This pursuit is vital to ensure trusts across the UK are equipped to communicate with patients digitally, allowing them to engage on their channel of choice, encourage them to make better choices about their health and validate their position on the waiting list. The question that remains is, is it achievable?

During my time working in the NHS, I’ve worked with a number of trusts that aspire to achieve big digital transformation goals that will improve patient and clinical outcomes. Unfortunately, I’ve witnessed too many of these projects stall or fail due to a lack of core fundamental digital capacity to support transformation.

Poor processes lead to poor results

It’s no surprise that poor processes often lead to poor results. This stifles transformation and significantly delays project completion. Before implementing any digital transformation project, it’s essential that the right foundations are in place for the project to be successfully delivered.

Across the country, it’s not unusual to see administrators manually preparing letters or feeding envelope machines by hand. All processes that, if automated, would free up a significant amount of time which could be better spent supporting their clinical colleagues.

Additionally, problems stem from sensible processes that haven’t been properly implemented previously, such as mobile phone number recording. This is the process of recording patients’ mobile phone numbers for appointment reminders and safety precautions. If this recording is done consistently, this simple step can significantly help trusts reduce waiting lists.

When delivering our diagnostic programme, we analyse all trust departments to determine what patient communications could be digitised. In one Trust, we found an  administrator manually sending texts to patients every day to remind them of their appointments and in an attempt to reduce waiting lists. This incident would have been unknown to the trust without our diagnostics. Digitising such processes is possible and necessary, as opposed to forcing admin staff to take matters into their own hands.

In another trust, mobile capture was very low, with only 20-30% of patients’ mobile phone numbers. We worked with them over the course of a year to increase this, by ensuring patient mobile numbers were consistently being captured by administrators. Over this period, we found that internal processes had to be completely overhauled, receptionists retrained, and reporting into monthly board meetings to maintain visibility.

Once these steps were completed the results showed that mobile capture increased to over 65%. This led to more patient communications being sent by SMS, improved workflows, reduced DNAs, and less paper used at the trust. All of this was achievable due to the right processes being in place.

Templates matter

Many trusts don’t fully understand the process of moving from analogue to digital patient communications. It’s not something you can just switch on.

To get a Patient Engagement Platform up and running, the first priority is to ensure all outpatient letters are loaded onto the platform. However, a major factor that slows down this initial process is the number of letters across the trust that are not standardised. Often each department and speciality is slightly different. Meaning you could have the same letter from one department that uses different terminology or branding to another in the hospital.

Even if most of these letters give the same message, these slight differences amount to thousands of different variations. For a patient, it’s essential that they trust the information they receive from their hospital in whatever format, or on whichever channel they receive it. Inconsistencies in branding, fonts and terminology diminish this trust.

For example, we’ve previously worked with a trust to implement a Patient Engagement Platform and found that it had thousands of different templates for letters, similar in look to party invites. The design of these letters depended on the department’s definition of what was professional. To rectify this and standardise patient letters, we worked with every department to implement and enforce a standardised template using NHS standards.

Ensuring buy-in at all levels

Having decision makers involved in the project from the very beginning is another major factor in success. When implementing a new Patient Engagement Platform, we encourage trusts to ensure the right people are in project meetings and staff are educated on what is happening. That way, the important questions are asked early in the process. For example, what’s the current process? Is the proposed way easy to digitise? Can we even digitise it? How much work will this mean for the team? All important questions that everyone affected should be aware of.

It is especially important to involve information governance and business intelligence. Without these key decision-makers, projects are often delayed. For example, a project to rationalise letters quickly with processes signed off in good time could be put on the back burner if the trust does not have the required business intelligence resource. Without essential data from the business intelligence team at the trust, projects can be completely derailed, wasting precious time.

Ultimately, a project’s success relies on whether the right people are available and engaged throughout, and that understand the processes they currently have and what it will take to achieve goals.

Fast approaching deadlines and increasing waiting lists

As well as Patient Engagement Platform NHS App integration, all Acute Trusts now have fast-approaching deadlines to provide efficient communications for patients. In an environment with increasing waiting lists and ongoing industrial action, the targets set become harder to achieve.

In our experience, for a trust to implement a Patient Engagement Platform successfully and quickly, the fundamentals must be right before embarking on a digital transformation programme.
For a hospital to flow, every cog needs to be working together, efficiently. Every trust has a backlog of patients waiting for treatment, if you enable these trusts to reduce non-essential tasks and digitise them, this freed-up time can be used to support tackling these waiting lists. Digitising some of the many manual processes for administrators, like manually sending letters, can release capacity, enabling these staff to focus on more important tasks.

