EPROMs Collection on MyClinicalOutcomes to Enable More Efficient Follow Up of Joint Replacement Patients in Virtual Clinics.
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Abstract
Background
myClinicalOutcomes uses clinically validated outcome assessments to provide patients with a score and individualised feedback about their musculoskeletal condition. Patients are asked to complete assessments regularly so that changes in their condition can be measured and monitored by them. Progress is shared with their surgeon and general practitioner (GP) to monitor into the long term. Following a trial across the Orthopaedic Directorate at the Royal Cornwall Hospital (RCH), the system is being rolled out across the South-West and is now in use by greater than 3,000 registered patients in eight NHS hospitals and a private hospital group. The new Clinical Commissioning Group (CCG) in Cornwall, Kernow CCG, has recently embraced the system.
Objective
The primary objective of this paper is to describe how the myClinicalOutcomes system will potentially enable follow up of joint replacement patients in more efficient Virtual Clinics.
Methods
This paper describes the need for efficiency savings in the National Health Service, the policies and processes that have driven change in the UK and how an online platform has been deployed by a Clinical Commissioning Group to deliver a more efficient treatment pathway. The potential health economic benefit will also be described.
Results
National healthcare budgets are struggling to keep pace with an increasing elderly population and more expensive medical treatments. The Quality, Innovation, Productivity and Prevention (QIPP) challenge is one area of government healthcare policy in the UK that is hoping to deliver efficiency savings of £15-£20 billion per year by 2013/14.
Meanwhile, best practice National Guidelines1 continue to dictate that joint replacement patients are followed up at one, five and every subsequent five years following operation. At one hospital n the South West of the UK, 1200 hip and knee joint replacements are performed each year resulting in a requirement for some 4000 face-to-face follow up appointments. By linking each patient with their GP and hospital medical team, the myClinicalOutcomes website enables patients to record a symptom score that is visible to both primary and secondary care. The patient’s specialist surgeon views this score, in combination with an X-ray film taken in the community, in a Virtual Clinic and provides feedback to both the patient and the GP. Only patients with deteriorating scores or abnormal X-ray findings need be called back for a face-to-face appointment. This new treatment pathway is therefore releasing clinic capacity that can be targeted to those patients who are most in need. The programme is forecast to deliver a saving of 1000 face-to-face follow up appointments each year, a cost saving of £84,000 per annum for hip and knee replacement.
Conclusions
This new Virtual Clinic pathway will potentially deliver on the efficiency savings demanded by pressurised healthcare budgets by using the myClinicalOutcomes website that links patients, GPs and hospital medical teams.
1. British Orthopaedic Association. Total Hip Replacement: a guide to best practice. 1998 Oct 24:1–37.
myClinicalOutcomes uses clinically validated outcome assessments to provide patients with a score and individualised feedback about their musculoskeletal condition. Patients are asked to complete assessments regularly so that changes in their condition can be measured and monitored by them. Progress is shared with their surgeon and general practitioner (GP) to monitor into the long term. Following a trial across the Orthopaedic Directorate at the Royal Cornwall Hospital (RCH), the system is being rolled out across the South-West and is now in use by greater than 3,000 registered patients in eight NHS hospitals and a private hospital group. The new Clinical Commissioning Group (CCG) in Cornwall, Kernow CCG, has recently embraced the system.
Objective
The primary objective of this paper is to describe how the myClinicalOutcomes system will potentially enable follow up of joint replacement patients in more efficient Virtual Clinics.
Methods
This paper describes the need for efficiency savings in the National Health Service, the policies and processes that have driven change in the UK and how an online platform has been deployed by a Clinical Commissioning Group to deliver a more efficient treatment pathway. The potential health economic benefit will also be described.
Results
National healthcare budgets are struggling to keep pace with an increasing elderly population and more expensive medical treatments. The Quality, Innovation, Productivity and Prevention (QIPP) challenge is one area of government healthcare policy in the UK that is hoping to deliver efficiency savings of £15-£20 billion per year by 2013/14.
Meanwhile, best practice National Guidelines1 continue to dictate that joint replacement patients are followed up at one, five and every subsequent five years following operation. At one hospital n the South West of the UK, 1200 hip and knee joint replacements are performed each year resulting in a requirement for some 4000 face-to-face follow up appointments. By linking each patient with their GP and hospital medical team, the myClinicalOutcomes website enables patients to record a symptom score that is visible to both primary and secondary care. The patient’s specialist surgeon views this score, in combination with an X-ray film taken in the community, in a Virtual Clinic and provides feedback to both the patient and the GP. Only patients with deteriorating scores or abnormal X-ray findings need be called back for a face-to-face appointment. This new treatment pathway is therefore releasing clinic capacity that can be targeted to those patients who are most in need. The programme is forecast to deliver a saving of 1000 face-to-face follow up appointments each year, a cost saving of £84,000 per annum for hip and knee replacement.
Conclusions
This new Virtual Clinic pathway will potentially deliver on the efficiency savings demanded by pressurised healthcare budgets by using the myClinicalOutcomes website that links patients, GPs and hospital medical teams.
1. British Orthopaedic Association. Total Hip Replacement: a guide to best practice. 1998 Oct 24:1–37.
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