Virtual consultations

Following High Quality Care for All, there is increased pressure on trusts to improve patient safety and care quality.

In critical care in particular, an immediate medical response may be required at times when resources, in terms of consultant expertise, are limited. The ability to access and share crucial medical information securely and remotely can be critical to the safety and continuity of care for patients.

This need has led many trusts to invest heavily in IT, which in itself presents a number of challenges. Not least of these is the serious concern surrounding data security.

Three years ago, Dr Loua Shaikh, a consultant intensivist and anaesthetist at Frimley Park Hospital was looking for a way to gain secure portable access to his trust emails.

At the time, there was no means of sharing data outside of Frimley Park’s network, and transferring large files via the NHS email system could end in distorted data.

Dr Shaikh often found himself travelling to the hospital to make decisions which, with the right technology, could have been made off site by viewing patients’ files remotely. He believed that enhancements to the trust’s existing systems could improve patient care.

As a result, Dr Shaikh decided to research ways of achieving this. Following a pilot scheme in the adult intensive care unit last year, the ISEEU Clinical Workforce Accessibility system was rolled out across the trust.

The system incorporates two functions: ISEEU Global Data Access to connect remotely to all administration and clinical applications and ISEEU Global Data Transfer technology to virtually courier patient data.

Also included is a secure virtual medical meeting centre. Multiple healthcare professionals can virtually meet and simultaneously view and discuss patient files, saving travel time, cost and enhancing efficiency and resources.

The technology integrates with the hospital’s own systems and complies with the hospital’s governance and security standards.

Accessing patient data

Dr Loua Shaikh’s plans for using IT were wider than simply allowing remote access to x-ray files. With a large range of digitalised patient information available, the idea of clinicians using digital files to aid remote consultation can go far beyond the image.

“My radiology colleagues had a vision to digitalise radiological studies at Frimley Park well before the NHS national programme for IT identified an interest in the area,” says Dr Shaikh.

“With a host of servers collecting patient data from x-rays, ventilators, infusion pumps and heart monitors, a whole network of information was becoming digitalised. The next step was to get this data to clinicians swiftly, whatever their location, to aid decision making.”

With the increased complexity of critical care and changes to medical training, there is a growing skills gap for junior medical staff. Senior clinicians at Frimley Park Hospital can now provide additional support and mentoring out of hours, thereby enhancing patient safety.

“Intensive care is centred on care of processes,” continues Dr Shaikh.

“Effectively the situation and care of a patient in the unit can change at any time. A consultant may not be present in the hospital when they are required to aid decision making.”

According to Dr Shaikh, the system means that a consultant can effectively be available 24/7 without the high costs of having them constantly on site.

Before the system was introduced, consultants providing remote advice to junior doctors would have to take their word on the reading of an x-ray or diagnosis of a situation.

Consultants can now view the images at the same time as discussing a patient’s situation with the junior colleague.

“For example, at times a junior doctor’s interpretation may be wrong. If I can see the image it aids decision making, mentoring and patient therapy.”

The ability to achieve secure and fast remote access also assists ward rounds and handovers, helping consultants to strategise with other medical professionals or multi-disciplinary teams.

Consultants can “virtually” be at a patient’s bedside within minutes. Reviews on individual patient statistics can be made in real time, between a consultant on the ward and one on call.

Immediate responses to acute situations

Dr Shaikh was at home but on call when a patient suffered a pulmonary embolism. He consulted with the registrar by phone, using the new IT system to gain a full picture of the situation.

Following the virtual consultation, a prescription was given and the relevant drug infused as Dr Shaikh began his 30 minute journey to the hospital.

“The system impacted in the exact desired way. The right dose was prescribed immediately. By the time I arrived on site, the therapy had commenced and the patient’s condition started to improve.”

Dr Shaikh is now working to deploy a clinical information system at the hospital to digitalise historical patient data. The hope for this is that by creating a wealth of data, available to review easily and securely by clinicians, patient care can be improved even further.

“With the full rollout of the service, radiology doctors can view scans and orthopaedic surgeons are able to give advice on spinal x-rays without having to be on site. The whole medical network now has the potential to achieve rapid turnaround times on delivering the highest quality patient care.”