Follow-up digital care pathway helps address backlog

Endometriosis patients at Homerton University Hospital in east London now have greater control of their care following the launch of its digital Patient Initiated Follow-Up (PIFU) care pathway this week.

The service, facilitated by Healthcare Communications, will automatically trigger digital questionnaires via the Patient Portal at three, six- and nine-month intervals, when patients would normally attend a face-to-face appointment.

And responses are immediately available for review, enabling the hospital to call those patients that require active management to attend a face-to-face appointment and releasing capacity for additional urgent appointment requests.

In addition, patients can access the questionnaires at any time to report flares in their condition or worrying symptoms.

These are then immediately triaged, resulting in faster access to clinicians.

Like all NHS trusts, we are experiencing huge demand for our services and so are looking at ways to reduce backlogs and operate more efficiently while also delivering quality care. PIFU is one way that we can do this

The hospital believes the initiative will deliver improved outcomes for its patients, enabling them to access care when they need it and removing the need to attend a face-to-face appointment if their condition is under control.

Dr Marianne Wild, consultant obstetrician and gynaecologist at Homerton, said: “Endometriosis is a long-term chronic condition that takes an average of eight years from onset of symptoms to diagnosis. And, following diagnosis, it can still be difficult to manage, with patients experiencing flares at short notice.”

Marcus Pradhan, the hospital’s performance improvement manager, explained that the hospital took the decision to implement PIFU in response to NHS England guidance and as part of the NHS response to the COVID-19 pandemic.

He said: “Like all NHS trusts, we are experiencing huge demand for our services and so are looking at ways to reduce backlogs and operate more efficiently while also delivering quality care. PIFU is one way that we can do this.”

Working with the hospital’s clinical teams, Pradhan identified the gynaecological department, and specifically endometriosis patients, as suitable for a pilot PIFU project.

And, following demonstrations of several PIFU solutions, the trust selected Healthcare Communications to deliver the service due to the simplicity of the system and the user-friendly patient interface.

Pradhan said: “When implementing a patient-facing solution, we had to be sure that it wouldn’t negatively impact on their care.

“In particular, we had to be sure that our patients could navigate the questionnaire, which is very lengthy.”

It means that those patients who are well won’t need to see us unnecessarily and those that do need treatment will have access to care

Dr Wild added: “PIFU is the perfect model for managing long-term conditions such as endometriosis.

“It means that those patients who are well won’t need to see us unnecessarily and those that do need treatment will have access to care.

“It is improving the overall patient experience and will ultimately lead to better care for our patients.”

The PIFU model is also providing additional benefits for the trust as the data captured is available for auditing and research purposes.

Dr Wild said: “As a tertiary referral centre for complex or severe endometriosis, accredited by the British Society of Gynaecological Endoscopy, we are required to monitor our patients for two years and we need to be able to demonstrate this during regular audits.

“Through the data we are collecting via our PIFU questionnaires, we will be able to demonstrate this very easily.”

She also hopes the data will open up opportunities for research.

“There’s a huge drive for research to determine effective endometriosis treatments and to generally improve our knowledge of the condition,” she said.

“The data we are collecting will, with our patients’ consent, enable us to undertake comparison studies looking at the effectiveness of various treatment options. It is really exciting for us to be able to do this.”

This has significant potential for supporting trusts in their efforts to optimise appointment scheduling and to tackle backlogs and capacity challenges

Following successful completion of the pilot, the trust hopes to roll the initiative out for other long-term conditions and within other departments.

Concepta Wayment, vice president of transformation at Healthcare Communications, said: “Our technology is primed to easily facilitate bespoke questionnaires, such as that used by Homerton, ensuring that the PIFU care pathway can be tailored for specific medical conditions.

“This has significant potential for supporting trusts in their efforts to optimise appointment scheduling and to tackle backlogs and capacity challenges.”