordshire County Council’s, Health and Social Care in Northern Ireland and Dorset CCG.
Redmoor Health
As COVID-19 changed the way Health and Social Care delivered their patient services, Redmoor Health was at the forefront of supporting organisations – at scale and pace – to adapt to the “new normal” and manage the switch to home working, find innovative solutions to support their users and develop new digital products/services.
It was clear the first priority was to create a flexible, agile and collaborative workforce. And that is where Redmoor Health came in. Whilst, Microsoft Teams provided the much-needed technical support to allow NHS staff to operate in a virtual environment, protecting crucial clinical teams from unnecessary face to face contact, specific expertise was needed to roll out such a high profile programme.
Redmoor’s team of digital experts had the experience and the knowledge of the IT systems needed – but also of how the NHS works and how the changes could be deployed both widespread and rapidly.
Redmoor were quickly able to mobilise an extensive training programme which they delivered remotely to thousands of NHS staff and developed a suite of learning materials which were freely available online. Help and advice was also available during working hours from Redmoor’s experts which was crucial as staff grappled with the new technology, whilst working in such high pressured environment.
The bespoke training programme was adapted for each area and flexible enough to respond to any MS Teams updates or challenges. And it had to be deployed rapidly. One such area was Norfolk and Waveney. Over the course of 14 weeks, one of the core challenges was that the majority of the attendees needed to be self assessed as to their level of confidence in using Microsoft Teams. Redmoor had to ensure that the learning was both comprehensive but also accessible.
This training was reviewed on a weekly basis to incorporate ongoing changes to the platform. Training workshops were run twice a day, three times a week, developed between Redmoor Health and Microsoft, followed by a Q&A.
Provision of a dedicated Norfolk and Waveney Teams programme telephone support desk – staffed by people with GP practice and commissioning experience was opened to answer queries Monday – Friday, 8am – 5pm. All queries were responded to within one hour. An email helpdesk was also available to answer queries out of hours and at weekends. A total 0f 1,271 attended the training workshops in Norfolk and Waveney in just 14 weeks. Some 242 people accessed the Redmoor support desk, and a total of 581 viewed the pre-recorded workshops which were made freely available.
Alder Hey and Liverpool Heart and Chest
The digital service that spans across Alder Hey and Liverpool Heart and Chest hospitals, iDigital, has implemented a number of initiatives to support both hospitals during the COVID-19 pandemic to support healthcare teams, patients and their families.
The iDigital team, which spans both trusts, was focused on a set of workstreams to digitise patient services across the hospital, including Telemedicine, Virtual Consultations and Virtual Visiting. Exploring the opportunities Telemedicine could present to the trust was already on the roadmap for the digital strategies. Due to the pandemic, a substantial proportion of staff were required to shield and were therefore unable to provide face to face patient care. The specialist telemedicine equipment and software has allowed clinicians to make decisions on patient care remotely, enabling those shielding to do virtual ward rounds, and contribute to the staff rota. It has reduced the need for clinicians to travel to visit the patient and allow earlier intervention where needed.
Due to the pandemic, many services were not allowed to carry out face to face appointments anymore. The implementation of virtual consultation software meant that patients who would otherwise have missed their appointments were still able to be cared for. The ambition of the hospitals was to enable as many clinicians as possible to deliver care to their patients via video calls. Within a six-week period, they went from no virtual consultations to nearly 1,000 a week across the medical, surgical and community divisions across the two trusts.
To keep patients and staff as safe as possible, the hospitals were forced to restrict on-site visiting of patients. Understandably, this was distressing for families and the iDigital team were asked whether there was anything we could do to help. The team built tablets installed with Skype, Whatsapp and Spotify and assigned free generic accounts for patients to use, improving the experience for patients at Alder Hey and Liverpool Heart and Chest hospitals in this challenging time.
Wellbeing Software
Determined to transform the patient experience digitally, Royal Berkshire partnered with Wellbeing Software to implement eConsent, a clinician-led, paperless solution to radically streamline consent to the treatment processes during covid.
Royal Berkshire NHS Foundation Trust, like so many up and down the country, are on a journey to digitally transform their workflow in line with the HIMSS electronic medical record adoption model. This is to not only increase the efficiency of their workflows but to ensure that patient care is being continuously improved upon at every point of contact.
Determined to become more digitally mature, they sought the help of the connected healthcare specialist, Wellbeing Software, to implement eConsent, a clinician-led, digital solution that enhances patient consent consultations.
