Project Name: 

IHD Digital Solution - Penguin Patient Management System (Joint Working) - DERMATOLOGY

Start Date and Duration: December 2021 to June 2023 (18 months)

Joint Working Project Summary:

Provide and implement a remote monitoring solution in Dermatology to assist both in the ongoing monitoring and care of disease management and health to improve access and experience of care.

In this project, Cievert (on behalf of Novartis), will complete the configuration of a bespoke Dermatology clinical template by determining the clinical data to be collected including PROMs, patient pathway, clinical data to be imported from other systems (e.g. blood test result systems) and the configuration of the clinician’s and patient’s dashboard. Following configuration, the Penguin system will then be implemented within the Trust’s system.

Implementation of the solution in the NHS aims to;

  • Empower patients to own their disease through the ability to track their disease through validated PROMs and clinician touchpoints over time;
  • Flag to clinicians patients who report outcome measures that are outside of the clinically-determined tolerance levels, or whose scores are on a consistent downward trend. These real-time rapid alerts of patients not achieving optimal outcomes will enable their care to be reviewed and optimised more quickly than if the patient had to wait for a scheduled appointment;
  • Support the move to a needs-based care model, keeping well-managed patients with minimal disease impact out of secondary care and managed through virtual consultations, recycling capacity to manage those patients who are not achieving optimal outcomes;
  • Support clinicians to make a confident and informed decision about a patient’s treatment plan, virtually or face to face, based on patient reported outcomes; and
  • Enable clinicians to prioritise new patient referrals and the backlog of patients caused by unanticipated workload e.g. COVID-19, based on assessment of patient need using the validated PROMs.

The Penguin system will meet the needs of Dermatology clinical teams treating the following conditions: Psoriasis (“PsO”), Chronic Spontaneous Urticaria (“CSU”), Atopic Dermatitis (“AD”) and other dermatological conditions.

Planned Milestones:

  • Project kick-off meeting
  • Preliminary paperwork/sign-off (including completion of SLA between Cievert and Trust)
  • PDS IT interfacing work completed
  • Pathway mapping and completion of baseline report
  • Local training and configuration of local test platform
  • Live system set-up
  • Start of 12-month license, hosting and support
  • Business case, write-up and project close (including baseline +6 months and +12 months reports)

Expected Benefits

Anticipated benefits for patients:

  • Empower patients to own their disease through provision of educational resources and ability to track progress through validated PROMs and clinician touchpoints over time.
  • Better management of their disease via the clinician’s specifications to the Penguin software solution (including the clinical template).
  • A digital platform to record their PROMs at home between appointments, freeing up appointment time to discuss results and patient health factors identified via the PROM questionnaires.
  • Support to move to a needs-based care model with patient initiated follow up, keeping well patients out of hospital and freeing appointments for patients not achieving optimal outcomes.
  • Reducing the number of hospital appointments for patients who are feeling well and achieving optimal outcomes – saving patients time, reducing time off work and the associated financial outlay with travel to hospital appointments.

Anticipated benefits for the NHS:

  • Ability to access to clinical data, including PROMs, for individual patients in one digital platform.
  • Flagging to clinicians patients who report outcome measures that are outside of the clinically-determined tolerance levels, or whose scores are on a consistent downward trend. These real-time rapid alerts of patients not achieving optimal outcomes will enable their care to be reviewed and optimised more quickly than if the patient had to wait for a scheduled appointment.
  • Support the Trust to move to a needs-based care model, keeping well-managed patients with minimal disease impact out of secondary care and managed through virtual consultations at reduced frequency, recycling capacity to manage those patients who are not achieving optimal outcomes or who are on waiting lists for initial review.
  • Support clinicians to make a confident and informed decision about a patient’s treatment plan, virtually or face to face, based on patient outcomes.
  • Enabling clinicians to prioritise new patient referrals and the backlog of patients caused by COVID-19 based on assessment of patient need using the validated PROMs

Anticipated benefits for Novartis:

  • Creation and real-world use of the Novartis clinical template in the Penguin system for Patient PROMs.
  • Baseline, non-patient identifiable, aggregated Trust data in baseline reports.
  • Increased opportunities for the appropriate use of Dermatology licensed medicines, including Novartis medicines in suitable patients, in line with local and/or NICE guidelines.
  • Improved reputation through joint working with the Trust to meet an unmet need of benefit to the patient.
  • Aligns with Novartis focus of innovating to address the most significant unmet needs of patients in the UK.

UK2112140298

Project Name: 

IHD Digital Solution - Penguin Patient Management System (Joint Working) - DERMATOLOGY

Completion Date: April-2023

Outcome Summary:

Evergreen Limited (previously known as Cievert) on behalf of Novartis, started the configuration of a bespoke Dermatology clinical template within the Penguin Patient Management System. However, it did not meet expectations due to the high workload in clinical service meaning the initial momentum to co-develop the platform and test it on patient cohorts became difficult to sustain.

While Evergreen tried to accommodate changes to Penguin platform and integrate with NHS digital services, unfortunately it became apparent in the very high patient volume associated with Clinical Dermatology that the platform was not sufficiently able to deliver meaningful data that would facilitate efficient clinical care within this area of the service. This was particularly exacerbated by skin cancer pressures within the trust following COVID-19.

Outcomes:

Date electronic Patient Reported Outcomes Measures (ePROMS) questionnaires first sent: 01 April 2022
Patients: 53
Responses: 18
Questionnaires: Dermatology Life Quality Index
Response rate: 33%

Staff members reported: 

  • 50% reported they believe the ePROMs platform helps to monitor patients health conditions.
  • The platform is easy to use.

The Penguin platform had great potential to help monitor LTHT patients and was easy to use for the patient, but was not able to deliver meaningful results that integrated with NHS digital systems

Feedback from Evergreen is as follows:

  • Initial engagement dropped off due to clinical staff workload, in particular increased post covid suspected cancer referrals which were prioritised within the team
  • Busier clinics than anticipated put a burden on NHS staff and shifted priority.
  • The high workload in clinical service meant the initial momentum to co-develop the platform and test it on patient cohorts became difficult to sustain.

Another barrier to this solution was the need for a large investment of time from both Evergreen and NHS IT services to integrate Penguin fully into the NHS IT system. Without the full integration, Penguin cannot not link directly with the Trust’s Electronic Patient Record system, this direct link is required to allow Penguin to be able to fully meet the requirements of the service.

Quote from partner

We are grateful for Novartis providing support to develop innovative solutions facilitiating clinical care. This project has highlighted the challenges associated with transitioning to digital care utilizing limited NHS IT platforms. LTHT Dermatology Team

Conclusion

Leeds is tackling health inequalities with one area of focus being long term health conditions. Novartis aligned to the West Yorkshire Association of Acute Trusts (WYAAT) ambition to harness health technology at pace and scale through the deployment of the Penguin Patient Management System.

Dermatology Services is an area of focus for WYAAT Group and moving forward Novartis is actively looking at ways to continue to partner with the Group to address capacity issues and support patients.

LTHT would positively welcome further support and remain firmly of the belief that digital options could be highly effective in improving patient care with additional efficiency gains. 

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