Transforming the face of traditional dermatology services
Patients Know Best (PKB) has been working with Swansea Bay University Health Board since 2015 to connect patients with their health and care information and provide the tools that enable them to self-assess and manage their conditions.
Convenient care and improved outcomes
One of the services using PKB for remote care and management is the Dermatology Service at Singleton Hospital. Here, the team is using the PKB personal health records platform (or patient portal) using a patient-initiated follow-up model, to make it more convenient for patients to access ongoing care and treatment.
The service supports patients diagnosed with a range of skin conditions including chronic eczema and psoriasis. Often, these patients will need regular blood monitoring and new prescriptions from the hospital as conditions progress or exasperate. However, access to health information allows these patients to seamlessly view their blood results and arrange appointments online. They can also collect medications at a time and place that suits them.
Prior to using PKB, patients would attend their pre-booked outpatient appointments every 12 weeks for routine blood tests. This would be the only interaction these patients had with their specialist clinical team between appointments.
Reduced demand - increase capacity
Remote management and real-time monitoring of skin conditions has reduced the demand for outpatient appointments. At present, 188 patients diagnosed with chronic eczema or psoriasis are benefitting from remote monitoring and support using this approach.
In the initial pilot study, clinicians used PKB to initiate virtual communication, follow-ups and to carry out medication reviews. This avoided the need to call patients into hospital for an appointment every 12 weeks. Instead, patients had their blood tests done at a time and place that suited them. They simply contacted the department using secure messages via PKB. If the clinician deemed that all was well, a prescription was issued to be collected when convenient. This has resulted in the following key outcomes:
“It puts patients in the driving seat..”
Dr Sharon Blackford, Consultant Dermatologist and Clinical Lead for Dermatology led the pilot study. She and her team uncovered how the new system could create outpatient capacity in addition to other benefits for patients and professionals. She said: “It puts patients in the driving seat when managing their chronic skin disease. If we sign up 100 patients to PKB, that’s another 300 slots we can allocate to patients that need a face-to-face appointments. Also, if more teams and more patients adopted this approach, the health board could reduce our carbon footprint and the pressure on car parking facilities. Patients often remark that finding a parking space is the most stressful part of attending an outpatient appointment.”
The future of dermatology services
Dr Ashima Lowe, a specialist registrar in dermatology, added: “The study has the potential to completely transform the face of traditional dermatology services, bringing them well into 2020 and beyond. This would not be possible without the hard work, dedication and vision of our excellent dermatology team at Singleton Hospital.”
In March 2019, Dr Lowe and Dr Black were invited to address the prestigious American Academy of Dermatology at its annual conference to share their findings. The meeting took place in Denver, Colorado.
“It’s a very prestigious meeting and only a very small number of people get accepted to give an oral presentation so, it’s a great achievement for both Dr Lowe and for everyone in the dermatology department in Singleton Hospital”, said Dr Blackford.
About Patients Know Best in Swansea
At Swansea Bay University Health Board, the Patients Know Best service is used across 15 services including dermatology, audiology, cardiology, rheumatology, diabetes, gastroenterology, urology and breast services – where for the first time, patients are taking control by self-managing and coordinating their care, and choosing who to share their information with. From clinicians, family, friends or carers, they are joining up information to drive their own health outcomes and ensure they always receive the best care, no matter where they are.
Patients have been able to send asynchronous messages to clinicians, conduct virtual consultations, access a library of resources, co-edit and co-create care plans and track symptoms to help spot any early signs of deterioration. Patients also have access to their test results in real-time and with granular consent, they have the power to decide who they share their information with.
In December 2019, Patients Know Best (PKB) and Swansea Bay University Health Board (SBUHB) were awarded for transforming healthcare services, winning the prestigious MediWales Award for ‘Partnership with the NHS 2019’.
Overall, the partnership has recorded evidence of the following reported outcomes:
In other areas:
Patients that are prescribed disease-modifying medications are using the system to monitor side effects and communicate digitally with their clinical specialists about their medication needs.
The clinical team managing patients with prostate cancer are enabling patients to access their PSA blood test results faster with PKB. Patients are informed and educated on the importance of PSA monitoring and given support to recognise a pattern in their results. Before PKB, patients would typically wait several weeks to learn about their PSA result and its significance. Now, they are alerted to new blood results after 7 days and offered support to understand and manage their condition accordingly.