Mr Afsar Jafree is a leading Ophthalmologist in his field, and a key innovator within East Kent Hospitals University NHS Foundation Trust (EKHUFT).
He was the first to use WebEx for video conferencing within his day to day medical work, and his colleagues soon followed suit. This has been successfully used in meetings throughout the hospital, not to mention the invaluable training with other ophthalmology staff and medical students. WebEx provides secure web conferencing, with screen sharing capabilities, and cross device compatibility, which has been essential for the diverse NHS workforce.
Like many trusts, EKHUFT have embraced Attend Anywhere software for patient appointments. Mr Jafree has been explaining complex Optical Coherence Tomography (OCT) retinal scans to patients over video call and has received many positive comments. He feels the ability to use video is so much better than a traditional, audio only, phone call.
Mr Jafree is also championing electronic patient records for ophthalmology. When it is launched in the coming months, this electronic record will bring together all hospital eye records, and also hold vital OCT images. The Kent Ophthalmology Record (KOR) will be for all participating trusts within the Kent & Medway area, high street optometrists, general practitioners, screening services and private providers across the county.
The county wide KOR is based on the open source software ‘OpenEyes’. This large project will provide connected care through technology to streamline referrals, image sharing and improve feedback. Using open source software designed from the ground up by clinicians themselves, makes an extremely cost-effective option, whilst ensuring the application development prioritises the clinician’s requirements.
By recording data in real-time, the KOR will undoubtedly improve patient safety and quality of care. The whole team working on this forward-thinking project, have been totally focussed on providing the best care for the patients of Kent and Medway and allowing the medical and admin workforces to become more time and cost-efficient, with the added benefit of no more paper records being needed.
Mr Jafree has plans for Community Imaging Hubs within local optometrists. With all the required information in the OCT scans, hospital staff can triage patients virtually and invite patients into the hospital only when necessary, without the need for unnecessary visits.
While this approach to Digital Hospital Eye Services was in discussion, it might not have been developed with such speed, had it not been for the Covid-19 crisis.
Well done to Afsar and the all the teams involved!
The CW Innovation programme, run by Chelsea and Westminster Hospital NHS Foundation Trust and its charity, CW+, has been transforming service delivery at the Trust’s hospitals, and Mike Wright knows first hand what an enormous job rolling out video consultations, for outpatient appointments was, early on in the pandemic.
Mike explained that during March, the nature of work changed quickly. Any teams within the trust with ICU capabilities were deployed where necessary to Covid-19 wards. While the rest of the hospital had to find a new normal in order to continue to run on a virtual level, managing large caseloads. With Europe’s largest HIV cohort managed by this Trust, together with diabetic patient check-ups requiring a continuation of care, the day to day business quickly became largely about managing risk.
Mike had been having conversations for years in the NHS about services becoming digitally oriented, but NHS Trusts had concerns about the maturity of the technology and the software, information governance, and security. With Attend Anywhere and Zoom Pro now being given the go-ahead by NHS England, staff have welcomed the swift digital transformation.
Training the workforce to use the Attend Anywhere browser-based system, was made easier by the multitude of training videos available. Quick reference guides about lighting, quiet environments, and technical requirements were essential to staff. In time, they were able to train each other, helping the roll out immensely.
ENT, podiatry, and burns therapy departments were some of the first to start using Attend Anywhere for triage, because they needed visuals on the patients in order to put them on the correct pathway.
Zoom Pro, a cross device app, came into its own for large group therapy sessions of 5 or more people, because of its ability to organise breakout rooms. Allowing CBT patients to carry on with the same format of their therapy sessions, from the comfort of their own home.
Mike noted that the most challenging aspect of the process was the administrative actions that were going on behind the scenes. He praised the administrative staff for doing such an excellent job of ringing thousands of patients to explain the new way in which they would be seen by the medical staff, in order to minimise attendance at hospital.
Many have a belief that patients might encounter difficulties using this technology. Especially elderly patients, patients unfamiliar with using modern technology, or those affected by certain disabilities. The evidence from this exercise, found that this was not the case.
The effect of the pandemic has been to speed up the use of video consultations, which are now seen as critical in managing caseloads. Implementing new technology is not a substitute for good quality care, which is the Trust’s top priority, and the workforce have welcomed the new processes with open arms. Mike is happy to report that the majority do not want to go back to the old way of working, because the new system is proving to be more efficient while also improving time management.
Care Information Exchange
Digital innovation in 2020 also has a focus on patient records. The Care Information Exchange is (CIE) for anyone living in north-west London who wants to have more information about their own health and care. This highly populated area is covered by 8 hospitals, all of which can access the CIE, along with GPs and community healthcare professionals.
Funded by Imperial Health Charity and built on the Patients Know Best computer system, patients now have the ability to access digital appointments. This is improving booking efficiencies by letting patients change and cancel their appointment online, quickly and easily. Those that sign up are given access to their care record. The benefits of which are listed on the CIE website, and include:
- Control over their own information:
- Past and future care appointments
- Test results
- Care plan
- Help and advice materials
- Home healthcare devices
- A journal of their health
- Messaging and video conferencing functionality
Although it has been a developing technology for a year, Chelsea and Westminster Hospital NHS Foundation Trust accelerated invitations for patients as part of its response to coronavirus. This resulted in a 4-fold uptake, within a period of 6 weeks at the start of the pandemic
Around 70,000 patients and service users in North West London are using the Care Information Exchange. However, it is important to recognise that not everyone has access to a smart phone, tablet or laptop and patients still need access to a traditional method of appointment booking and communication with medical staff. All channels of communication are still open to patients.
Vital signs monitoring patch
Another successful area of digital health work, implemented during the pandemic, was the management of patients in Heathrow airport’s isolation hotels, using SensiumVitals®, a wireless, wearable, disposable patch.
The technology monitors vital signs of patients to provide early identification of physical deterioration and opportunities for early intervention. Designed by Sensium Healthcare Ltd and implemented when the Covid-19 outbreak came about, meant that travellers arriving at Heathrow needed to quarantine for 14 days and required monitoring. The patches attach to a patient’s chest and monitors and reports their heart rate, respiration rate and axillary temperature providing data back to the hospital IT system, every two minutes. Notifying the Clinical Nurse Specialist of changes in patients’ vital signs.
Mike explained that this type of monitoring technology had been trialled in some areas of the hospital for 3 years but was especially useful in this situation. He was especially pleased that by offering this service and managing it in house, Chelsea and Westminster Hospital NHS Foundation Trust could be part of the wider fight against Covid-19.
Read our interview blog series to find out how NHS Trusts have successfully transformed their services.
It has been more than 6 months since the world had to start adapting to a new way of working during the Covid-19 pandemic.
Hospitals face an enormous challenge as to how they manage large caseloads of poorly patients in an ever-changing climate, whilst ensuring the safety of their workforce and keeping hospitals and community healthcare providers communicating.
With this increased need for digital technology, NHS England were quick of the mark to licence video consultation software for a 12 month period, giving NHS Trusts the platform to carry out virtual appointments where necessary. It was up to each individual trust to innovate and implement the new systems.
We’ve been talking to some key innovators within the NHS on how the digital revolution in health care is speeding up, to help navigate the pandemic, with the aim to be more efficient in the long run.