Project Name: IHD Digital Solution - Penguin Patient Management System

Project Summary:

Provide and implement  a remote monitoring solution in Rheumatology 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 Rheumatology 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;

  • Empower patients to own their disease through the ability to track their disease through validated 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 need using the validated PROMs.

The Penguin system will meet the needs of Rheumatology clinical teams treating the following conditions: Rheumatoid Arthritis (“RA”), Psoriatic Arthritis (“PsA”) and Axial Spondyloarthritis (“AS”).

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 15-month license, hosting and support
  • Business case, write-up and project close (including baseline +6 months and +15 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 Rheumatology 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.

Start Date & Duration: December 2021 to Feb 2024 (27 months)

UK2309120057

Project Name: IHD Digital Solution - Penguin Patient Management System (Joint Working)

Partner Organisation(s): The Royal Wolverhampton NHS Trust

Completion Date: November 2023

Outcome Summary: Digitalising Rheumatology pathway for patients on PIFU. 

Key Project Outcomes Data:

Patient engagement with the Penguin Patient Management System was beyond expectations with of patients completing ePROMS within the 2 week reply period.

The following is the patient’s completion rate at the end of the project:

· A total of 350 patients were invited to complete a set of PROMs.

· A total of 232 patients responded, with a response rate of 66.2%.

The data gathered from these questionnaires informed patients’ appointments and informed the Rheumatology team of patient uptake and acceptance of a digital PIFU initiative.

When utilising the Penguin Patient Management System, a wealth of data was provided by the patients, however the interface of this data with the existing NHS IT infrastructure was sub-optimal meaning that staff would have to look on both Penguin and NHS systems for a full picture – this could be resolved with EPR integration which was requested but not completed by NHS IT teams.

Patient experience survey was distributed to 188 patients, with 93% stating Penguin was easy to use, 86% saying they understood the purpose of the surveys, 80% believing the Rheumatology team would review their results and 70% stating they believe Penguin helps the Rheumatology team understand their conditions. 

Outcomes:

Identify the estimated 1000 patients in the OWL waiting lists need for face-to-face consultation or remote monitoring of their rheumatological condition by sending ePROMs through the Penguin platform regularly. 

Reduce face-to face appointments in clinic and put assign 10% of patient cohort with PIFU codes, in order to be remotely monitored for their Rheumatoid Arthritis, resulting in cost-saving to the NHS, reduced waiting lists and better wait times for appointments.

Provide patients regular monitoring of their Rheumatology conditions and provide a better standard of care.

Conclusion:

The outcome of this project proved that Rheumatology patients at Royal Wolverhampton were willing to take up a remote PIFU initiative, and that 66% of patients responded to a digital survey. The patient experience survey has provided us with data to back up the belief that Rheumatology patients would benefit from this kind of initiative.

Off the back of this project there has been interest from other departments within Royal Wolverhampton and exploration of how the ePROMs software can be used to support further pathways in Rheumatology and other clinical directorates such as Sexual Health.

The Rheumatology clinicians seemed engaged with this initiative and were willing to take this forward with many of their patients.

The project has been paused with the hopes of continuing the work between Evergreen and RWT in the near future.

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