The NHS Transformation Directorate recently released the Perioperative digital playbook. The resource seeks to provide support to clinical teams and organisations that are looking for digital tools that support the delivery of patient pathways. Five current and alumni Accelerator companies were featured:
Digital consent to treatment in North West London: Concentric Health
Two Trusts wanted to introduce digital consent to replace the existing paper consent process and decided to introduce Concentric’s digital consent application – Imperial College Healthcare NHS Trust in April 2020 and Chelsea and Westminster Hospitals NHS Foundation Trust in July 2020. The Trusts introduced the process in phases across the two organisations, this included elective and emergency treatment pathways for surgical, radiology and oncology specialties.
Introducing Concentric’s digital consent has been a success across the two organisations. There was positive feedback and support for use of digital consent by default across patient and clinician groups. An evaluation demonstrated an increase in shared decision-making quality across all shared decision-making domains.
Dr Dafydd Loughran, CEO, Concentric Health said: “The NHS digital playbooks are key to spreading good practice and impactful innovations at a national scale. The perioperative care digital playbook categories – digital consent, digital pre-operative assessment, and prehabilitation support – should be key elements in all Trusts’ elective recovery plans. With over 20 NHS Trusts having introduced Concentric over the past two years, digital consent, as described by the Imperial College Healthcare NHS Trust and Chelsea and Westminster Hospital NHS Foundation Trust teams in this case study, is now a mature offering that can be introduced with relative ease, and for the benefit of patients, clinicians and organisations. We are grateful to DigitalHealth.London, in particular our NHS Navigators Ruth and Brett, who provided such valuable support during the roll-out described in the playbook.”
Improving shared decision making and digital informed consent at Nottingham University Hospital NHS Trust: EIDO
Clinicians at Nottingham University Hospitals NHS Trust wanted to support patients to make informed decisions. They wanted to give them more time to consider the benefits, risks and alternatives to their proposed treatment and involve them in their surgical journey, as well as recording their engagement. Furthermore, communicating the risk and managing expectations of surgery outcomes helps to improve patient experience.
The Trust used EIDO Healthcare’s Inform Consent Suite in general surgery. EIDO’s Inform Patient Education module is an engaging and interactive environment for patients and includes videos with animations which they can watch and gain a helpful visual overview of what to expect in their upcoming procedure. They improve patient engagement, comprehension and experience with the content. Patient experience feedback from the pilot was generally excellent, and any improvements will feed into phase two of the pilot.
Making digital preoperative assessment (POA) the default at South West London Elective Orthopaedic Centre (SWLEOC): Lifebox
Digital solutions enable patients to enter data from home, and this reduces the administrative burden on staff during face-to-face appointments. SWLEOC wanted to streamline the POA process by sending and receiving key information earlier in the pathway.
The POA service was redesigned to increase efficiency for patients and staff – Lifebox was introduced to facilitate health screening questionnaire – the LifeBox dashboard and comorbidities questionnaire support clinical decision making. Results showed completed POAs increased by 800 patients per month.
Rosie Scott, Co-Founder, Definition Health said: “We are very happy to be identified in the NHS Peri-operative digital playbook as a successful provider of digital pre-op assessment for patients. Our time on the DigitalHealth.London Accelerator programme in 2020/21 provided Definition Health with a firm foundation on which to build and improve. Since our year, supported by the DigitalHealth.London team, we have continued to listen to our users and responded by developing a total surgery solution which now guides the patient through their personalised total surgical journey, including patient education and monitoring of recovery after surgery. DigitalHealth.London provided a friendly and informative launch into the world of digital healthcare for us.”
Remote surgical prehabilitation: Sapien Health
The PREPWELL team collaborated with a digital health technology provider, Sapien Health, to deliver a remote prehabilitation programme. Approximately 150 patients from five surgical specialties were supported. There was excellent patient feedback and high levels of patient attendance and engagement (over 75%) with the programme.
Matthew Beatty, CEO, Sapien Health said: “We are delighted to be recognised in the NHS Perioperative Care Playbook, highlighting our complete, at-home digital clinic as a critical tool to achieve better surgical outcomes by helping people to get fit for surgery and fit for life. The extensive ecosystem of mentorship and support provided by DigitalHealth.London has given us invaluable opportunities to work closely with digital health experts and NHS services, to optimise our solution and achieve the very best for people preparing for and recovering from surgery. We’ve also met and been inspired by many of the other amazing and like-minded organisations on the programme, who are also doing brilliant work to create new and innovative technologies that are genuinely changing lives for patient and healthcare professionals.”
Developing a digital POA pathway and clinical decision support: Synopsis
The Trust wanted to identify fit-for-surgery patients as early as possible in the preoperative pathway – this would give staff more time to identify patients at high-risk of being unfit for their operations. The Trust decided that patients awaiting elective surgeries should begin the preoperative pathway at home, using the digital POA questionnaire Synopsis. The platform launched across the Trust in February 2020.
Synopsis iQ is a digital POA pathway used by staff and patients in hospital and face-to-face. Patients can complete their POA questionnaire using a tablet while waiting to see a member of staff, or with a member of staff if they need support. The Trust reached its target of 750 completed POA questionnaires using Synopsis by the end of the first month of deployment, demonstrating positive uptake by hospital staff.
EIDO and Sapien Health are on the sixth cohort of the DigitalHealth.London Accelerator programme. Concentric Health, Definition Health and Synopsis are alumni companies of the DigitalHealth.London Accelerator programme.
The DigitalHealth.London Accelerator is a collaborative programme funded by London’s three Academic Health Science Networks – UCL Partners, Imperial College Health Partners, and the Health Innovation Network, MedCity, CW+ and receives match funding from the European Regional Development Fund.