Wednesday 15th July 2020
Last week I spoke with Professor Simon Ray, President of British Cardiovascular Society, about changes to appointments, clinics and MDT’s. In our discussion, we looked at how digital innovation has been used to limit in-person services in favour of virtual clinics. Now, the reasoning for this move may be COVID-19, but as we move forward, it is clear that these changes will remain. Patient experience must be at the centre of this new practice, and we recreate the same sense of comfort patients receive from meeting their clinical team in person.
Virtual clinics are an example of how practices have fundamentally changed, with the abandonment of face to face clinics in favour of virtual clinics. There’s no doubt patients understand why this change has happened, and it is difficult to see a situation where we will return to dozens of people in waiting rooms waiting for their appointment. But for these new clinics to be successful, they need to run smoothly and deliver a similar, if not same, the experience of in-person services.
Firstly, we have to maximise the output from the IT infrastructure that is there to ensure best practice for patients. Be it phone or video, 70-80% of outpatients clinics will be conducted digitally. So, there needs to be a cohesive approach from the NHS. Systems have to be accessible, efficient, the functionality needs to be open to patients of all technological abilities, and this needs to be well communicated to the patient.
Secondly, there needs to be an expectation set between patient and clinician regarding contact. There are two parts to this; from our discussions with patients, they have said that the removal of in-person services have made them feel more detached from their clinical team and therefore, treatment pathway. I suggest an expectation of the volume of contact needs to be agreed upon to ensure patients feel connected to their team. Also, patients need to have primary contact decided upon, and a set means of contacting them if anything changes. It is the job of the patient and their clinical team to ensure that patients are comfortable and confident enough to report changes in their symptoms immediately.
Lastly, and most importantly, these new clinics must deliver the same level of care for every patient. There is no denying, that many people do not like talking on the phone or even fail to report changes in their condition that they maybe haven’t noticed or have modified behaviours to cover. In-person services allow a clinician to see subtle differences. We need to make sure that patients are getting the most out of these calls, to ensure this change is having a positive impact on their pathway.
At Heart Valve Voice, our Gold Standard of Care 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 designinga 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 about fostering comfort in this new method and making sure we retain the comfort patients feel when they see and hear from their clinician.
Patients are, of course, central to this process. We have consulted with patients and clinicians from across the treatment pathway who have first hand experience of these new methods. From these discussions, we have identified key areas of concern from both sides, and have developed a guide that will act as a road map to best practice in digital appointments. The guide will allow for patients to plan for the appointment, and identify key issues in their symptoms and pathway that they want to discuss. We want to foster an environment that is comfortable and empowers the patient to be open and honest in this new practice.
Ultimately, communication is going to be central to this digital innovation in clinics, consultations and MDT’s. Patients need to understand why this is the new way of doing things, which I’m sure they do, but they also need to understand what to expect from this unique style of service. In addition to this, patients and clinicians need to improve their digital relationships, to promote comfort and confidence in this system. We’ll be working hard to find out what practice meets everyone's needs and will communicate that very soon.