In addition to this being a part of a wider national scheme, Royal Berkshire wanted to use eConsent to improve the patient experience, optimise consultant time, as well as improve access to standardised and up to date information throughout their consent to the treatment process.
eConsent has been designed to enable trusts to improve patient experience, save consultant time and standardise the information delivered during the consent to treatment process. The solution enables digital consent forms to be created dynamically, pre-populated with individual patient demographics and shared with the patient in the context of the proposed procedure, along with information leaflets during the consultation.
By introducing eConsent, the trust has also been able to report on, analyse and further optimise the consent process, which would not be available via a paper process. For example:
- Consent form usage across a specific date range showing them the number of procedures by department, which can then be further filtered down to show both procedure type and numbers by consenting clinicians.
- Remote form access shows which forms have been accessed, downloaded and/or signed by a remote link across a specific date range.
- Access to ‘raw’ consent data that is provided weekly for the trust, for analysis, by their own Business Intelligence team.
All these enhanced features enable Royal Berkshire hospital to adopt a more dynamic and secure approach to the consent to the treatment process.
accuRx
At the end of 2020, accuRx launched accuBook – a product that helps GPs to easily invite patients to book their COVID-19 vaccination appointments via SMS and record their appointments. This has been used throughout 2021 to manage over 35 million vaccines, supporting practice staff through changing vaccine guidance and administering boosters.
accuBook works by allowing practice staff to set up their clinic times and capacity, and upload csv files of patients with their mobile numbers so they’re texted with a personalised link which enables each patient to book themselves into an appointment time convenient for them. This is saving a huge amount of admin time for healthcare staff who would have had to do a lot of this manually, via letters and over the phone.
Since launching accuBook, they reacted to new guidance to ensure that it’s clinically suitable, with patients being invited for their next vaccine at the right time, younger age groups becoming eligible for Moderna in August this year and adapting accuBook to enable booster booking for the over-50s from September.
And, most recently the team have made changes to booster eligibility to help with the Omicron variant, so that patients are now able to book in for their booster 91 days after completing their primary course. They are now seeing almost one million vaccinations booked via accuBook a day and 2.81 million of them so far have been boosters.
35,000 healthcare staff are using accuBook weekly and it is active in 5,383 GP practices. This has reduced the administrative burden across the primary care system. GPs and administrative staff have been able to avoid hours spent manually inviting patients to vaccines and boosters via telephone, emails and letters.
Thriva
Thriva has developed and supplied an innovative, scalable at-home antibody testing solution to support the fight against COVID-19. These tests have allowed for antibody testing to be dramatically increased, offering DHSC (the Department of Health and Social Care) insights about the vaccine roll-out that directly informs the Government’s COVID policy – without phlebotomists or nurses, and with no impact on testing quality.
The programme was delivered at rapid speed and offers a broad and rich understanding of the prevalence of antibodies and antibody response, both in the general public and specific patient groups and the prevalence of symptom free infection in specific parts of the population.
To date, it has processed 900,000 tests and at its peak, the programme was processing 10,000 tests per day. These tests has allowed for SARS-CoV-2 antibody testing to be dramatically increased, reaching a wider audience across the UK.
In addition to this, it has also been used by the DHSC to answer a variety of research and policy questions through multiple surveillance projects about, for example, the efficacy of vaccine booster jabs and antibody responses for at-risk groups, including those who are immunosuppressed.
Thriva is providing an end-to-end solution for this programme through laboratory-run COVID antibody testing, whereby subjects are sent/provided with a CE-marked finger-prick blood collection kit such that they may collect a small sample of their own before posting it to a UKAS accredited laboratory in order to be provided with a result. Results can differentiate between antibodies from natural infection and vaccination.
The service has been built on a dedicated platform and proprietary network of partners, that is flexible at its core and allows Thriva to tailor the service to optimally respond to the changing nature of COVID-19, and new use cases for antibody testing. The programme includes sourcing all necessary materials, building and fulfilling kits, logistics, lab testing, and reporting results back to the DHSC and relevant scientific partners. In doing so, Thriva provides the full infrastructure for at-home antibody testing.
Leeds Teaching Hospitals NHS Trust
COVID-19 has seen Leeds Teaching Hospitals NHS Foundation Trust (LTHT) begin to operate in completely new ways, many of which are reliant on effective digital solutions. From sourcing and supporting hardware, to vastly increasing remote working capability, the Digital IT team has been at the centre of the support response. This entry showcases some of this work, focusing on three of the many areas specifically designed to support the COVID-19 response.
