Elliott Engers, CEO at Infinity Health, speaks to Sarah Cartledge about the advantages of treating patients at home.
New concepts abound in healthcare as professionals try to resolve current crises revolving around ageing populations, the proliferation of complex long-term conditions, and new diseases. Even before COVID, there were treatment backlogs across all nations, which are now increasing with no sign of slowing. We must find meaningful solutions to ensure patients get the care they need safely, whilst bringing down waiting times.
With increases in new technologies and the recognition that digital is the way forward, there is much talk about virtual wards. For Elliott Engers, CEO of Infinity Health, virtual wards are a vital mechanism to provide care outside of the walls of a hospital. Virtual wards can reduce lengths of stay, prevent admissions, and decrease waiting times in emergency departments by providing clinical care safely at home.
Beyond virtual wards, there is the opportunity to digitally-enable Patient Initiated Follow-Up pathways (PIFU) and reduce the number of outpatients appointments by making follow-up appointments only when necessary.
Infinity is a digital platform on which health and care staff can log, share and coordinate their daily care tasks in real-time, solving many communications issues that arise with current paper-based processes. Virtual wards are a natural extension of this system, allowing clinical staff to co-ordinate and manage care remotely, and can be incorporated without too much difficulty and extra learning for already overloaded healthcare professionals.
Hospital-at-home
Once a patient is on a virtual ward, they remain under the care of the medical team that has been treating them in hospital. Clinicians can review assessments, view readings from remote monitoring devices, and communicate with patients remotely, safely reducing the need for in-person visits. Flare ups or deterioration can be identified and acted upon through this active monitoring, helping to reduce A&E attendances and reduce avoidable hospital admissions.
London North West University Healthcare NHS Trust’s Rapid Response team implemented Infinity to co-ordinate patient visits and treatment in the community, and save more than 8 hours a day in administration time, freeing up more time to spend with patients. In fact, their capacity to see patients has increased by up to 57 per cent, without an associated increase in staff numbers, showing how the right technology on a virtual ward can truly help get on top of the backlog.
For patients, being on a virtual ward may mean fewer visits to hospital for check-ups and follow-ups, as only those who need to attend will have to be there in person. It reduces the number of individuals inside a hospital, and allows for more timely appointments.
Virtual wards still require staff to carry out monitoring, treatment, and follow-up tasks, but with Infinity these can be easily and securely co-ordinated and shared by multidisciplinary teams within the community and hospital, from GPs to district nurses, phlebotomists to physiotherapists. This is a significant shift from current processes, which can be hindered by siloed working, outdated systems, and inadequate methods of communication.
Safe and efficient healthcare is becoming ever more reliant on structured communication between clinicians, specialists, patients and other stakeholders like GPs, families, and care services. Effective information-sharing tools are the key to making the right things happen at the right time. This is not to say that software is making the decisions – far from it – but it aids professionals to make faster and safer decisions by removing the obstacles that currently exist such as slow communication and lost paperwork. With the full visibility that Infinity gives, a virtual team connected by technology is a reality.
Reducing hospital outpatient lists
Infinity Health is taking part in a national pilot programme that partners trusts in England’s National Health Service (NHS) with technologies that can support them to reduce the backlog. It is part of wave one and is focusing on digitally-enhancing Patient Initiated Follow-Up (PIFU) pathways.
Instinctively, everyone understands it is easier to see outpatients first in a video or telephone clinic to assess them at home, rather than obliging them to sit sometimes for hours waiting to see a clinician. Alongside this, with the introduction and digitisation of PIFU, patients can fill out their own assessment forms for review and request an in-person appointment only when they need it. Those who are assessed as requiring treatment can then be monitored remotely and communicate with clinicians whilst waiting for in-person follow up. Those who require no further treatment can be discharged back to their GP without an unnecessary hospital appointment.
Digitising PIFU reduces the administration time for staff who otherwise manually manage lists of patients – for example using spreadsheets – freeing up clinical time for in-person treatment. Clinicians don’t need to be co-located with the patient to have the necessary data, and if there are fewer attendances in clinic then there will be more time and additional resources to undertake virtual reviews.
The real advantage lies in the fact that, with the right solution and resource, thousands of patients on waiting lists can be validated and informed about their care without waiting weeks. This method reduces stress for the patients and can shorten waiting times while saving money.
The downside of PIFU lies with those unable or unwilling to engage using digital technologies. For this group of people there will always be the option to communicate with the hospital using previous methods, allowing them to attend the hospital and receive care as before.
There can be clinical resistance and concern around risk, which is very valid. So Infinity Health’s Clinical Director works closely with organisations to understand what the risks are, plan how to manage them and how to give clinicians the visibility and control they need to safely manage their patients.
Elliott is an optimist, and thinks we’re much closer to a solution than to the problem. “It’s just a question of how quickly healthcare organisations recognise the solutions that are already available.”