Project Name: Digital Solution - Penguin Patient Management System – Musculoskeletal Clinical Assessment & Triage Service (CATS) and Musculoskeletal Physiotherapy – Service Development

Project Summary:

Provide and implement the Penguin remote monitoring solution in the Musculoskeletal Clinical Assessment & Triage Service (CATS) and Musculoskeletal Physiotherapy Service to assist both in the ongoing monitoring and care of disease management and health to improve access and experience of care.

In this project, Cievert (on behalf of Novartis), will complete the configuration of a bespoke clinical templates by determining the clinical data to be collected for Service Development. Following configuration, the Penguin system will then be implemented within the Trust’s system.

Implementation of the solution in the NHS aims to;

  • Empower patients to own their disease through the ability to track their disease through validated Patient Reported Outcome Measures (PROMS) and clinician touchpoints over time;
  • Flag to clinicians patients who report outcome measures that are outside of the clinically-determined tolerance levels, or whose scores are on a consistent downward trend. These real-time rapid alerts of patients not achieving optimal outcomes will enable their care to be reviewed and optimised more quickly than if the patient had to wait for a scheduled appointment;
  • Support the move to a needs-based care model, keeping well-managed patients with minimal disease impact out of secondary care and managed through virtual consultations, recycling capacity to manage those patients who are not achieving optimal outcomes;
  • Support clinicians to make a confident and informed decision about a patient’s treatment plan, virtually or face to face, based on patient reported outcomes; and
  • Enable clinicians to prioritise new patient referrals and the backlog of patients caused by unanticipated workload e.g. COVID-19, based on assessment of patient needs using the validated PROMs.

The expected outcomes from this project (from baseline to 12 months) will be as follows:

  • Improvements in PROMs and disease assessment scores measured at baseline and after every interaction or at regular intervals (as determined by the clinician) with the platform up to 12 months
  • Improvements in patient experience scores measured at regular intervals (as determined by the clinician) with the platform up to 12 months
  • Improvement in clinician experience scores measured at regular intervals up to 12 months
  • Faster access to emergency appointments for patients not achieving optimal outcomes measured by PROMs at baseline and up to 12 months
  • Reduction in DNAs measured at baseline and up to 12 months
  • Reduced backlog of patients waiting for treatment reviews measured at baseline and up to 12 months
  • Maintains NHS data security standards with no data breaches

Planned Milestones:

  • Project kick-off meeting
  • Preliminary Paperwork/Sign off
  • PDS IT interfacing work completed
  • Participant Mapping
  • Local Training & Configuration of Local Test Platform
  • Live System Set-up
  • Start of 12-month license, hosting and support
  • Business Case, Write-Up and Project Close

Expected Benefits:

  • Empower patients to own their disease through provision of educational resources and ability to track progress through validated PROMs and clinician touchpoints over time.
  • Better management of their disease via the clinician’s specifications to the Penguin software solution (including the clinical template).
  • A digital platform to record their PROMs at home between appointments, freeing up appointment time to discuss results and patient health factors identified via the PROM questionnaires.
  • Support to move to a needs-based care model with patient initiated follow up, keeping well patients out of hospital and freeing appointments for patients not achieving optimal outcomes.
  • Reducing the number of hospital appointments for patients who are feeling well and achieving optimal outcomes – saving patients time, reducing time off work and the associated financial outlay with travel to hospital appointments.
  • Ability to access to clinical data, including PROMs, for individual patients in one digital platform.
  • Flagging to clinicians and patients who report outcome measures that are outside of the clinically determined tolerance levels, or whose scores are on a consistent downward trend. These real-time rapid alerts of patients not achieving optimal outcomes will enable their care to be reviewed and optimised more quickly than if the patient had to wait for a scheduled appointment.
  • Support the Trust to move to a needs-based care model, keeping well-managed patients with minimal disease impact out of secondary care and managed through virtual consultations at reduced frequency, recycling capacity to manage those patients who are not achieving optimal outcomes or who are on waiting lists for initial review.
  • Support clinicians to make a confident and informed decision about a patient’s treatment plan, virtually or face to face, based on patient outcomes.
  • Enabling clinicians to prioritise new patient referrals and the backlog of patients caused by COVID-19 based on assessment of patient need using the validated PROMs
  • Increased opportunities for digital innovation and engagement across the trust, aligning to the Novartis strategic priority: driving the use of data and going digital.
  • Creation and real-world use of the Novartis clinical template in the Penguin system for Patient PROMs
  • Baseline, non-patient identifiable, aggregated Trust data in baseline reports.
  • Improved reputation through joint working with the Trust to collect PROMs via a robust online system.
  • Aligns with Novartis focus of innovating to address the most significant unmet needs of patients in the UK.

Start Date and Duration: March 2022 – 18 months

UK2203228340 

Project Name: Digital Solution - Penguin Patient Management System – Musculoskeletal Clinical Assessment & Triage Service (CATS) and Musculoskeletal Physiotherapy – Service Development

Partner Organisation(s): Northern Care Alliance Foundation Trust

Completion Date: September 2023

Outcome Summary: 

Improve the clinical outcomes for physiotherapy patients and identify clinical improvements. Pre-assessment and discharge questionnaires.

Key Project Outcomes Data:

Patient engagement with the Penguin Patient Management System was beyond expectations with 90 patients out of 142 patients completing PROMS with the first month of going live. By the end of the project, Musculoskeletal physiotherapy and Musculoskeletal Clinical Assessment & Triage Service (CATS) staff were able to send questionnaires to 2,818 patients and received a response from 1675 patients. Initial patient feedback from 98 patients found that 69% either agreed or strongly agreed that they believed completing the symptom questionnaire in Penguin helped identify issues they would like to discuss with their Musculoskeletal physiotherapy and Musculoskeletal Clinical Assessment & Triage Service (CATS) team. According to 98 patients, 74% of patients either agreed or strongly agreed to the acceptability of completing the symptom questionnaire.

60% of patients were clinically validated through the platform so therefore is of great benefit. Follow up is going to be done with the patients who didn’t engage digitally to find out why. Due to lack of integration with the systems much of the feedback had to be inputted manually which is very time consuming, involves a level of human error and cuts back on clinical availability. Barriers with the actual formatting made analyzing the data to triage the patient extremely difficult.

Useful information collected but a very high level of data to disassemble. 

It is a great opportunity to look at different ways of working and see the patients that need to be seen due to their feedback.

Outcomes:

This exercise highlighted the need for a digital solution in Musculoskeletal physiotherapy and Musculoskeletal Clinical Assessment & Triage Service (CATS) due to the sheer volume of patients, the patients took well to this initiative with a great response rate overall and many agreeing this improved their care. Patients were sent the Musculoskeletal Hq questionnaire pre-assessment and then 6 weeks after discharge, this allows clinicians to be better informed upon seeing their patient, and to also highlight what treatments are working best, and where areas of improvement need to be made or follow-ups booked. 
We also carried out a waiting list exercise to reduce the physio waiting list, which allowed those patients who no longer needed appointments to be discharged.  

Conclusion:

The impact this exercise has on in Musculoskeletal physiotherapy and Musculoskeletal Clinical Assessment & Triage Service (CATS) has been significant, and enough to provide a case for change and taking a digital approach, however the Trust will need to become self-sufficient in adding patients to the system for this work to continue, alongside the need for Electronic Patient Records integration. 

UK2408226676

UK | UK2408226676 | September 2023