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

When bronchiectasis patients have exacerbations, they need to submit sputum samples, start pre-prescribed rescue antibiotics before calling to enquire about their results. More proactive management of results by healthcare professionals can be very time consuming and increases dependence. We aim to improve this process using automation to retrieve sputum sample results and reporting directly to patients (via SMS initially). We will use an algorithm supported chatbot to help the patient manage their antibiotics with minimal health care professional intervention. This will eventually incorporate video links to patients and may involve an AI chatbot, to provide a more fluid experience for the patient.  The aim of this work is to improve the patients’ experience of the management of their disease, and free up clinician’s time for tackling difficult cases. The functionality could be translated into other chronic diseases.

What does your project aim to achieve?

This project aims to support patients to self-manage their condition and to ensure timely provision of results and advice where necessary. We hope to achieve this whilst reducing unnecessary health care worker interventions.   By ensuring timely communication of results and supporting this with simple advice via chatbot the quality of care should be improved whilst also freeing up clinician time for more complex cases. We want to work with patients to develop user centred tools to communicate with patients utilising devices patient already have without the need to download dedicated apps ie using SMS, SMS interactive chat and email for those that choose.

How will the project be delivered?

This project has already gone through a phase 1 implementation. We have utilised robotic process automation in a Microsoft Access 2010 database to check sputum samples daily for our bronchiectasis patients. Abnormal results are forwarded to the appropriate clinicians. We have also used the GOV.uk Notify to send patient information links and management plans to patients. As it stands, a clinician needs to connect these two processes. We are currently working with the digital team on how to automate the retrieval of lab results via the more stable protocols using APIs (application programming interface). We are also collaborating with Gloucestershire University to receive two placement computer science students starting this September. Benefit to patients will be via survey of their experience of the bronchiectasis service before and after implementation of this new system. Risk will be carefully assessed with the help of the trust’s clinical governance team.

How is your project going to share learning?

We plan to share all programming, so that others can use the code, and hence implement the digital system in other disease sites and trusts (where possible we will use open source code). We plan to showcase our work at the BTS (British Thoracic Society) conference and also Q meetings. We hope to develop interest from other Q members who could benefit and even collaborate on this work. We hope that learning on this group of patients will inform the development of similar approaches in patients with other chronic diseases to support their self-management and have had interest within our organisation from other specialties.  In the early phases of this work in Gloucestershire, this has already benefited a 2021 Q Exchange project to share learning around remote models of care and this will continue.