An NHS England pilot at Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH), which involves embedding Patient Initiated Follow Up (PIFU) to open capacity in outpatients, has helped to avoid 29,000 unnecessary appointments in one year.
The aim of the pilot was to give patients and their carers more flexibility over their follow-up appointments and it is now benefitting over 30,000 patients.
A partnership between digital suppliers Infinity Health and DrDoctor, has enabled the trust to roll out the digital PIFU service, helping clinical teams to review patients remotely and enabling patients to book their appointments digitally.
One year into the project, 31,862 patients with chronic conditions or who have had surgery or treatment are on a PIFU pathway. Of these, 2,389 (7%) have booked an appointment, saving at least 29,473 appointments in one year, although it is likely to be more as patients often attend more than one appointment per year.
Chris Cobb, chief operating officer at NNUH, said: “Our partnership with Infinity Health and DrDoctor is already having a positive impact on patients and clinicians. Patients tell us that they feel in control of their condition and can communicate with their clinical teams more easily.
“It is also releasing appointments in the hospital, while giving clinicians the tools to remotely monitor patients. We are working hard to ensure even more patients benefit from PIFU and I’m looking forward seeing the impact brought about by integrating blood tests into the process.”
Clinicians remotely monitor appropriate patients using digital assessment forms, with 1,126 returned for review over the 12 months, therefore with the time spent reviewing the forms, the time saved is closer to the equivalent of 29,022 appointments.
Patients are only attending hospital when necessary, freeing up appointments for those who need them the most.
Routine follow-up appointments can be inconvenient, stressful and an unnecessary expense for patients, including booking time off work, arranging someone to come with them and paying for travel.
Through PIFU, patients can decide if they need an appointment and request it via the DrDoctor app at a convenient date and time. Patients have welcomed the changes, with an average of 4.2/5 patient feedback rating.
Remote monitoring across 30 specialities
Clinicians across 30 specialties are able to monitor their patients on PIFU pathways, remotely. Infinity Health’s task management platform integrates with NNUH’s Patient Administration System (PAS) to send assessment forms to appropriate patients, at regular intervals decided by each specialty, and clinicians can efficiently review these and prioritise patients safely.
Patients who do not engage are identified to ensure that they are catered for, mitigating the clinical risk as no patients are lost to follow-up.
Elliot Engers, CEO at Infinity Health, said: “This is really exciting progress. To be able to offer 30,000 patients the option to book an appointment when they need one, and reduce the unnecessary appointments that clinicians attend.
“The patients that need care are seen quicker, while other patients can be reviewed remotely so no one slips through the net. The next phase to integrate with on-site laboratories will take it to an initiated follow-up care pathway, another level. This is a site to watch.”
As Engers mentions, the next phase of the project is to integrate Infinity with NNUH’s on-site laboratories, automating the process of requesting and reviewing blood tests, to increase efficiencies and reduce time.
There are currently over 4,000 blood tests processed per day at the laboratory, the second busiest laboratory in England.