Mike Wright, CW Innovation
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
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.