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ROC self management
- 1. ROC a clinic in your pocket TM Remote and self-management for patients. IBD Palliative Cancer Mental Health ©Openbrolly 2017
- 2. ©Openbrolly 2017 What have we learned? Many of the needs of patients and staff are the same across chronic conditions. Strong patient demand for peer group and holistic care. Strong demand for communication with care team when needed. Staff need integration with core systems. Tim Bishop for Weber Shandwick Worldwide danieljordahl
- 3. ©Openbrolly 2017 Patient centric Dietician Example of new personalised source of support. Clinician Clinical advice and information. Patient Organisation Other accredited, expert advice. Patient Expert Extensive non-clinical experience and advice. The patient wants care and control.
- 4. ©Openbrolly 2017 Our aim To deliver health outcomes which include: • Better management of symptoms. • Better management of life style. • Better decisions by clinicians through symptom and needs reporting to the clinician. • Better decisions by patients through access to relevant and timely self- management information. • The delivery of this IBD-related information and actions into core NHS secondary care systems. The change offered will enable a move from time-based clinic attendance to needs based attendance and early intervention.
- 5. ©Openbrolly 2017 What does it look like? Digital care library Signposting to accredited content categorised by disease, symptoms etc. Care decision rules set With given symptoms and needs the clinical team would advise X. We capture that. Integration to NHS SciStore PROMs and PREMs Feedback from patient cohort on advice given. Symptoms and needs reported by patients. Advice and content direct from care team with additional support from system for self-management. Communication
- 6. ©Openbrolly 2017 How does it work? Symptoms Needs Triaged Advice and signpost NHS Core Capture rule set Relevant content Dashboard Research
- 7. ©Openbrolly 2017 How does it work? - PROMs - PREMs Good or Bad Experience NHS Core systems Revise rulesUse rule set Relevant content Triaged Advice and signpost Symptoms Needs
- 8. ©Openbrolly 2017 Patient journey in progress • Cathie, lives with Crohn’s, fills her daily diary on her tablet computer. • She also enters her fecal calprotectin readings. • She’s received an SMS reminder asking to answer a few additional questions about concerns she may have in advance of her video consultation. • Cathie fills that in at the same time. She highlights that she’d like more control over her diet.
- 9. ©Openbrolly 2017 Patient journey in progress • ROC’s artificial intelligence system analyses the incoming information, along with known clinical information. Using the Harvey-Bradshaw index Cathie's condition remains stable. • No alert needs to be generated for the care team, but the information is recorded and graphed for use at the multi-disciplinary team discussion. • Meanwhile ROC notes her concerns and recommends information from the digital care library: the CCUK leaflet "Food and IBD" and a YouTube video on the effect of nutrition on Crohn’s. It also offers an app which could help.
- 10. ©Openbrolly 2017 Patient journey in progress • Cathie self-refers and the nutrition app is downloaded and, with her consent, is pre-populated with relevant information she's previously entered. It recommends foods, recipes & diet plans tailored to her based on an extensive nutritional database. • Cathie has already tried the video and the app but found neither really worked for her.
- 11. ©Openbrolly 2017 Patient journey in progress • Sam, her IBD nurse, has the latest patient reported information about Cathie’s symptoms, wellbeing and concerns, it saves time gathering information at the start of the consultation. • Since the app didn’t work Sam offers to refer her to a nutritionist for a 1-to-1 discussion. Cathie agrees and the decision is noted. As a result, she receives a new message from Sam with information on how to best prepare to make the most of her time with the nutritionist. • During a system review it’s noted a significant number of patients have fed back that the YouTube video was not useful or effective for them. As a result, it’s dropped from the digital care library. • Meanwhile, the new information held is sent electronically to update the national IBD registry.
- 12. ©Openbrolly 2017 Next AI Digital care library Signposting to accredited content categorised by disease, symptoms etc. Care decision rules set With given symptoms and needs the clinical team would advise X. We capture that. Integration to NHS SciStore PROMs and PREMs Feedback from patient cohort on advice given. Symptoms and needs reported by patients. Advice and content direct from care team. Artificial Intelligence support from system brings self-management closer to the patient and quickly.
Editor's Notes
- Good afternoon everyone. Thanks for attending and contributing to this SBRI. Over the last three years we have learnt of the many of the problems, concerns and complaints that surround chronic health care, IBD in particular. But we have also seen there are opportunities going forward. We began with IBD symptom reporting, then developed in to more holistic palliative care, then bowel cancer, more recently mental health and now we are back to applying our learnings in IBD and raising our game by bringing in AI, not computer at this stage :-). Key partners eHealth team NHS Highland, RGU.
- Patients are a key resource that can be used for their own care. They want care and control and that offers the opportunity to better manage intervention though less unplanned care, clinic sizes etc. BUT, they also mentioned that they need something beyond clinical care. They want help managing their disease on a day to day basis. There is also a role for holistic care agencies such as councils etc.
- Care quality issues
- Based on our ROC system that has developed over the last three years. Library is signposted content: web pages, video, apps, contacts etc. It can be created internally but need not. Apps for mobiles and tablets. Secure 2 way messaging. The key thing we are adding is the ‘Artificial Intelligence’ - the rule set. RGU academic partner - Intelligent systems team.
- Symptoms and needs go to clinical dashboard. The clinical team triage and may offer advice and signposting to relevant content. This is captured and built up into a rule set. Cores systems for anyone interested are SciStore, TrakCare etc.
- The rule set comes into play. It offers early advice and allows the patients to feedback on it. Experience - PROMs and PREMs.
- What does it mean for the patient? I’m taking for granted the potential outcomes of changing the care pathway; less busy clinics, early intervention, holistic patient well being.
- Consultation by phone.
- Based on our ROC system that has developed over the last three years. Library is signposted content: web pages, video, apps, contacts etc. It can be created internally but need not. Apps for mobiles and tablets. Secure 2 way messaging. The key thing we are adding is the ‘Artificial Intelligence’ - the rule set. RGU academic partner - Intelligent systems team.