Digitising the outpatient model

With outpatient capacity limited and demand on the NHS increasingly growing across the board, Dan Worman, Executive Director at Cinos discusses why it’s time to reconsider traditional outpatient services and move to digital models of care.

Outpatient services can be difficult for many people to attend and don’t always meet the needs of patients. This often leads to high rates of non-attendance appointments and poor patient engagement. Last year alone there were in excess of 26 million unattended outpatient visits across the NHS.

The reality is that missed appointments not only result in poor health outcomes and greater use of emergency services but they also contribute to rising costs. With people living longer, many with multiple long-term illness and complications, there is a need for the outpatient care model to be more flexible, responsive and leave patients with a positive experience.

Whether it’s navigating complicated booking methods, lengthy waiting times or delays to see a consultant – the current process contributes to patient as well as staff frustrations and dissatisfaction. For those with complex care needs, attending outpatient appointments can be a traumatic experience. For instance, many stroke patients lose their driving licences after suffering an episode. This makes travelling to appointments more difficult as they have to rely on relatives and loved ones for assistance. In some cases, patients’ needs are better met by residential care and moving from this setting in an ambulance can be a stressful and unsettling experience.

A leaner, greener outpatient model

A large part of the issue is that the current outpatient care model was created at a time when doctors delivered the majority of treatment through face-to-face appointments. The current system not only contributes to the increasing costs and inefficiencies facing the NHS but also the service’s carbon footprint. Its estimated that that the NHS produces higher emissions than the global average for healthcare, making it responsible for 5.4% of the UK’s total carbon footprint.

However, the NHS Long Term Plan sets out the ambition to provide alternative models of care. Its aim is to avoid up to a third of face-to-face outpatient appointments by 2024, instead delivering these interactions through video-link.

Virtual consultations and clinics enabled through video conferencing platforms are poised to have a significant impact on the outdated outpatient system. Firstly, teleconsultations would mitigate the huge cost associated with missed appointments. But secondly and most importantly, video can be a great option for patients who find it difficult to travel.

Shifting towards video consultations removes the general inconvenience, cost, travel and waiting times associated with face-to-face appointments. If implemented effectively there is also the potential to reap efficiency benefits, reallocate scarce resources and generate a positive impact for the environment. All whilst improving patient satisfaction by transforming their experience with outpatient services.

Sharing expertise through MDT’s

Aside from consultant-to-patient communication, video conferencing also enables hospitals to efficiently coordinate health and care services for individuals with complex needs. Known as Multidisciplinary teams (MDT’s) they see specialist clinicians from across primary and secondary care come together, use their expertise to consult on treatment plans and gain an overview of complex patients. For neurological conditions, like patients suffering from a stroke, the MDT might be made up of a consultant, GP with a special interest, a specialist nurse and health professionals relevant to specific conditions.

With patient needs at the forefront, MDTs sometimes require specialists from up and down the country to come together and collaborate in one room. Reliable video conferencing solutions are a central part of an effective MDT setting. It’s important that the in-room video conferencing solution enables users to remotely join the meeting, from any device.

Facilitating inter-person and inter-organisation collaboration is crucial for modern day Trusts and hospitals. Not only does video conferencing technology allow for learning and expertise to be shared but it also presents the opportunity to coordinate care pathways and treatment plans, making sure they are integrated and aligned across the MDT.

By ensuring that audio and video conferences are simple to host and join, MDT clinics have the ability to enable greater communication, understanding and integration between primary, community and secondary care services. With the right investment and specialist video conferencing technologies in place, MDTs can help to improve the quality of referrals and guarantee patients have access to the right clinician first time. Ultimately, this goes some way to helping primary care professionals manage patients in the community. Leading to reduced referrals to secondary care providers and a reduction in waiting times for outpatient services and appointments.

A new approach to appointments

For outpatients, an appointment is often their main opportunity to ask questions and learn about the options available for managing their condition. Video consultations and clinics can benefit this type of appointment style as it lessens the disruption to a patient’s life. As well as reducing the need for hospital resources such as consultation rooms, parking and support staff.

With clinical staff and patients sharing similar frustrations with outpatient care, video conferencing technology is well placed to provide patients with engaging experiences. Whilst also helping clinicians access the information they need, at the time they need it, so they can make informed decisions and continue to provide quality care for long term conditions.







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