Shaping the Future
The Role of Digital
Communication in PatientClinician Communication
Dr Eleni Karasouli
 Partnership between the NHS, Warwick
Manufacturing Group and Warwick
Medical School
 Aims to improve people’s health and
wellbeing through the development,
evaluation and use of innovative digital
technologies and services.
 Our model of research-led innovation in
healthcare entails identifying real
problems, understanding them by
identifying relevant theories, selecting
appropriate technologies and developing
new solutions where necessary.
Overview
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Examples of current practice
Possible ICT uses
Research evidence
Benefits
Challenges
Questions that need addressing
Growing role of ICT in daily interactions
What is currently happening in
healthcare… some practice examples
Videoconference
Email
English prison service:
Teleconsultations save
£2,500 per case by not
physically transferring
patients to hospitals.
NHS Derbyshire primary care
trust:
Online consultations release
over £92 per person.
Text
messages
Out of hours stroke care: 6
acute trusts and 7 PCTs
across Lancashire and
Cumbria expect savings of
£1.8 million annually.
University Hospital of North
Staffordshire:
proposal submitted for Skype
consultations in attempt to
tackle waiting times.
Patient
portals
Social
media
What about research evidence…
 The LYNC study – Lead Investigators: Profs Frances
Griffiths (University of Warwick) & Jackie Sturt (Kings
College London)
 Aims:
– 1) evaluate the impacts of digital clinical communications for
young people living with long term conditions,
– 2) analyse critically the provision and use of digital clinical
communications by NHS specialist care providers.
For
whom?
Where?
When?
What
works?
Why?
What are the
ethical and
safety issues?
What is the
impact?
How much
does it cost?
Rationale
 Young people with long term conditions tend to
disengage with services
 Disengagement is more likely to lead to poor
health outcomes
 Service related reasons for disengagement include
poor patient-clinician communication, inflexible
access to clinicians and information, lack of
continuity
 Young people are asking to communicate with
health care staff digitally
Methods
 20 specialist clinics across UK (e.g. diabetes,
mental health, cancer)
 A range of conditions
 A range of communication tools
 Several studies:
– observation,
– interviews with staff, patients and carers,
– examination of clinic policy and guidelines
Initial findings
 Young people are positive about the convenience of
using text messages to communicate with their
clinician
 Text messages can be read anytime, anywhere and
can be reread so the patient doesn’t have to
memorise what was said
 Some young people suggest that keeping in contact
with clinicians via text message can improve clinicianpatient relationships, by increasing the frequency, and
reducing the formality of their communication.
 Variable concern about security and confidentiality
 Some older clinicians will need training
Possible ICT uses
Monitoring
health
conditions
Adjustment of
medication
Discharge after
routine surgery
Providing test
results
The benefits are…
 Reduction in face-to-face appointments
 Service engagement & reduce did not attends
(DNAs)
 Improve patient satisfaction
 Reduce inequalities, e.g. people who cannot take
time off work, live in remote areas
 Positive patient outcomes such as improved selfcare
 Financial benefits
Challenges to be aware of…
 Targeting young or IT savvy patients
 Not all forms of communication can be replaced
 Doctor-patient relationship may need to be
established
 What about confidentiality, legal context, health
policy issues, and technical conditions?
Concluding remarks
 Digital communication is still rare, but interest is high and
likely to increase.
 Already a vast number of benefits
 Are these technologies and systems safe and effective
when applied across a variety of healthcare settings?
 How to design these systems and target their use, to make
sure that society obtains the most benefit?
 What policy and procedural changes are needed for
gaining benefit and limiting harm?
Thank you
e.karasouli@warwick.ac.uk