20 April 2020
We launched our Best Practice Awards to highlight and share innovative solutions to challenges in rheumatology that help improve the lives of patients. Despite the difficult circumstances we’re all living in, we wanted to continue to celebrate all the hard work and dedication of rheumatology teams.
In the first of our series of blogs showcasing our 2020 Best Practice Award winners, we speak to the rheumatology team at Northern Devon Healthcare Trust. They are pioneering virtual video clinics for patients, which are proving even more essential during the COVID-19 pandemic.
Our Best Practice Award winners were shortlisted before the COVID-19 pandemic, but what is clear is how innovative the team at Northern Devon Healthcare Trust was in introducing secure virtual video clinics to reduce patient travel time, limiting impact on staff while improving patient experience.
The project
The team had the idea due to the geographical spread of their patients. As the most remote acute hospital in England, significant travelling distances means that a 15-minute appointment requires a patient to have half a day away from work, as well as incurring costs such as parking charges.
Dr Stuart Kyle, who led the project, explains: “It was very much about the rurality of where we are, it was in line with NHS Digital’s plan and it felt like the right thing to do.”
In 2018, patients began using a patient portal and demonstrated they had suitable IT skills and enthusiasm to embrace new technology.
Dr Kyle says: “I knew who my stable biologics patients were who were self-reporting, and I wondered why I was bringing them up to hospital for appointments when I could see them via video in their own homes. It’s not a substitute for face-to-face hands-on examinations; we still need to see patients, but we don’t need to see them physically as much as we do.
“I was lucky to link up with Amy Williams in our project development unit, who helped drive this through. It was critical to have her involvement; she was able to link up all the steps in the pathway, including information governance, IT and outpatient. It’s been nice for our small rheumatology department to be recognised by our peers for doing something innovative that’s got patients’ best interests at heart.”
A pilot took place between June-September 2019, using video consultation software ‘Attend Anywhere’, allowing clinicians to hold secure and confidential appointments. Patients could connect from any device using an app or internet browser and there was a virtual waiting room where the clinician could communicate with patients if they were running late. Blood results, scans or other visuals could also be shared during the consultation.
The benefits to patients have proved to be enormous; they say the virtual appointments are much more convenient, they feel more relaxed and it saves them taking time off work. More than 90% of patients said they would like to see their clinician via video consultation in the future.
Key benefits for the Trust have been the ability to provide follow-up appointments from a non-clinical environment, potentially freeing up clinical space for other services. This can also reduce the use of hospital transport and parking requirements.
What happens next?
Dr Kyle says the team is expanding the use of virtual clinics. He explains: “For stable biologics patients the idea is that we will alternate between virtual and face-to-face appointments. They will see us annually for a consultation and examination, and at other times we’ll use virtual clinics.
“We also want to use this in the mainstream with all our stable patients. In two years, around 20-30% of clinic consultations will be done virtually – not just rheumatology, but across everything.”
The haematology team at Northern Devon is now using the technology, with interest from cardiology and respiratory specialties.
What impact does COVID-19 have on the project?
Dr Kyle says COVID-19 will change the way that we practice medicine. He says: “I’ve used the technology during the COVID-19 pandemic to see patients who are shielding. It’s vital that we keep seeing patients during the pandemic and they get the support they need, so this is a great tool to be able to do that. I don’t want to be bringing patients up to the hospital if it can be avoided, but I want to check they aren’t deteriorating. There’s lots of ways I see this infrastructure being used throughout the healthcare system.”
What did our judges say?
The Best Practice Award judges were impressed with how technology was embraced.
BSR President Dr Elizabeth Price says: “Given the current COVID-19 pandemic this is a timely innovation. The video technology allows patients a virtual but still effectively ‘face-to-face’ appointment with their specialist. The software collects PROMS, allows sharing of blood and X-Ray results and can even allow additional team members, such as nurse specialists, to join the call if needed. Once the current pandemic is over, rheumatology has a real opportunity to adopt novel ways of working and this is an insight into what the future may hold for us all.”
Congratulations to the team on their well-deserved award. We’ll be showcasing the work of each of our Best Practice Award winners over the next few weeks.
View poster