The Digital Solutions Fund was created as a call to action for new and innovative ways to use digital technology in response to coronavirus and beyond, coordinated by Digital Health Ecosystem Wales, a collaboration between Life Sciences Hub Wales and the NHS Wales Informatics Service (NWIS).
In a move to help support the 887,000 people in Wales (which represents a third of the population) who suffer with musculoskeletal (MSK) conditions such as arthritis and back pain, the Life Sciences Hub Wales and the Welsh Government selected Connect Health to roll-out PhysioNow®. This digital triage and support tool was the only MSK technology selected and the feedback following implementation was extremely positive.
The project supported over 1000 patients from August to December 2020. Every Health Board within Wales were approached and almost all indicated a willingness to become involved, resulting in Cwm Taf Morgannwg and Hywel Dda Health Boards being selected to take part in the project. Connect Health, worked alongside partners EQL and PhysioSpace Cardiff, to rapidly provide the PhysioNow® technology within NHS environments, with a potential for scaling up across Wales.
Read the full evaluation summary
Challenges
- Growing waiting lists
- Concerns for patient safety
- Pressure on NHS workforce
- Mental wellbeing of patients and clinical teams
Covid-19 has further impacted waiting lists. There have been delays to treatment and an increase in sedentary lifestyles which further impacts health and wellbeing, creating a significant accumulation of demand for MSK physiotherapy care.
By delivering and implementing tools such as PhysioNow®, there is a significant opportunity to help and support colleagues in general practice and secondary care, to the betterment of patients.
The Solution
PhysioNow® is a clinically led chat-bot providing an agile and remote triage and support tool for musculoskeletal conditions. It is tried and tested and in use across many of Connect Health’s MSK services across the UK. Clinically developed and constantly reviewed sophisticated algorithms guide users to the appropriate pathway, enabling the right care, at the right time, from the right person.
Compared with other digital health solutions on the market which may only contain up to 10 questions, this tool has been clinically developed to adapt to 3000+ scenarios. Thousands of clinical hours have been invested into developing PhysioNow®. It has been rigorously tested by patients with senior clinical input, making it one of the most advanced and comprehensive tools in the field of MSK physiotherapy.
Users can remotely access an initial assessment 24/7 in multiple languages from anywhere – a positive step for many patients who may be apprehensive about accessing face-to-face services due to Covid-19.
Results
- 81% positive Friends and Family Test (FFT) score.
- Patient outcomes – 66% required routine care, 2% urgent care.
- Clinical validation of PhysioNow® during the pilot showed 99.9% agreement and accuracy.
- 20% required urgent physio. By having rapid access to assessment, patient care is not delayed by lengthy waiting lists and patients receive access to the emergency care they need at the necessary time.
- 59% of patients did not need to see a health professional.
Potential health economy benefits
The introduction of PhysioNow® into a small sized Health Board with relatively modest physiotherapy activity has the potential to create efficiency and productivity improvements of over £300,000 per annum. If implemented across Wales, the benefit would reach well over £1 million per year.
Rapid access to care 24/7
A key benefit of PhysioNow® is the capability for patients to self-refer and register without needing a direct referral from a health care professional.
PhysioNow® provides 24/7 access to not only self-referral but more importantly assessment and outcome. Some services provide the former and although very beneficial to allow self-referral, it is the ability to produce a full assessment and outcome that sets PhysioNow® apart.
This capability allows PhysioNow® to stratify patients instantly upon completion of their consultation. This will filter out these emergency patients and signpost them to the medical services they need. This ensures a patient’s next management step is determined by their clinical need rather than the date they were referred.
MSK physiotherapy services demand and capacity savings
The introduction of PhysioNow® has the potential to enhance and streamline pathways for patients by helping them see the right person at the right time.
The benefits of streamlined pathways are numerous;
- Increased capacity in departments, clinically and administratively.
- Increased time for staff training.
- Recruitment (increased time created would not need to be replaced).
- Service development / extension.
Shifting services out of hospital to communities
Through the above and by utilising PhysioNow®, services will have the opportunity to meet the aims of ‘A Healthier Wales’. The Welsh Government indicate they ”want to shift services out of hospital to communities, and we want more services which stop people getting ill by detecting things earlier or preventing them altogether”. PhysioNow® can help meet these aims and objectives.
Access for all
More people aged 65+ completed PhysioNow® compared to those aged 18-30. Active patient involvement and engagement were fundamental aspects in the development of PhysioNow®.
1 in 3 patients completed PhysioNow outside working hours. 24% of these patients needed urgent support.
Ease of use
- 75% of patients felt it was easy to articulate their symptoms using PhysioNow.
- 85% felt PhysioNow was easy to use overall.
I had to put off going to see my GP so this was an excellent prompt to investigate my pain.
I was impressed by the thoroughness of my initial assessment. I felt that someone with knowledge and skills was listening to me.
For me it was very positive and helpful. Worth considering as a long term help to ease the pressure in the service.
Future developments of PhysioNow®
PhysioNow® is constantly evolving and the ‘self-management’ outcome is one such area Connect Health will be developing extensively in early 2021. This will empower patients to manage their conditions without the need to directly interact with services where appropriate. A comprehensive suite of resources will be provided to guide patients on the road to recovery and be monitored every step of the way.
The technology underpinning PhysioNow® is constantly evolving and a move to a more interactional chatbot experience will be made available. This will enhance the patient experience whilst ensuring PhysioNow® remains at the cutting edge of digital technology.
Feedback from partners
PhysioNow is a great example of how we can enable patients to access services from a device when and where they wish to. Covid-19 has pushed us all to think differently, and this project has demonstrated the level of impact that can be achieved in a short timeframe.
Abi Phillips, Head of Innovation – Economy Skills & Natural Resources Group, Welsh Government
PhysioNow® is bringing benefits to our team of physiotherapists, providing important information about a patient’s condition before they even set foot in the clinic and helping us to streamline our services and treat those patients most in need.
Zoe Brewster, Assistant Head of Physiotherapy, Cwm Taf Morgannwg Health Board
At Connect Health we strive to be at the forefront of innovation and have been very active in the use of digital health to support people during these challenging times. PhysioNow® puts patients in the driving seat, empowering them with tools to take ownership of their health.
Prof Andrew Walton, Group Executive Director, Connect Health
This evaluation is the result of a partnership between Wales Government, Life Sciences Wales and Connect Health with support from PhysioSpace Cardiff and EQL.
Read the full evaluation summary
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