The CliniSys Summer conference and user group meeting was hosted at The Belfry and more than 250 delegates were treated to thought provoking presentations and discussion with some of the key innovators and thought leaders in Healthcare, Laboratory Medicine and IT. The central focus of the two day programme was the theme of “Patient Centricity”, and topics such as standardisation and interoperability, communication and information presentation, understanding and responding to patient needs, care pathway alignment, technological innovation and service development and promotion, were skilfully presented and debated.
Fiona Pearson (CliniSys CEO) opened the conference with a brief synopsis of some of the drivers for focused consideration on “Patient Centricity”, including the need for greater standardisation, as evidenced in the NHS Atlas of Variation, and the potential benefits in providing tailored and supportive information to patients, who are going to be increasingly able to directly access and view their pathology results.
The first of the guest speakers to address the audience was Professor Jonathan Kay, who until very recently was the Clinical Informatics Director for NHS England, before taking up his new position at the Farr Institute. Jonathan gave a very informative and passionately delivered presentation on initiatives to help patients access their reports and to help them understand what the results mean. He talked about the current mechanisms for the management of investigations and the pressures which challenge their sustainability and validity. Developing the themes of variability, interoperability and making better use of resource, he moved into the realm of shifting focus to encourage and support patient involvement and empowerment, in helping address the burden of chronic disease and potentially introduce new models of care. His presentation continued with an overview of the Patient Online programme, which aims to empower patients to take more personal control of their health and wellbeing by providing online access to services and information. He illustrated that for many patients, limited access to summary information may be all that is wanted, but for patients with long term conditions and those who wish to play a major role in the management of their health, wider access will be sought and the need for greater supportive information, evidence and case studies will grow.
Dr Danielle Freedman followed Jonathan, talking in her role as Chair of Lab Tests Online UK and as Consultant Chemical Pathologist at Luton & Dunstable University Hospital. Once again the audience was treated to an entertaining and insightful presentation which began with a light hearted view of what patients think pathology is and the message that without us “your doctor is just guessing”!
Danielle went on to reinforce the growth in Lab Tests Online and the valuable service it is delivering to medical students, healthcare professionals and directly to patients, in helping provide answers to key questions, such as what is this test for and what do the results mean. Links to Lab Tests Online (LTOL) have been established to provide a valuable knowledge base from several clinical and patient management systems, and Danielle encouraged all in the audience to visit the website and familiarise themselves with this valuable resource (www.labtestsonline.org.uk). Feedback from patients and carers using the system has been very encouraging and in recent research, conducted by the LTOL team, the key messages emerging were that the vast majority of patients want access to their results and that they found the information provided to be immensely helpful.
Danielle’s presentation was followed by a stimulating and thoughtful talk, delivered jointly by Dr Darunee Whiting (GP at Northam Surgery and Northern Locality Board member in New Devon CCG) and Dr Tom Lewis (Consultant Microbiologist and Clinical Lead in Pathology for Northern Devon Healthcare NHS Trust). They began by asking how aware and aligned laboratory medicine is to what really matters to the patient and illustrated this point with feedback on qualitative interviews conducted with patients with chronic diseases in primary care.
They found that these patients wanted the following:
to feel reassured
to feel safe and cared for
to know that their clinical care was correct for them
to know that they are doing the right things to keep healthy
to talk about what matters for them
and asked the audience:
“Do you know what matters?”
“Do you measure what matters?”
“What are you doing to close the gap between what matters and what currently happens?”
Using the example of LFTs in chronic disease management, they showed evidence that 60% of the ALT tests undertaken added no value and cost North Devon circa £25,000 p.a.
Their presentation provided a great example of how collaborative working across the healthcare community can deliver improved patient benefits and efficiencies.
Darunee’s and Tom’s talk was followed by a participative panel Q&A session with all of the morning’s speakers, before breaking for lunch and a chance for users to network and visit the exhibition.
The afternoon was opened by Dr Jonathan Berg (Pathology Director at Sandwell and West Birmingham Hospitals NHS Trust – SWBH) who engaged the post lunch audience with an entertaining session entitled “YouTube and Pathology”. Jonathan began with a message around the importance of getting the basics in place before embarking on a social media campaign and expanded on how they have embraced “YouTube” as part of their integrated marketing communications solution. He referred to the Mayo Clinic as an example of pioneering innovation in the adoption of social media in Healthcare, and how it has become a fundamental tool in their patient communication portfolio, with more than 16 Million views.
