Healthcare Science & The Patient Journey by Adele Foster

“Allow me to introduce you to the world of Healthcare Science”

Have you ever wondered just how many people are actually involved in a single patient journey?

It’s easy to account for people when you receive face to face care for example from Doctors, Nurses and AHPs but what about the unknown entity.

5 years ago I would never have known all the unique skills and talents that were used in the patient journey until I attended a meeting of those unknown entities. Even though my badge said that I was from Microbiology and the other attendees were from completely different domains, I found that I had something in common with them all.

So what was it that I, the above group and this picture have in common?

 Adele 1

(Taken from – Extraordinary you 2010 – Department of Health)

Science, Science was what connected us.

As a group we are all Healthcare Scientists and we make up the fourth largest clinical group in NHS Scotland. We are a diverse group comprising of more than 50 disciplines and are divided into three strands:

  • Life sciences the study of illness and disease – involving laboratory and phlebotomy services.
  • Physiological sciences are all about the study of the body and organs. This covers things like audiology, cardiac physiology and respiratory physiology
  • Physical sciences focus on developing techniques and technology for diagnosis and monitoring patients. Involves Medical Physics, Medical illustration and Maxofacial services

 

Collectively 60 million laboratory tests and 730000 clinical physiological measurements are undertaken by healthcare scientists, some of the services we provide are:

  • complex and specialist diagnostic services, analysis and clinical interpretation
  • direct therapeutic service provision and support
  • Introduction of technological and scientific advances into healthcare, and undertaking research, development and innovation

–          performance and quality assurance, risk management and clinical safety design and management

The Healthcare Science workforce plays a critical part in delivering healthcare. More than 80% of all diagnoses are reached with a contribution from healthcare scientists but it is not just to patient care, our skills are used for innovation and intervention

The model of healthcare is changing with increasing complexity and changing demographics, there is greater focus on preventative approaches and being pro-active instead of reactive.

So how does Healthcare Science fit in with this, and what can we contribute? – Many of us are behind the scenes in departments that most hospital staff have little reason to visit; this has led to us having often been described as the Cinderella service.

Over the past few years the Scottish government has supported Healthcare Science and has been very much involved in the creation of both National and Local lead posts. Most NHS boards now have a local lead and in NHS Dumfries and Galloway this is the post that I am very proud to have recently taken up and my reason for sharing this information with you today. We have a Healthcare Science Advisory Committee composed of different strands that feeds into Area Clinical Forum on a monthly basis.

On the 11th May, the Healthcare Science contribution was laid out in The Scottish Healthcare Science national delivery plan 2015-2020, this publication sets out service improvements that will deliver high quality and sustainable health and care services for Scotland. It focuses on:

  • Stream lining health technology management
  • Point of care testing
  • Demand optimisation
  • Developing sustainable services

–          Creating a new model for clinical physiology services

Adele 2The future vision within the delivery plan is that “healthcare scientists work with health and care teams and patients across the whole health system, driving proactive and flexible seven day services that provide diagnostic and service solutions throughout patient pathways and life course”

With the multitude of national visions and the ever changing landscape of health care provision it is all too easy to feel overwhelmed but we should not lose hope in the aspirations of our visions, but instead engage as a multi disciplinary team and contribute to new thinking, new solutions and new ways of working to ensure the future of health care is the best that it can be.

We as healthcare scientists are an integral part in helping to change service delivery and in transforming patient pathways, by being part of the whole patient journey. With the National delivery plan we have an opportunity to make ourselves much more visible and we have so much to be proud off.

I look forward to meeting and working with many of you over the coming months.

Adele Foster

Healthcare Science Lead NHS Dumfries and Galloway

 

Do you recognise some of these familiar faces of Healthcare Science within DGRI?

 Adele 5

If you would like to learn more about Healthcare Science please use the links below:

http://www/gov.scot/Publications/2015/05/8743

 http://www.nes.scot.nhs.uk/education-and-training/by-discipline/healthcare-science/all-healthcare-science/publications.aspx

Adele 4

Telemedicine – the Good, the Bad & the Future? by @murphieRNC & @Louisefclark

Phyllis Murphie

Phyllis Murphie

Louise Clark

Louise Clark

This week’s blog is by Phyllis Murphie – Respiratory Nurse Consultant and Dr Louise Clark – Consultant Diabetologist and is intended to share the experiences and views of Clinicians and service users regarding Tele-clinic Consultation in NHS Dumfries and Galloway.

 

Telemedicine 2The term “telehealthcare” involves healthcare delivery at a distance, enabled by information and communication technology and driven by national and international trends in healthcare needs (an ageing global population, care closer to home, low carbon economy, etc). Telehealthcare incorporates telehealth, telecare, telemedicine, assisted living, remote clinical monitoring and supported self treatment. In remote and rural regions tele-clinic review can offer significant benefits for all those involved in this model of health service delivery.

Scotland’s 2011-17 eHealth Strategy advocates there is a clear role for telehealth and telecare technologies in delivering health care for the people of Scotland. When implemented appropriately as part of clinical service redesign, telehealthcare can:

  • Afford people greater choice, control and confidence in their healthcare care;
  • Enable safer, effective, timely and more person centred care and offer better outcomes for the people who use our healthcare and support services;
  • Assist in delivering efficiencies with the added value of more flexible working and best utilisation of staff skill mix and by reducing wasteful processes, travel and minimising access delays.

