International Journal of Integrated Care (Aug 2019)
Digital technology providing real time feedback about what matters most to patients: lessons learnt and moving forward
Abstract
Introduction: The NSW Agency for Clinical Innovation (ACI) recently completed an e-enabled proof-of-concept Patient Reported Measures (PRMs) program. The PRM program was co-designed from inception, solution design, implementation and evaluation with consumers, clinicians and managers across care settings in NSW. The PRM program focused on measuring what matters most to people living with chronic and complex conditions and providing real-time reports to care providers to improve care coordination, care planning, shared decision making and importantly support people (patients/carers) to be partners in their healthcare. Description: The PRM Program held several workshops, established a community of practice, and worked alongside stakeholders across care settings to truly co-design, test, refine, implement, evaluate an e-enabled PRM program that measured what mattered most to a person, irrespective of their condition – focusing on holistic care, with PRM reports available in real-time. This enabled clinicians to view what mattered most to those they were treating, and often uncover key areas of concern they previously didn’t know about. Aim and theory of change: The overall aim of the program is to enable people to provide direct and timely feedback to healthcare providers about what matters most to them – the theory of change is through completing PRMs electronically, the reports are available in real-time to care providers who can then spend more time during consults focusing on what matters most and tailoring care and treatment – time is maximised and enables a broader holistic approach Targeted population and stakeholders: People living with chronic and complex conditions, across care settings for the initial proof-of-concept PRM program, focusing on integrated care (across care settings – hospital, community, general practice). Stakeholders including anyone with an interest in PRMs (clinicians, managers, executives, consumers, carers) and those interested in finding out the key challenges and enablers of committing to a true co-design process to implement, evaluate and build a robust system to collect PRMs electronically. Timeline: Proof-of-concept program is complete and evaluation finished in 2017. The further co-design of the new PRM IT solution and program is set to be complete late 2018, with implementation occurring early 2019 across care settings. Highlights (innovation, Impact and outcomes): Innovative resources to support and build capacity and capability of care providers. Innovative approach to co-design and partnership. Positive impact and outcomes of patients involved in proof-of-concept. Increased uptake (as evidence by request for assistance and implementation), evaluation will be discussed. Comments on sustainability: Due to the true co-design approach and robustness of the program, it is proven to be sustainable and scalable Comments on transferability: Transferable across jurisdictions/countries. Have already provided advice to many other Australian and international partners on our program Conclusions (comprising key findings): The PRM program transformed care delivery and through the proof-of-concept evaluation ACI is in the final stages of co-designing a robust e-enabled platform capable of integrating with electronic medical records and patient portal views to enhance integrated care with a focus on what matters most to patients (or their carers)
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