Project Name: Digital Solution - Penguin Patient Management System (Joint Working) – OPHTHALMOLOGY
Start Date and Duration: January 2022 to July 2023 (18 months)
Joint Working Project Summary:
Provide and implement a remote monitoring solution in Ophthalmology to gather patient data before patients attend the virtual diabetes (DRDC), virtual medical retina (MRVIRT) or virtual Age-related Macular Degeneration (STABVIRT) clinic to improve access and experience of care.
In this project, Cievert (on behalf of Novartis), will complete the configuration of a bespoke Ophthalmology clinical template by determining the clinical data to be collected including PROMs, patient pathway, clinical data to be imported from other systems (e.g. blood test result systems) and the configuration of the clinician’s and patient’s dashboard. Following configuration, the Penguin system will then be implemented within the Trust’s system.
Implementation of the solution in the NHS aims to;
- Engage patients prior to their appointment to encourage attendance and reduce the ‘Did Not Attend’ (DNA) rate;
- Gather patient information and outcome data ahead of appointments so that virtual reviews of patients can be carried out without the need for in-person patient input.
- Support clinicians to make a confident and informed decision about a patient’s treatment plan, virtually or face to face, based on a robust set of patient reported information supporting safer and more rapid, time efficient, reviews.
- Flag to the clinical team in advance patients whose information suggests high risk levels so that their care can be reviewed and managed more quickly 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 need using the patient information and validated PROMs.
The Penguin system will meet the needs of Ophthalmology clinical teams treating the following conditions: Diabetic Retinopathy (“DR”), Macular Degeneration (“MD”) and other retinal conditions.
Planned Milestones:
- Project kick-off meeting
- Preliminary paperwork/sign-off (including completion of SLA between Cievert and Trust)
- PDS IT interfacing work completed
- Pathway mapping and completion of baseline report
- Local training and configuration of local test platform
- Live system set-up
- Start of 12-month license, hosting and support
- Business case, write-up and project close (including baseline +6 months and +12 months reports)
Expected Benefits
Anticipated benefits for patients:
- 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.
Anticipated benefits for the NHS:
- Ability to access to clinical data, including PROMs, for individual patients in one digital platform.
- Flagging 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 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
Anticipated benefits for Novartis:
- 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.
- Increased opportunities for the appropriate use of Ophthalmology licensed medicines, including Novartis medicines in suitable patients, in line with local and/or NICE guidelines.
- Improved reputation through joint working with the Trust to meet an unmet need of benefit to the patient.
- Aligns with Novartis focus of innovating to address the most significant unmet needs of patients in the UK.
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Project Name: Digital Solution - Penguin Patient Management System (Joint Working) – OPHTHALMOLOGY
Partner Organisation(s): Leeds Teaching Hospitals NHS Trust
Completion Date: November 2022
Outcome Summary:
Throughout the course of six months Penguin Patient Management System utilisation within the Leeds Trust Ophthalmology Department, a backlog of Diabetic Retinopathy patients were reviewed remotely with only 15 patients determined to require a face to face outpatient appointment.
Key Project Outcomes Data:
698 Patient Reported Outcome Measures (PROMS) questionnaires were sent via the Penguin tool to remotely assess Diabetic Retinopathy ophthalmology patients.
471 responses were received from patients giving a response rate of 67.5%.
Through review of the responses, it was determined only 15 patients required face to face outpatient appointment and it took only 20 hours for the Ophthalmology Team to get through the review of these patients who have been waiting beyond their expected appointment date. None of the 15 patients who required face to face appointments required urgent interventions or suffered any adverse event.
Outcomes:
Benefits to patients
- Personalised consultant lead Patient Reported Outcome Measures (PROMS) allowed patients to feedback on their condition and feel greater involvement in their condition management
- Increased patient awareness of their condition
- Remote patient review decreased the number of unnecessary patient trips to hospital
- At risk patients were prioritised to see Ophthalmology Team face to face
- Helped improve patient confidence of a new model of care utilising digital tools
NHS benefits and Pathway Improvements
- 20 hours to review 471 patient in the pilot, traditionally it was estimated that it could approximately 160 hours to review the same number of patients.
- Allowed speedy review of patients on the backlog waiting list
- Face to face review of 15 patients costs significantly less than face to face review of 471 patients
- Using the Penguin Patient Management System helped decrease NHS Workforce Pressures
- Supports the NHS Care at Home Agenda
Novartis Benefits
- Real-world use of the Penguin system for Patient PROMs
- Increased opportunities for the appropriate use of Ophthalmology licensed medicines, including Novartis medicines in suitable patients, in line with local and/or NICE guidelines.
- Improved reputation through joint working with the Trust to meet an unmet need of benefit to the patient.
- Aligns with Novartis focus of innovating to address the most significant unmet needs of patients in the UK
Quote From Partner:
"Throughout Partnership working with Novartis and Evergreen, we have utilised the digital solution, Penguin, in our Ophthalmology department. It is a great initiative to empower patients with the ability to liaise with their clinicians using modern technology. Using Penguin we were able to prioritise our backlog based on clinical need."
Dr Raj Mukherjee, Ophthalmology Consultant, Leeds.
Conclusion:
The project has been a real success in remotely reviewing Ophthalmology patients. The Leeds Ophthalmology team have repeated the successes of this project by utilising the Penguin tool in age-related macular degeneration to reduce the waiting list by 10%.
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