Liverpool trust set to integrate digital PIFU across 30 pathways

Liverpool University Hospitals NHS Foundation Trust (LUHFT) is delivering digital patient initiated follow-ups (PIFU) at scale as part of its ambitious digital outpatient transformation.

The trust plans to exceed PIFU targets set by NHS England, which requires organisations across England to have 5% of patients on a PIFU pathway, with an innovative PIFU solution currently being implemented across many of its clinical specialities.

The trust’s success to date is underpinned by the implementation of digital PIFU solutions provided by DrDoctor, which are live across six pathways, with more planned.

The services include Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) in the gastroenterology department, specialities that have historically struggled with long wait times.

Integral to the trust’s elective recovery is its digital-first approach, which enables staff to manage patients safely and effectively, improving the patient experience.

While some NHS organisations are rolling out PIFU piecemeal, the trust is achieving it at scale by implementing digital PIFU.

Underpinning our clinical services with modern digital solutions is the best way to rapidly reach more patients

This approach avoids unnecessary telephone and face-to-face appointments and empowers patients to make choices about their care.

And, by integrating with its patient administration system (PAS) and electronic patient record (EPR), the trust will generate efficiencies and ensure a positive user experience, reducing administrative burden and freeing up clinical time.

Dr Jason Bincalar, chief information officer at the trust, said: “Our approach to PIFU breaks new ground. We identify opportunities to provide our patients with greater control over their care, and we use digital solutions to improve patient engagement and staff efficiency.

“I am proud that we have found an innovative way of achieving these goals, and we already have PIFU operational for several of our clinical services.

“Underpinning our clinical services with modern digital solutions is the best way to rapidly reach more patients and working with DrDoctor has been great, as we have co-designed a blueprint to onboard more clinical services, allowing us to provide greater opportunities for our patients.”

By incorporating digital PIFU across multiple pathways, clinicians are provided with another option for the patient when discharge is inappropriate and routine follow-up appointments are unnecessary.

For example, on the IBD pathway, patients and clinicians conduct remote monitoring instead of attending all follow-up appointments.

Incorporating a faecal calprotectin application, allows patients to receive a reliable stool reading without the need to visit the hospital.

Using these digital tools, the patient can exercise far greater control of their care, reaching out to us only when they believe we are needed

The patient receives real-time information about their condition and, depending on the result, can request an appointment, or the information will trigger a Clinician Initiated Follow-Up (CIFU).

There is potential for 80-90% of patients to be placed on a PIFU pathway once the clinician and the patient agree that it is the correct action to take.

Dr Bincalar said: “Using these digital tools, the patient can exercise far greater control of their care, reaching out to us only when they believe we are needed.

“And, as we are using purpose-built digital solutions, we will also have full visibility of the patient’s health record, making clinical intervention possible.

“Suppose an existing patient is admitted to one of our hospitals with a new condition. In that case, we will continue to grow the patient’s clinical history, providing our clinical teams with all the relevant information.

“ I am leading a patient-centric digital transformation that focuses on frontline care and the digital transformation paves the way for Care Record Liverpool (CaRL), a comprehensive and secure longitudinal electronic patient record for citizens of Liverpool, Merseyside, and beyond that we will share with our patients and our Integrated Care System partners.”

With plans to introduce PIFU across many more pathways, there is great potential for the trust to tackle its elective backlog as the digital solutions are scalable.

Tom Whicher, chief executive of DrDoctor, said: “While we have the tools, we very much hand over to the trust to do the plumbing.

“Every organisation, hospital, and department is different, so we provide them with the flexibility to configure the solution in ways that suit them.”