For example, our digital-first approach has already enabled 43 trusts and health boards to validate waiting lists at pace. As a result of Cardiff and Vale University Health Board focussing on the fundamentals, they digitised processes to reduce their waiting lists by 21.5% and continued to improve data quality throughout the project by requesting updates to contact details.

Enabling effective implementation through solid foundations

When working with a trust to implement a project effectively, we need to understand the processes already in place for that trust, making sure the right people are in the right place. If this means stripping back to the basics and working from the ground up, trusts will ultimately conclude digital projects in a better position while also creating better lasting foundations for future projects and process realignment.

By Concepta Wayment, former NHS Associate Director of Operations and VP of Transformation at Healthcare Communications

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The pandemic forced the rapid and sudden adoption of digital solutions in healthcare, such as video GP consultations on smart devices and SMS texts telling you to book a vaccination. Whilst these have been vital, many were hastily put in place due to the rapidly shifting circumstances, and often relied on siloed and outdated legacy technology. They were just short-term fixes with no long-term sustainable value, but their use has served to shine a valuable spotlight on patient healthcare communications. Healthcare teams are now more aware of what could be possible if all the siloed pieces of technology worked together in an integrated and holistic way.

Treat your patients like a customer when it comes to health communications

Communications technology, considered cutting-edge and necessary in other vertical service industries some years ago, is still being planned or in the initial stages of deployment in many healthcare practices. Depending on a traditional calling-centric communication model is potentially holding healthcare organisations back from the abundant benefits of digital communication services such as virtual care systems (telehealth/telemedicine) delivered via cloud-based software-as-a-service (SaaS) applications that can be accessed from smartphones or tablets. These solutions can help increase patient engagement levels, directly contributing to improving their overall health and outcomes. 

The key is to think of patients as a healthcare organisation’s customers. Like every modern customer, they want to be able to connect and engage with their healthcare providers in the same way that they connect with people, businesses, and services in their personal lives – in whichever way they want and in the moment. We’ve found in other service verticals that this level of customer-centric engagement and accessibility is best delivered through digital communication services such as CCaaS (contact centre-as-a-service) capabilities. CCaaS solutions bring together channels of engagement such as voice, video, chat, email, SMS, collaboration, social media, even elements such as IoT and wearables, all into a unified and, most importantly, integrated contact centre environment. From this, a healthcare organisation can design and deliver its own unique patient experience and engagement strategy.

Benefits for patients, staff, and society

Improving patient access to healthcare services through CCaaS has many benefits when it comes to efficiently running an organisation. Integration between IT systems and cloud communications can help with patient self-service, process automation, and patient enablement. All these will reduce the workload for administrative and clinical staff who are having to spend too much time dealing with time-demanding administrative task on patient records, schedules, prescriptions, referrals, etc. Instead, they can attend to more important and urgent matters. What’s more, if communications and information sharing are personalised to each patient, they feel more individually catered for and uniquely valued, thus improving the chances of effective engagement. Digital solutions can provide the pivotal level of personalisation at scale, which today’s overburdened healthcare staff simply don’t have the bandwidth to create.

Finally, illnesses caused by lifestyle – otherwise known as chronic illnesses – are putting a huge strain on healthcare systems worldwide. By 2030, the proportion of total global deaths due to chronic diseases is expected to increase to 70% according to the United Nations. Integrations between IT systems, communications solutions and wearable devices can make a critical difference, which matters because as our population ages we become more susceptible to these sorts of illnesses, increasing the burden on our already under-pressure healthcare systems. Digitalised and automated solutions can be used to devise and deliver personalised, individually tailored communications to help manage and prevent such chronic illnesses. Patients who become more aware and engaged through digital communications, could see an increase in proactive engagement with their healthcare plan or associated medications and a reduced necessity to go to their Primary or Acute Healthcare service to deal with the impact of such chronic illnesses and therefore avoid further readmissions. 

So, what should a healthcare provider look for in a modern cloud communication and customer engagement solution? Here are four vital components to consider as a starting point:

1. A unified communications platform

A unified communications and patient engagement platform in the cloud provides seamless connections across multiple modes of communication (voice, SMS, messaging, chatbots, online meetings, social media, video, IoT wearables), as well as devices (desktop, mobile, and tablet). This integration means patients can use their communication channel of choice over their device of choice, while healthcare providers have access to the capabilities they need to ensure their patients can engage with a suitable person when they get in contact. Additionally, self-service capabilities such as appointment scheduling, reminders, and confirmations in the form of automated messages will help to reduce time wasting no-shows or last-minute re-arrangements for healthcare organisations.

