News and presentations from today’s conference focusing on setting up and running virtual clinics in practice.
Setting up and running Virtual Clinics
Joe Wherton, Research Fellow, University of Oxford
The VOCAL study (funded by the National Institute for Health Research, 2015-2017) is an ethnographic and action research project that seeks to illuminate the complexity of remote video consultations and the system in which they are nested (including organisational, legal, regulatory and policy contexts). The research is based in two contrasting clinical settings (diabetes and cancer). It consists of in-depth studies of real consultations (micro-level) embedded in an organisational case study (meso-level), and review of the national context (macro-level).
This presentation will highlight the key challenges to the implementation and sustained use of Skype for remote consulting in a large NHS trust. The presentation will highlight the benefits and challenges to conducting remote consultations, organisational barriers and the practical steps taken to help integrate such service within routine care practice.
Developing National Standards for Virtual Clinics
Dr Tim Yates, National Medical Director’s Clinical Fellow, NHS Digital
In his presentation Dr Tim Yates stated:
“The CQC have spent some time drafting a digital practice report. They have inspected 6 and found that these 6 had bad practice”
“The GMC have several core documents that direct us to good practice”
“Primarily the patients should benefit from virtual consultations. Benefits should be clear to the patient and consented”
“There are going to be some cases were virtual clinics is not going to appropriate.”
“You have got to get backup plans, other wise there is going to be risks – what is skype does not work etc.”
“Virtual clinics is not something that you just get in to, you really need to think about how you are going to make it work and the risks.”
“We need different quality metrics for Virtual consultations.”
The Practicalities of Virtual Clinic implementation: Case study: An Allergy Virtual Clinic
Roisin Fitzsimons, Consultant Nurse Allergy Service Lead for Quality, Patient Experience and Transformation, Guys & St Thomas’ NHS Foundation Trust
This talk will look at the trials, tribulations and successes of setting up virtual clinics in an allergy service. The allergy service at GSTT has worked in close collaboration with stakeholders to develop innovative care pathways for children and their families with allergic disease. Having an advanced knowledge of patient experience and listening to patient feedback we recognised patients and their families do not all want traditional access to healthcare. The development of a rapid access referral pathway for children with a suspected drug allergy, is one such example. Through collaboration with stakeholders in Children’s A&E and the allergy service, guidelines were developed and implemented where no precedents existed. The service has been a success and has become incorporated as everyday practice. Benefits include the reduction of waiting times for investigation, liberating children from the label of ‘allergy’ which can have implications for microbial resistance, treatment and cost. This service development demonstrates how a quality improvement programme can have far reaching implications for the wider NHS.
Asynchronous Virtualisation: Supporting Virtual Clinics with web-based questionnaires
Case study: Virtual Clinics: From Urogynaecology to Pre Operative Assessment
Dr Stephen Radley, Consultant Obstetrician and Gynaecologist, Sheffield Teaching Hospitals NHS Foundation Trust
Pre-Conference Abstract: Virtual Clinics: From Concept to Implementation
The initial development of an electronic Personal Assessment Questionnaire (ePAQ) was driven by issues of data entry & analysis as well as aiming to enhance the value and reduce the burden of questionnaire use in clinical practice. Harnessing the power of detailed, reliable, objective and meaningful patient self-assessments is now proving valuable, not only for outcomes monitoring, but more importantly, better understanding of patients’ conditions, particularly those of a sensitive or complex nature and when patient’s views of their condition and symptomatology are critically important in well informed shared decision making.
Well-designed web-based self-completed questionnaires can enhance communication and support Virtual Clinics, where elements of patient assessment are conducted remotely and inform consultations and subsequent management. This is proving particularly useful in the context of surgical follow-up, where ePAQ is combined with scheduled telephone consultation, usually 3 months post operatively. The technology is now being applied more widely in other areas, such as vascular disorders and pre-operative assessment, enabling enhanced communication, efficiency and quality of healthcare. Demonstrable benefits include cost, capacity, patient flow and patient experience.
Full PowerPoint presentation
From Virtual Clinics to a Virtual Ward
Dr Majid Akram, GP, The Deepings Health Centre
Telemedicine has the potential to offer patients enhanced access to healthcare and promises convenience to both patients and clinicians. Is the NHS ready for this challenge to disrupt the way it operates and delivers care to patients and communities through video medicine?
Dr Majid Akram will share his experiences of working within the digital health sector with his roles as an advisor to both digital providers, the NHS and the regulator. The audience will learn from his experience of designing a Telemedicine service within a large rural community, and his knowledge of how to overcome professional inertia and organisational bureaucracy. While remote consultation seems like a good idea to health leaders the clinical work force is still sceptical and has concerns about potential pitfalls. Mass utilisation of remote consulting might be made possible through an incremental approach by introducing telemedicine within defined areas of clinical need. Using this approach the success can be measured and safety and quality can also be proven. We also need a program of telemedicine training designed for clinicians that will improve confidence and allow the healthcare work force to feel as comfortable with remote digital health care as they currently feel about direct face to face and telephone care.
Future events of interest:
Nurse Clinics 2017
Monday 20 November
De Vere West One Conference Centre, London
Emergency Day Surgery Summit
Effective Operating Theatres Summit
Setting Up and Running Virtual Clinics
National PROMs Summit 2017
In-depth legal masterclass: Informed Consent After Lanarkshire
9 October 2017