How Royal Berkshire NHS FT Are Using Amplitude To Power Their Virtual Rheumatology Clinic
The following case study relates to the implementation of Amplitude in the Rheumatology Department at the Royal Berkshire Hospital for use as a virtual follow up system for patients with Psoriatic Arthritis.
Royal Berkshire Hospitals had a clear objective for how they would like to procure a system to manage their patient’s outcomes and also simultaneously make cost savings by introducing virtual management of patient’s using the system.
At the start of the project Royal Berkshire Hospitals presented their aim: “to simplify our clinics, releasing time to assess our patients, with outcomes recorded digitally in our paperless record, improving wellbeing of our staff and patient experience by end 2021” – Dr. Antoni Chan, Consultant Rheumatologist, Royal Berkshire Hospitals.
Patients suffering from rheumatic diseases, live with its effects daily. Some patients inconvenienced by mild symptoms, whilst others live with crippling symptoms, severely limiting quality of life.
The gulf between the two extremes makes managing them with a ‘one size fits all’ approach impossible.
With limited funding available to manage an increasing demand for medical interventions in their clinics, the consultant team at RBH found an innovative digital solution in Amplitude to balance patient needs with commissioning responsibility.
The traditional process saw a patient referred for assessment and the creation of a treatment plan, with follow up appointments set to a pathway specific schedule. This meant that patients would be booked in to see a Consultant Rheumatologist at regular intervals, regardless of their symptoms and disease condition. Unfortunately, because some patients might go years without symptoms and others may flare only days after an appointment, the synchronisation of access to a Rheumatologist when you needed them most, seldom correlated. Consultants could not monitor the health of their patients outside of clinic appointments and most patients would attend clinic without real need.
Amplitude applied their standard approach to the project, early on identifying success criteria with the customer and the clinical requirements to make the project a success. Amplitude Account Managers worked closely with the customer once the system went live, to ensure the continued success of the project.
The new process adopted is such that, once a diagnosis is made on the patient, a treatment plan is
created and entered on to Amplitude’s against that patient’s record so they can be monitored virtually using recognised Rheumatology specific scores. These severity scores, created by clinicians and recommended by GIRFT, ensure key and necessary information is recorded.
Patients embark on a digital approach to their care plan, engaging patients in their own treatments,
empowering them to take control of their condition and aiding the patient to record and demonstrate symptoms over a period of time, as opposed to a pressurised recollection of symptoms experienced in a clinic appointment, particularly advantageous when clinic appointments are months and even years apart.
The implementation of a PROMs programme means that clinicians can monitor a patient’s quality of life and not just the patient’s symptoms, helping the clinical team to triage those in greater need of face to face appointments.
Because patients no longer get routine appointments, time pressure in clinics is reduced and patients identified by the system as needing urgent review can easily be offered a clinic appointment immediately, when they need it.
All patients receive continued interaction from their clinician, with the ability to alert the clinical team to any deterioration in their condition. Importantly, clinicians have instant access to; a patient’s record (no 3-6 weeks delay while clinic notes are typed); the diagnosis; treatment history; response to individual treatment regimens; a structured pathway approach to ramping up treatment regimes, based on documented and evidence based responses to lower level treatment; all available in real time.
Besides the benefits to patient care, the use of outcomes data in the Rheumatology clinic has had multi-dimensional benefits for clinical services;
– Improved efficiency impacts on clinicians, admin, managers and pharmacy
– Better use of time, resource and budget
– Increased compliance
– Easier clinical research, teaching, training and reporting
– Better rationalisation of treatment for the appropriate patient
– A simple way to follow and evidence that commissioning guidelines have been followed
Amplitude’s structured clinical datasets, ensures all patients are monitored equally and measured against the same set of criteria whilst supporting case mix adjustment, resulting in clinically validated data, supporting better patient care.
Data collected will help to provide a better understanding of rheumatology treatment efficacy and significantly impact on lowering of long-term costs for the NHS.
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