2. Real time communications and team collaboration

Patient care requires constant and intuitive access to clinical information, usually by more than one staff member, in addition to the ability to communicate across dispersed teams efficiently and effectively, often exchanging critical healthcare information throughout care-coordination workflows. Secure, real-time collaboration across all communications channels helps staff receive support from the right people at the right time. Most critically of all, these communication services must be easy-to-use, leveraging features like Single Sign-on authentication across multiple apps and offering intuitive click-to-call or team-calling abilities that help teams collaborate easily and rapidly. 

3. Follow-up Patient Engagement

Cloud-based communications solutions offer features such as automated outbound patient notifications using SMS or Chatbots, following up on patient queries, requests, or satisfaction surveys, freeing critical staff to focus on in-hospital patients and higher priority, higher quality services. 

4. A Secure and Flexible Platform

We’ve often seen it in many hospitals – clinical staff laboured down with multiple phone and pager devices as well as a personal device so they can handle calls or notifications from multiple sources and on-call escalations. To avoid the increased burden and operational complexity of having to carry multiple devices like this, healthcare staff need a “one-device, multiple numbers” experience that enables them to use one device for both personal and on-call extensions as well as alarm-handling and monitoring. And lastly, a communications solution should be able to seamlessly integrate with the most common digital systems used by healthcare professionals today, including Electronic Healthcare Record systems, creating an All-In-1 intuitive experience of communications and information.

With cloud services, communication and collaboration can become integrated into one solution that works the way patients and providers work — across any device, anytime, anywhere. Most importantly, the flexibility of cloud communications — particularly when it comes to solutions with open platforms — means providers can add new capabilities in minutes, with almost immediate access to the latest innovations. Learn more about the benefits of integrating healthcare IT systems with digital unified communications from a solutions provider that has extensive experience of working with electronic health record (EHR) vendors.

by Dave O’Shaughnessy, Healthcare Practice Leader – Avaya International

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New data from patient engagement experts reveals that the greatly increased levels of patient-led digital adoption during the pandemic have been sustained. This suggests a change in attitudes towards digitally enabled healthcare across the country, with the North of England continuing to adopt at an accelerated rate. The data, which comes from DrDoctor, is sampled from more than 10 million patients from 36 NHS trusts across the UK.

The data shows the level of engagement with care coordination tools, including scheduling appointments, digital letters, appointment reminders and video consultations. It reveals that patient engagement across the platform has increased by 937% during the period from March 2020 to September 2021, signalling a wider acceptance of patients using technology to manage their care.

Most noticeably, the number of patients choosing to view their appointment letters through the online portal has increased by 383% percent from March 2020 to September 2021. The largest peak in adoption occurred in June 2021, long after the third lockdown had eased in England.

In the North of England, this behavioural trend is most demonstrable. From May to September 2021, the number of patients choosing to reschedule appointments using digital tools increased by 62% in the North, whereas in the South the increase was only 23%.

According to Graham Walsh, Chief Clinical Information Officer at Calderdale and Huddersfield NHS Foundation Trust, the North now has a strong digital foothold and is accelerating their digital adoption at an impressive rate. “Increased digital investment in the North of England has led to the creation of northern digital powerhouses which may be driving the increased digital adoption across the region. Trusts such as my own are able to be very agile in their response to digital adoption. We have a workforce that has accepted digital and understands the benefits to patients and staff.”

The different regional experiences of the backlog testify that a tailored approach to healthcare needs to be implemented so that the country can effectively recover.

“Moving forward, we all need to be sharing our journeys and success stories so that the NHS as a whole, regardless of geographies or divides, benefits,” Walsh added.

As of September 2021, of the NHS trusts using DrDoctor technology, adoption of video consultation technology continues to be 21% higher in the North compared to the South. This indicates a shift in attitudes towards having care delivered digitally in the region as well.

Dr Paul Dimitri, Director of Research and Innovation and Consultant in Paediatric Endocrinology, Sheffield Children’s NHS Foundation Trust, comments, “Geographical population distribution is one of the drivers of digital adaptation. For example, the population of Yorkshire and Humber is 5.4 million and the population of London is 8.4 million. However, Yorkshire and the Humber is geographically dispersed and so in the North, the population spread may drive digital change to reach patients.”

As a result of this accelerated uptake, the North has seen an impressive reduction in DNA rates. For example, Liverpool University Hospitals NHS Foundation Trust have recorded DNA rates as low as 1.08% in anaesthetics.

“Our behavioural data reveals that patients are choosing to engage with their healthcare providers in digital ways, reiterating the most important point – a digital first NHS shouldn’t be an imposition, but a choice, decided by patients based on them finding it beneficial.” said Tom Whicher, Chief Executive of DrDoctor.

“The uptake in the North is particularly interesting – we know that there are major health inequalities between the North and South but recent data from NHS England has shown that the North is currently the best performing region when it comes to addressing the backlog. The region is providing accessible care to the largest number of patients per population and it’s likely that this is being supported by technology.”

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