The Paper Lite approach involves digitising paper Medical Records, which are scanned and uploaded into PPM+, LTHT’s Electronic Health Record (EHR). Paper Lite is a key step in LTHT’s digital journey, playing an important role in supporting the trust’s Covid Infection Prevention regime by significantly reducing the volumes of documents and people moving around the trust and contributing to an increasingly rich electronic patient record.
The Corporate & Health Records team play an essential role in supporting clinical teams, ensuring patient data and information is stored and processed effectively. At the beginning of the COVID-19 pandemic, the routine provision of paper health records at LTHT was stopped. With restrictions around document handling in place, the team has quickly adapted to a different way of delivering their service, using digital solutions to help.
The team developed a solution at scale and speed, involving a sustainable and comprehensive Pick-up & Scan Service for all in-patient and outpatient areas, visiting every ward daily, and meeting the requirements of clinicians to deliver safe, effective patient care. A reimagined Medical Records library is supported by scanning hubs with industrial scanning equipment, which are operational on every LTHT site – a service that required comprehensive partnership, resource and supplier negotiation.
Paper Lite has delivered a 95 per cent reduction in the number of paper records requested since the beginning of the COVID-19 pandemic, with 59 million images scanned so far.
The COVID-19 pandemic created many challenges for all health services within LTHT, but in particular for critical care. The Digital IT team was able to respond immediately to the needs of critical care clinicians, developing a suite of documents that could be used within PPM+, with a focus on patient safety, assurance and supporting remote working. The documents prioritised for development included Intensive Care Medical form, Critical Care nursing risk assessment and evaluation form, Critical Care Outreach form and Blood Gas summary form.
There were many beneficiaries once the eforms were launched. Once the critical care forms were released, the family support teams could read medical and nursing summaries in PPM+, immediately update the families and record the outcome of the conversations again on PPM+. This improved workflow and also ensured clear, supportive communication with families.
Support from the Information & Insight (I&I) team has also been critical to the trust’s COVID-19 response, with the team managing and developing many data and reporting requirements, often to incredibly short timescales.
Cardiff and Vale University Health Board
Ophthalmology services in Cardiff and Vale UHB has seen a significant increase in demand over recent years, which has been exacerbated by the COVID-19 pandemic. Traditionally delivered within secondary care, the service has had to re-think how it delivers eye-care to the citizens of Cardiff and the Vale of Glamorgan.
The ambition is to deliver “shared ophthalmic care” and the journey commenced in 2018 with the decision by the Welsh Government to procure an Electronic Patient Record (EPR) and Electronic Referral Platform with read/write access. To deliver the vision of Healthcare without Boundaries, the UHB required a higher trained workforce and a five-year development plan was therefore required.
The School of Optometry provides higher qualifications in the delivery of Glaucoma, Medical Retina and Independent Prescribing, the qualifications are mainly distance learning for a period of up to 12 months and placement for the same duration in a Hospital Eye Unit, all at the Optometrist’s own cost. The biggest challenge is often securing a hospital placement.
The Welsh Government monitors the performance of its eye care outpatient new and follow-up appointment by classification R1 patients (Macular Degeneration, Glaucoma and Diabetic Retinopathy) unless seen timely, will have irreversible harm, to their sight.
The UHB’s first objective was to create more “social distancing” space by moving 94 per cent of unscheduled care patients into Primary Care, supported by trained Independent Prescribers. This was completed over a four-day period, all virtually.
They moved out more than 3,000 patients during March 20 and April 2021, into Primary care, providing increased social distancing in hospital for the ‘Complex Patients’.
Its second objective was to post technology to every Consultant and Fellow, including a “black box”, HD laptop, headsets and video camera. The “black box” was connected to their broadband circuit and provided a “highly secure” tunnel into the Cardiff and Vale UHB Data Centre. All Consultants were then able to undertake Virtual Clinic’s using OpenEyes and access to ALL Images.
The third objective, having already been working with Carl Zeiss, was to connect their imaging hardware located in an Optometry Practice, using the same “black box” technology. Within four weeks they made five Ophthalmic and Diagnostic Treatment Centres (ODTCs) operational, supported by qualified Optometrists and managed by Consultant Virtual Clinics.
