Monday 13th July 2020
President of the British Cardiovascular Society, Professor Simon Ray, recently recorded a podcast with the British Medical Journal on ‘The Future of Cardiology in the Post-COVID-19 era', where he discussed how digital innovation is changing the cardiovascular landscape. Professor Ray took some time to talk to our CEO Wil Woan about virtual valve clinics, digital consultations, virtual MDTs, and how digital innovation will change the future of valve disease care.
Wil Woan “Hi Simon, thank you for taking the time to speak to me today I really enjoyed the podcast you did with BMJ and wanted to go through some of things you talked about, and what that means for valve disease patients.”
Prof Simon Ray “No problem. Thanks for asking me, Wil."
WW “During the podcast, Simon, you talk a lot about how practices have changed during the COVID-19 response and how we can learn from this moving forward. One of the things you discuss, which we’ve also heard talked about by other clinicians, is ‘Virtual Clinics” - can you tell us a little more about them?"
SR “Well there has been an extraordinary amount of changes made using this crisis, Virtual clinics are in example of how practices have changed in a fundamental way, with an abandonment of face to face clinics in favour of virtual clinics, and I just don’t see that going back. For me, remote outpatient clinics are here to stay, so we have to maximise the output from the IT infrastructure that is there to ensure best practice for patients. Be it phone or video, I think 70-90% of outpatients clinics will be conducted digitally. Now there will be examples of patients who will need to have face to face clinics, and we need to collectively identify who those groups are convey that to patients, primary and secondary care."
WW “It does feel like virtual clinics and digital consultations are here to stay. And groups of patients sitting together in crowded clinics doesn’t seem like something anyone wants to go back to. In this new way of doing things, it’s about making sure patients are getting the right experience, because this is a totally new way of doing things. So how do we make sure patients are getting the most out of these new consultations?"
SR “You’re completely right, Wil. As we transfer to this new style of clinics we have to ensure patients are comfortable and confident in the new method. That’s a job for the health service, and patient organisations like yours. Documents like your Gold Standard of Care and the recent BHVS best practice guidelines will form a pivotal role in that.”
WW “Of course, our Gold Standard is more important than ever, and we need to look at how we can adapt it to suit this new way of working. One thing we are in the process of designing at Heart Valve Voice is a patient guide for a virtual clinic. We want to alleviate the anxiety patients might feel from sitting at home waiting for the call, and make sure they get the most from the time they have with their clinicians on the phone. It’s just about fostering comfort in this new method, and making sure we retain the comfort patients feel when they see and hear from their clinician.”
SR “That patient comfort is crucial. We need to set a level of expectation for communication between patient and clinician that ensures they are still informed, they have confidence in their treatment and they feel connected to their healthcare service."
WW “I completely agree. We’re in discussions with patients and clinicians to find out what a realistic contact expectation is. Just knowing what that level is will improve patient experience. This is a new system so there’s learning on both sides of it."
Another thing you talked about on the podcast is Virtual MDT’s. Can you tell us a little about the impact that has had on treatment pathways?"
SR “Well, normally an MDT takes place in a meeting room at the hospital, , and it’s where the health care team get together to make decisions on patients treatment pathways. Due to COVID-19, we are no longer able to meet in person, so they’re all done securely via video call. Doing it this way has had two major differences, greater frequency of MDT’s and wider involvement."
WW “By wider involvement, do you mean better interaction with external services?”
SR “Exactly. In a virtual MDT more than one institution can be involved. This improves access to MDT’s and contributes to better decision making. In addition to that virtual MDT’s allow for a more nimble process. One of the frustrations is often that if an MDT is on a Thursday and a patient presents on Friday it can be a wait till they get a formal clinical response. Doing it virtually removes this issue as it provides the flexibility to have more frequent meetings. Rapid decision making and patient flow from these virtual MDT’s is something we need to capture and cement in the guidance."
WW “I totally agree. These elements of digital transformation need to be harnessed. These are new processes, and so communication to the patient is crucial. We need to develop the culture of virtual clinics to ensure they’re delivering for patients, and then grow the MDT’s. One thing I was discussing with a GP involved with Heart Valve Voice is how do we get them involved in these virtual MDT’s? These connections could a powerful resource and improve treatment pathways exponentially.”
SR “The next step with these processes is guidance and guidelines. We’re due to update the 2015 guidance on MDT’s in the near future. So we need to cement these changes into them, but also look at how we develop and improve the changes we’ve made so far.”
WW “Those guidance will be important. At Heart Valve Voice, we’ll look to our Gold Standard to see how we can work with patients and clinicians to secure a best practice that suits everyone. I look forward to working with you and others to ensure heart valve disease patients’ needs are heard and delivered on. Thank you for your time, Simon.”
SR “No problem. Thank you for opportunity to discuss things.”
Thank you, Professor Ray, for taking the time to talk to us. This week we will be publishing further information on how these new consultations relate to our Gold Standard of Care, as well as a Patient Guide to Digital Consultations, which will ensure patients and clinicians are getting the most out of their consultations.
To listen to Professor Ray's interview on the BMJ podcast, click here.