The rheumatology department at Guy’s Hospital performs over 18,000 face-to-face out-patient contacts per year. The largest patient cohort with inflammatory arthritis require long-term disease and blood monitoring.
In the current state, clinics are overbooked due to unpredictable demand from patients in disease flare as well as those in remission who potentially attend unnecessary appointments. Paper-based patient-reported outcome measures (PROMs) are recorded at appointments with limited impact on the patient-clinician interaction and with potential missed opportunity to capture changes in disease status in between clinician-led appointment scheduling.
In its future state, the rheumatology department aims to offer a remote monitoring service via two-way SMS messaging to optimise clinic utilisation for those in flare. The development of a clinician dashboard to capture a range of multidimensional electronic PROMs and centralisation of blood monitoring enables ePROMs to be used proactively to support patient-centric appointment scheduling. Patients could also receive notifications of their blood results or need for testing. Also by offering two-way SMS messaging with the rheumatology service during a flare, electronic PROMs could be used as a surrogate for clinical assessment to trigger a consultation (face-to-face or remote) when patients need them most, offering a more intuitive and flexible model of care.
The successful transformation of the NHS into our digital futures will rely upon the co-production of services which adopt user-centred digital technologies which are accessible to all, leaving no one behind, especially harder to reach patients.
I have enjoyed a portfolio career as a physiotherapist within the NHS. I currently balance an advanced practitioner role in rheumatology with leading a cross-functional team designing a user-centred remote monitoring service for long-term conditions.
I have achieved national recognition for my work in out-patient transformation, winning the 2019 Clinical Prize awarded by the British Society for Rheumatology and first prize in the 2019 British Medical Association Patient Information Awards for my digital self-management toolkit for inflammatory arthritis.