Digitisation of patient reported outcome measures (PROMs) in pulmonary rehabilitation

In March 2020, the face-to-face offering for pulmonary rehabilitation was suspended due to the high risk posed to service users from the COVID-19 virus and subsequent global pandemic.

Situation

A solution to offer virtual pulmonary rehabilitation was sought through a readily available procured platform that the organisation had access to.

As part of the assessment and discharge process, patients are asked to complete a number of PROMs questionnaires.

As of March 2020, all outcome measures used in the service were only available in a paper format. Retrieving and interpreting information from patients in paper form within the virtual offering would have been complex and time consuming. This could potentially compromise safety and the quality of care.

Aspiration

The team at the Royal Brompton and Harefield Hospitals wanted to digitise the paper questionnaires so that they could be accessed instantly by patients. Their results would then be calculated and then made available to the clinician.

During the face-to-face programme, it was estimated that the process could take up to 60 minutes per patient to:

• photocopy
• post
• complete
• calculate
• manually transcribe the results

Solution and impact

The Royal Brompton and Harefield Hospitals had already procured Microsoft Forms and Power Automate applications as part of its Microsoft enterprise user licence. It was possible to simply redesign the forms into an electronic format and automate the calculation process.

Working with colleagues from the hospital’s transformation team, the team had to present these applications to their IT hub to ensure it met organisational standards of security, safety, usability and IT support. As an example, all information provided by patients would be stored on cloud servers that were owned by the organisation. This would satisfy GDPR requirements.

Digitisation has saved approximately 45 minutes per patient on average which allowed more time for care.

Functionality

Microsoft Forms allows for the creation of any questionnaire or survey that can be sent out to colleagues or patients dependent upon the requirements.

A workflow can be created where data generated in the form can be set to automatically appear in a Microsoft Excel spreadsheet where formulas can be applied to calculate results.

The team added to the existing workflow to allow the completed form to be automatically transcribed into a Microsoft Word document. This provided a report that would be much easier to view. The Word document could then be manually uploaded to the electronic patient record.

Capabilities

Microsoft Forms can:

• create a questionnaire or survey easily
• be shared with anyone via an email link, embedded on to a webpage or scanned as a QR code
• be pushed into a Microsoft Excel spreadsheet where further analysis can be done
• be accessed on a smartphone, tablet or PC

It cannot:

• be uploaded automatically to the electronic health record
  

Scope

The questionnaires that were created for the clinic can be used in any setting, provided the patient has access to a PC, tablet or smartphone and has the confidence to use digital applications such as email.

Key learning points

The team had been trying to digitise forms long before the pandemic. They’d been told by colleagues in IT that it would need to go through an expensive procurement process.

It appears that the solutions were always available in-house. Do not be discouraged by someone saying no. Keep asking questions and pushing for solutions.

Key figures

The initial assessment form rolled out on 14 September 2020. This has been sent to 189 patients as of 26 July 2021.

Based on an estimation of 45 minutes of time being saved per patient, approximately 142 hours of time have been released.

Key contact

Bhavin Mehta, Therapy Lead, Adult Lung Service, Royal Brompton and Harefield NHS Foundation Trust

b.mehta@rbht.nhs.uk