The distance to travel to remote and rural clinics within NHS Dumfries and Galloway is considerable in terms of mileage and time spent for clinicians and service users if they have to travel to the main centre of Dumfries for review. A trip to Stranraer for clinicians or patients to the D&GRI is a 150 mile round journey that can take up to 4 hours of travelling time. NHS D&G Respiratory Sleep Medicine, Diabetes, Neurology and Weight management services have established tele-health clinics in the Galloway Community Hospital – Stranraer and Creebridge Medical Centre- Newton Stewart.

Telemedicine 5A review of the experiences and opinions of those using tele-clinic consultation using video conferencing technology and Office Communicator/Lync technology – clinicians, clinic staff and patients – was conducted and the outcomes are reported here.

 

 

Benefits of Teleclinic review for Patients/Service users:

  • Formal patient feedback/surveys by participating clinical teams have demonstrated high levels of service user satisfaction with this model of health care review;
  • Reduced waiting lists and a shorter waiting time for review are reported;
  • Care is delivered closer to home and supported by local staff in line with the NHS Quality strategy;
  • A reported clinicians concern was an initial scepticism about developing the clinician /patient relationship via a tele-clinic link. However, the tele-clinic model seemed to facilitate a more open, honest and transparent consultation that enhanced the clinician patient relationship.

Benefits of tele-clinic review to delivery of participating Clinical Health Services:

  • All clinicians reported reduced travelling time and travel expense for people utilising this model of clinical service delivery;
  • Timeous patient review that has enhanced patient experience and assisted in developing positive patient and clinician relationships;
  • Reduced travelling for clinicians has freed up time in terms of clinical sessions to reinvest this in other aspects of service delivery;
  • The number of clinical sessions freed up by delivery of teleclinic model for all specialties involved:
    • Consultant Diabetologist – 12 sessions;
    • Consultant Neurologist – 6 sessions;
    • Consultant Biochemist – 24 sessions;
    • Respiratory Nurse Consultant – 18 sessions;
    • Diabetes specialist Nurse – 12 sessions.
  • Clinicians also reported that for return review patients this provides a very good quality equivalent service compared to face to face review;
  • Having a prior face to face clinical relationship before the participating in tele-clinic review was also reported to be advantageous;

Benefits of tele-clinic review to the Healthcare organisation:

  • Again clinicians reported a reduction in waiting times, reduced costs in terms of travel and fuel cost impacting positively on the environment;
  • More patients can be seen in the tele-clinic model by reinvesting travelling time saved in delivering more telemedicine clinical sessions.

Environmental impact of delivering tele-clinic reviews with the participating specialities in the last year:

  • Mileage saved by all clinicians is estimated at 9,300 miles;
  • Travelling time saved for all clinicians is estimated at 244.5 hrs;
  • Travel costs saved for all tele-clinics to date is estimated at £5,766;
  • Carbon Car footprint impact is estimated at a reduction of 3.03 tonnes of Carbon dioxide emissions based on a standard 1.8 diesel engine car.

Negative aspects reported with tele-clinic review:

  • The reliability of the broadband connection can be challenging with connectivity issues that can disrupt the flow of the consultation. The issues of communicating via this technology with service users with hearing difficulties were raised and this needs to be considered in future service planning to overcome this problem;
  • There was agreement that the clinicians themselves should be the ones to decide if tele-clinic review is appropriate for their service delivery and not necessarily be driven primarily by the National telehealth agenda;
  • A very small number of patients felt uncomfortable with teleconsultation and would prefer face to face review if offered.

Undertaking this review of current tele-clinic services offered in NHS Dumfries and Galloway has demonstrated many benefits to patients/service users, clinicians and the organisation. Telehealth technology and solutions are advancing and evolving at a rate that exceeds the current pace of change within the NHS and Scotland is recognised internationally as a leader in the development and deployment of telehealth and telecare. In undertaking this collective review of tele-clinic delivery in NHS Dumfries and Galloway we have demonstrated the real benefits of adopting this model of service in the Respiratory, Diabetes, Neurology and Weight management services and we are contributing to the delivery of the National Telehealth and Telecare Delivery Plan for Scotland 2015. Other clinical specialities and service users may benefit from this model of clinical care in the future and if delivered at scale the reduced travel costs, fuel consumption and impact on the environment are significant.

Thanks are extended to:

NHS Dumfries and Galloway IT department

Jill MacIvor – Diabetes Specialist Nurse

Jill MacIvor – Diabetes Specialist Nurse

Karen MacKie – Health Care Support Worker - GCH

Karen MacKie – Health Care Support Worker – GCH

Dr Fiona Green – Consultant Diabetologist

Dr Fiona Green – Consultant Diabetologist

Dr Ondrei Dolezal – Consultant Neurologist

Dr Ondrei Dolezal – Consultant Neurologist

Dr Ewan Bell – Consultant Biochemist/Associate Medical Director

Dr Ewan Bell – Consultant Biochemist/Associate Medical Director