Capturing patient reported outcome measures using a digital tablet

Collecting patient recorded outcome measures (PROMs) is important in understanding the needs of patients living with inflammatory bowel disease (IBD) at both local and national level.

Historically, PROMs have been input into the IBD registry by a clinician in the hospital.

Situation

At a district general hospital on the south coast of England, the IBD nurse-led service introduced an eHealth system in 2015 linked to the IBD registry. This was limited to access through computer desktop, meaning only staff members could directly input data into the system.

This is time-consuming as the clinician has to ask the patient the questions then input the data into the registry. It also creates room for clinician bias and meant that less PROMs data could be captured.

Aspiration

To implement a solution which permits self-recording of PROMs.

Solution and impact

The lead IBD nurse worked closely with the system supplier Civica to permit use of its InfoFlex software on a digital tablet.

This meant that patients could record their own symptoms, using a tablet while in the outpatient clinic waiting room. This data is then uploaded to the IBD registry and to the patient’s personal hospital record.

Additionally, a disease activity score is collected at the same time. These scores can be extracted from the system and evaluated by the service.

Impact

The data gave the hospital the opportunity to identify patients who needed medically optimising or required support services (for example, if reporting low mood).

The data was also used to create a business case for a counselling service. In addition to this, it supported the remote management of some patients when combined with remote faecal calprotectin (FC) monitoring.

Functionality

The solution capabilities enable patients to record their PROMs directly into InfoFlex from a tablet in the clinic waiting room before their appointment. This saves time, as these questions would normally be asked during the face-to-face appointment. It also allows the clinician to review the answers before seeing the patient.

For patients with the facility to log in from home through a portal, they can see a summary view of their record, including details of their disease, recent tests and documents. InfoFlex allows them to record further PROMs either when requested or necessary.

The use of this technology means that data recorded by the patient is not sitting in the cloud but actually saved directly to the clinical system. This adds immediate benefit to the overall notes available to the clinical team and supports any decisions about the patient's care.

The final stage, yet to be introduced at Dorset, is to schedule the PROMs and other questionnaires so the patient could fill these in over time. It is anticipated this would lead to a better integration of patient and clinician-reported data into a single solution.

Scope

For use by patients in an outpatient clinic setting. The technology was used by Dorset County Hospital NHS Foundation Trust to gather data in both consultant and nurse-led clinics.

Key figures/quotes

“Patients who remain in the service could also be targeted with more personalised support and the data can reinforce the business case for new services, such as counselling, which our team is now exploring… Overall these patient reported outcome measures collected in a district general hospital setting show promising value for improving the care of IBD patients.”
Pearl Avery, IBD clinical nurse specialist, Dorset County Hospital

Find out more

Read more about recording PROMs using a digital tablet

Read about early benefits for care of IBD outpatients who report their symptoms using a tablet

Key contact

Pearl Avery, IBD clinical nurse specialist, Dorset County Hospital

Pearl.Avery@dchft.nhs.uk

Phillip Brown, sales and marketing director, Infoflex

pbrown@infoflex.co.uk