What is the challenge your project is going to address and how does it connect to your chosen theme?

The first question asked of any new innovation is “what is the evidence it works?”  Torbay Hospital has being using short focussed patient facing information videos (presented as web based library and app) to leverage significant pathway redesign – reducing need for pre-assesssment OPD visits (22% reduction in angiogram), reduction in length of consultations (cardiology / podiatry), improved satisfaction with consent (urology) and reduced need for follow up (30% reduction post shoulder surgery). The Trust is now planning to scale this approach across a minimum of 20 new pathways with the aim of achieving a 4% reduction in OPD appointments, but wishes to understand in greater depth and robustness the impact this approach will have, in terms of patient (and staff) experience and service efficiency. This will not only provide reassurance re the current planned investment, but enable future work to be targeted at specific points in pathways that have been evidenced a having highest impact.

What does your project aim to achieve?

On behalf of the Trusts partnership venture (Health and Care Videos) the South West Academic Health Science Network (SW AHSN) has commissioned the development of a health economics evaluation framework from York University. This will specifically focus on the introduction of video based information into cardiology pathways. The work commissioned only encompasses the development of the framework.

This project aims to

• validate the framework through data collection and comparing the modelled impact with actual achieved
• add qualitative evaluation eg patient and staff experience tools to the framework
• model and test transferability of the framework to other clinical pathways
• assess this approach  as a potential foundation for the impact of other digital interventions

The intended output is a validated tool that can be made available to other Trusts undertaking clinical service redesign to use.

How will the project be delivered?

The cardiology service redesign undertaken in TSDFT has been used to develop a set of assumptions with respect to health economic benefits (appointments avoided / staff time saved). YHEC are modelling these and developing an evaluation framework (commissioned by SW AHSN).  Validated qualitative questionnaires will  assess patient experience and acceptability of the video based patient information.

This project will focus on collecting baseline and post implementation data from two sites – Torbay and Truro where video based information redesign of the cardiac angiogram pathway has been implemented.  Data sources will be patient administration systems, surveys and direct measurement (consultation time). Comparison of this observed impact will enable validation of the YHEC model.

The validated evaluation framework will be developed into a web based tool that can be used to model predicted benefits of video based patient information in other clinical pathways.

What and how is your project going to share learning throughout?

The transferrable learning from this project will include

• understanding the  potential benefits of video based patient information in enabling clinical pathway redesign (and in particular impact on number / duration of OPD appointments).
• factors that need to be considered in evaluating the health economic and patient experience impact of digital interventions
• a web based toolkit that can be used to model the health economic impact that is transferable across clinical pathways and providers

Awareness of the tool will be raised through collaboration between TSDFT,  SW AHSN and YHEC and utilising networks, such as the AHSN network, Devon STP partnership and the Q Community. The results of the evaluation of the cardiology pathway will be disseminated through appropriate mechanisms eg presentations, abstracts, posters and potentially published articles.