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  • Joanne Morris posted an update in the group Sustainable Healthcare 2 years, 6 months ago

    Re: Delivering more ‘sustainable healthcare’ using video consultations – what do traditional face to face outpatient appointments ‘cost’ patients and wider society
    Hi,
    We are involved in a Health Foundation funded project to scale up the use of video consultations in outpatient clinics. We believe video consultations provide more ‘sustainable healthcare’ – more sustainable in terms of environmental factors which are key but also in terms of ‘costs’ to patients and wider society (e.g. costs of time of work and away from other commitments, travel, parking). We are currently gathering data from our outpatient clinics to determine how people travel to clinic, how much time it takes and how much it costs them and any companions. We use the travel information to calculate approximate carbon footprint.
    Message me if you want to know more or would be interested in using our self completion questionnaire for patients in any of your clinics, it could be interesting comparative data.
    Jo (Barts Health NHS Trust)

    • Hi Joanne! Definitely interested in exploring this.

    • Dear Jo,

      It would be great to hear how your project is progressing, especially given the shift that the coronavirus pandemic has created to remote consultations.

      Amongst the difficulty and real threat of the pandemic it is heartening to see how people and organisations are responding creatively and making changing happen, accelerating transformation.

      In our local hospital trust 40 video-consultations took place on this Monday, with more computers and iPADs ordered to help scale up this change. Local GP practices are switching to telephone appointments for all first contacts.

      What are you seeing, Jo?

      And I wonder what the experiences are of other members of the SIG?

      It would be great to hear. In the midst of this busy time it is still going to be important to note the impact of these changes.

      • Hi Olivia,
        Nice to hear from you. Great that your local Trust had 40 video consultations in one day. Is this within OUHs? Would be good to learn more.

        We have been streamlining set up here –
        – fast tracking the changes required to the appointment systems (currently only setting up whole clinics to use video rather than allowing clinics to have a mixture of video and face to face appointments)
        – prioritising clinics (ICT are testing bandwidth capacity)
        – training staff remotely in how to use the ‘attend anywhere’ system
        – increasing the number of virtual ‘waiting rooms’ we have with attend anywhere
        – updating guidance on our intranet and website (in progress) see https://www.bartshealth.nhs.uk/video-consultations
        – considering other ways to use video consultations

        There will be a HF webinar on Wed for those that are interested 25th March, 14.00 – 15.00 for ‘Video consultations: how to set them up well, fast?’ which is being delivered by Professor Trish Greenhalgh

        If anyone has any questions feel free to get in touch.
        Bw, Jo

      • Thank you for your reply, Jo.

        Yes, the 40 consultations were at the beginning of running video consultations at OUH. I’m sure that many more have been run since then. In the meantime teams are using Telehealth.

        It was interesting to hear what you’re doing at Barts in adapting rapidly (although perhaps you were ahead of the game?).

        I’m really curious what the need is for virtual waiting rooms when videoconferencing and what function they serve?

        Also, what support do you think that the SusQI community or other communities can give to healthcare organisations making the transition from face to face to video-consultations/telephone consultations?

        One aspect that struck me was that telephone consultations are a particular skill (not all patients have internet or are able to use it) and staff may need communications/triage training?

        What about technical support for patients dialling in?

        And what are your thoughts on capturing data on the impact of the changes for sites who are not a test site for a research study?

        It’s great that you’re working on this area!

        All good wishes,

        Olivia

    • Hi again,
      The ‘virtual waiting rooms’ are a feature of the package we are currently using called ‘attend anywhere’. The patient clicks on a link on the hospital website and enters a ‘virtual waiting room’ until the clinician is ready to see them – the clinician then effectively calls them into the ‘consultation room’ when ready. It’s not necessary but makes a smooth process, as close to the face to face experience as possible.

      I believe the clinicians who have used video have felt it is more like a face to face consultation than a phone call, but it does take a bit of getting used to – our guidance documents are aimed at giving some advice for those just getting started – https://www.bartshealth.nhs.uk/video-consultations

      Technical support for a patient dialling in may be an issue (and some places in Scotland have provided support or provided a test call), however the current system we are using is very easy to use and there are good guidance documents available. There is no need for a patient to download anything to their device or set up any log in’s. Just follow a link or click a button.

      With regards to capturing data, this is always important. We have a very short patient feedback questionnaire that pop’s up at the end of the consultation. You can also use anonymised routinely collected data, such as DNA rates, which is not considered research.

      With regards to support from the community, I think sharing the learning and directing people to resources that are available. People are welcome to contact me; joanne.morris15@nhs.net. In most Trusts I suspect there are people who are already working on this.

      Very best wishes,
      Jo