Fortius Clinic London, previously operating as Schoen Clinic London

Background 

In 2018 Schoen Clinic Group knew they wanted to expand internationally and open their first hospital outside of Germany. After much consideration, they decided to bring their extensive experience to London and combine workforces with the city’s top consultants. Fortius Clinic London, previously operating as Schoen Clinic London, was therefore built for the sole purpose of being a world-class orthopaedic and spinal hospital. 

Prior to opening their London-based orthopaedic and spinal hospital, Schoen Clinic Group began searching for a UK-based electronic outcomes supplier that was aligned with their vision to provide a digital platform that was simple to use and easy to navigate, for both clinicians and patients. It was important that the system was integrated from the day of opening and embedded into the normal working practice of the clinical teams. This would then allow clinicians to ensure individual patients’ needs were met, and facilitate urgent and necessary changes when required. 

The Approach

In June 2018, Fortius Clinic London went live with the Amplitude pro enterprise™ system to capture patient and clinical outcomes data. This enabled them to deliver the best care to their patients, whilst simultaneously reporting on patient data at a useful and meaningful level. 

As part of Fortius Clinic London’s initial set-up, it was agreed that Amplitude would integrate with the hospital’s internal PAS system. The interface that was designed ensures that once a patient has been added to Fortius Clinic London’s internal booking system, a triggers message is sent from their PAS system to Amplitude, which Amplitude then processes, and creates the patient’s clinical record based on their demographic details. This process vastly reduces the burden of having to manually add every patient, saving both time and resources. 

In addition, Fortius Clinic London also knew they wanted to submit their spinal surgery details to the British Spine Registry (BSR) through Amplitude, as this would again eliminate the need to re-enter the same data into multiple systems. To facilitate this, an Automated Data Exchange was set up which enabled Fortius Clinic London to seamlessly transfer the necessary patient records from their pro enterprise™ system to the BSR, providing the relevant patient consent has been given.  

As a private healthcare provider in the UK, Fortius Clinic London is obligated to submit their outcomes to the Private Healthcare Information Network (PHIN). As an established supplier and a strong track record in easy reporting of PHIN data, Amplitude enables the Fortius Clinic London to collect, monitor and analyse their PHIN PROMs and Patient Satisfaction data in one place. Amplitude also has a wide range of reports as standard that Fortius Clinic London can access, including bespoke PHIN extracts, compliance, and outcomes reports. This data is available in real-time and can be retained by the organisation for research and auditing purposes. In addition to this, last year, Fortius Clinic London went live with PHIN structured reporting. This new reporting feature enables PHIN PROMs and Patient Satisfaction data to be consolidated and downloaded in an accessible format that facilitates onward submission to the relevant stakeholders, thereby taking away the monthly burden this task can often create. 

The same year, service extensions were further improved with the introduction of the National PROMs service. The electronic capture of National PROMs allowed Fortius Clinic London to collect data on Hip and Knee Arthroplasty procedures and retain the data locally whilst also uploading Q1 and Q2 returns directly to NHS Digital on a monthly basis. 

The Result

The Amplitude pro enterprise™ platform has been used at Fortius Clinic London for almost five years and is used by orthopaedic and spinal consultants and their support teams to demonstrate hospital performance, identify and implement service improvements, and ultimately enhance patient care. 

The implementation of an outcomes programme has enabled Fortius Clinic London to achieve their goal of having a digital approach to patient care and has empowered patients by allowing them to take control of their health. As clinicians can monitor a patient’s health and quality of life and not just the patient’s symptoms, this can support the clinical team to triage those in greater need of face-to-face appointments.  

Amplitude’s structured clinical datasets have also ensured that all patients are monitored equally and measured against the same set of criteria whilst supporting case mix adjustment, resulting in clinically validated data, further supporting better patient care. Patients also receive continued interaction from their clinician, with the ability to alert the clinical team to any deterioration in their condition. 

As of January 2023, over 100 members of staff use the Amplitude platform at Fortius Clinic London for the monitoring of thousands of patients. Due to the enormity of the data collected, whether that be for PHIN PROMs, National PROMs, or BSR, Fortius Clinic London has been able to analyse this for the purpose of improving the quality of care provided to Fortius Clinic London patients, provide a better understanding of treatment efficacy, and ensure real value is achieved from the healthcare delivered. Not only that, but the data can be of benefit to their German counterparts too, as they can access and review the data that has been collected in the UK and apply the findings to their own internal processes.

Future Development

The team at Fortius Clinic London are continuously striving to deliver the best care to their patients, whilst simultaneously reporting on and interrogating patient data at a useful and meaningful level. Therefore, they are committed to refining and expanding their digital processes to ensure their patients continue to receive world-class outcomes.  

To date, Fortius Clinic London has already applied some system enhancements, including adding SMS messaging functionality to improve their patient engagement which has already had a positive impact on their PHIN PROMs compliance. In addition to this, as we move into a new year, Fortius Clinic London plan to further improve and refine their processes to include: 

• Interface Development 

Currently, only patient demographics are added to Amplitude via the interface. This means that there is still a level of manual work to ensure every patient has been allocated to the correct clinical pathway. This process therefore comes with the added risk of human error and patients being allocated incorrectly or missed completely.   

To combat this, Fortius Clinic London intends to extend their current interface so that clinic codes are mapped to Amplitude pathways and are received via the HL7 interface. Not only will this save valuable time and resources, but it will also speed up the baseline data collection process by ensuring patients are contacted at the earliest opportunity. 

• Alert Triggers  

The new alert system will allow consultants to activate alert notifications which will notify them when a patient returns an “out of expected” response. For example, a patient could have reported a complication post-surgery and need intervention sooner than originally anticipated, there could be a rapid decline or unexpected increase in the patients’ health which needs further investigation, or a patient could be suffering from a new, non-related, condition which could impact the treatment they receive.  

• NJR data submissions 

Up until now, Amplitude has only been able to support an electronic bulk upload to the NJR for Hip and Knee arthroplasty procedures. This is because the number of Shoulder, Elbow and Ankle procedures are significantly lower than Hips and Knees, and therefore the NJR does not accept a bulk upload for these procedure types.  

However, from 1st January 2023, Amplitude will be offering hospitals, including Fortius Clinic London, the option to collect NJR for all joint specialties, including Shoulders, Ankles and Elbows. The data for Hip and Knee will continue to be submitted via the bulk upload and the data for Shoulder, Ankles and Elbows will be submitted to the NJR by our internal admin team. 

Adopting NJR submissions via Amplitude has always been something the management team at Fortius Clinic London have been in favour of, and with the recent service expansion, it is possible extending the service to include NJR submissions will be one of their objectives over the next few months.