Jonathan provided delegates with pointers and tips on producing good video footage and using illustrated examples, he showed how “YouTube” can be part of an effective marketing mix and support a considered marketing plan. Together with traditional materials and communications, SWBH pathology is effectively using YouTube, Twitter, and more recently Facebook, to communicate with existing and prospective service users and continues to strengthen branding and support growth. (www.cityassays.org.uk)
Jonathan Kay then returned centre stage, to deliver the next presentation on behalf of Matthew Campbell–Hill, who was unable to attend due to injury. Matthew is a Lay Member of the Medical Technologies Advisory Committee of NICE and also a Non-Executive Director of the MHRA and Independent Member of the National Information Board. Prior to a spinal injury, Matthew competed nationally in modern pentathlon and now competes internationally in wheelchair fencing and is hoping to represent GB in the Paralympics in Rio. Jonathan spoke to the presentation prepared by Matthew, which considered the potential impacts of wearable technology on pathology. Matthew’s presentation displayed his keen interest in emerging technology and began with a brief historical tour from old world beginnings and an early abacus ring, through Leonardo’s pedometer, Reflection Technology’s Private Eye in the 90’s to today’s Fitbit and Apple’s iWatch. He reflected that not a great deal had moved on in wearable technology since 2009, other than performance and aesthetics, however his presentation proceeded to look at the increasing interest in internal/implantable technology which is gaining momentum.
Beginning with an FDA approved, ingestible, feedback system from Proteus Digital Heath, he provided further examples such as Google’s project to develop a smart contact lens that could monitor glucose levels. In his concluding slides, Matthew proposed that lab requests are likely to diminish in areas where the technology can provide patients with more immediate information and feedback to better manage their health, and illustrated the commercial appetite with reference to the Qualcom Tricorder xPrize.
Professor Jo Martin (The National Clinical Director of Pathology) was next to talk on “Can portable education change the way we learn”. Jo has a keen interest in health education, and in her role as Director of Academic Health Sciences at Barts Health and as Professor of Pathology at Queen Mary, she is always looking at innovative ways to improve learning and education. She began her session with consideration of the mounting pressures and challenges encountered in the education of health care professionals, including demands on resources, the burden of compliancy and accreditation, increasing knowledge requirements and building on lessons learned. During the body of her presentation she went on to provide illustrative examples of how providing portable learning resources have dramatically improved the uptake, compliancy and efficiency of training programmes with examples ranging from the use of a statutory training booklet through to the development and use of mobile Apps which she has been enthusiastically developing to support training and CPD activities.
In her closing summary, Jo reinforced that in appraising the best way to support learning and provide information, it is important to consider cost, sustainability, accessibility and significantly how to make it fun.
The final speaker of the first day conference was Professor Tim Helliwell (Vice President for Learning in the RCPath and Clinical Director of Cellular Pathology at Liverpool Clinical Laboratories). Tim spoke under the title of “Pathology is a Foreign Language – the importance of education and communication”.
He opened with text taken from an instruction leaflet for a product he had recently acquired which used the terms “snaths” and “acute hafting angle” and questioned as to whether the terminology and language used in pathology is equally incomprehensible to the general public, who under the strategy published in the Personalised Health and Care 2020 framework, will have direct access to results as patients and carers. He went on to explain that the information which pathology generates is used by many stakeholders for many reasons and introduced the potential value of adopting a common language and terminology and the benefits of standard and considered datasets. Tim then provided some feedback on the Liverpool Medical Student Project which explored the re-wording of reports for medical students and lay people. The project received comments which included that standard reports were incomprehensible and provided facts without explanation, measurements were meaningless without context, and that patients would generally like medical guidance and support in helping them understand results and what they mean to them. As other examples of the importance of clear communication he described a recent RCPath document that offers a possible solution to the differences in understanding of “uncertainty of measurement” between accreditation assessors and laboratories, and the value of Key Performance (Assurance) Indicators in communicating clinically important measures of laboratory performance to managers and commissioners. Having cut a swathe through miscommunication, he finally let the audience know that the instruction booklet from which he had taken his opening example was for a “Scythe”!
Fiona then invited all the afternoon speakers to participate in second panel Q&A session and discussion before ending the conference.
The second day of the programme provided delegates with further opportunities to interact with some of the latest technologies and solutions in the exhibition and morning workshop sessions and users were invited to the video suite to see how the CliniSys solution supports the complete”end to end” process in multi-site service configurations, from requesting through to reporting, and to see some of the latest offerings including dashboards and logistics management. In the latter half of the morning and during the afternoon, users broke into their disciplines for more detailed updates and discussions with CliniSys management and domain experts.