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Remote Monitoring Service in Rheumatology

Posted by Kyle Beacham (Admin) Oct 27, 2020 Posted in Rheumatology

What Happened?

When did you change?

In January 2019 a remote monitoring service went ‘live’ for patients with Rheumatoid Arthritis (RA).

Who was involved?

Multiple stakeholder groups- patients, clinicians, commissioners and a multifunctional team of designers, developers, user researchers. The change was led by a Topol Digital Fellow supported by the Health Education England Topol Digital Fellowship programme..

How did you change?

In 2017 clinicians involved in the change embarked on discovery work to explore better ways to help identify patients who could benefit from greater flexibility through remote care and continue to live well by avoiding the reminder of disease through attending unnecessary hospital appointments. Framing the significance of the regular remote capture of patient-reported outcome measures (PROMs) between appointments to support shared decision-making about when patients needed care the most was the cornerstone of the change.  An agile, multi functional team led the user centred design and delivery of a minimally viable rheumatology remote monitoring service in South East London for RA patients. ‘A service designed for patient with patients’. The solution has been to implement a two way SMS channel for patients with RA which captures monthly PROMs whilst allowing for two-way SMS contact from patients between clinic visits. 

What challenges did you face?

Whilst opening multi channels of remote dialogue with patients was seen as risky it was essential to sustainable transformation of care. Limited funding led to the need to prioritise service features and a growing product backlog. There were frequent requirements to engage with Information Governance to ensure the service met data handling regulations.

What successes occurred

Design features such as automated reminders, graphical feedback on scores, a red flag system to alert to changes and an SMS template library have supported personalised care for disease flare, emotional well being and appointment deferment, accelerated in uptake by COVID-19.  Learning and sharing insights from patients’ experience of the digital service has been invaluable in understanding the building blocks needed to form meaningful remote clinician-patient relationships and optimising user engagement at scale.

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This post was edited on Oct 27, 2020 by Kyle Beacham

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