With c.7.6m patients in the UK waiting for surgery following COVID, there is a need to move away from traditional pre-assessment processes to deal with the current backlogs and build resilient processes for the future. 

Definition Health, partnered with the Royal Surrey NHS Foundation Trust and the Kent Surrey Sussex Academic Health Science Network (KSS AHSN) to secure funding from SBRI Healthcare to support the rollout of its digital surgical solutions to the hospital. The primary objective was to reduce the backlog of 7,000 patients awaiting surgery and to improve the legacy pre-assessment pathway which only met the needs of 30% of patients. 

The study compared the previous year’s data for the Royal Surrey County Hospital before launching Definition Health’s Lifebox pre-operative assessment solution. The study directly compared the two systems with the same number of pre-assessment appointments in both groups. All study parties were blinded to data outcomes and a report was produced and validated independently by Unity Insights on behalf of KSS AHSN. The report was also sent to NHSE as a study sponsor.

Definition Health worked with the Royal Surrey team to develop a comprehensive understanding of the existing legacy processes and re-engineer those processes to optimise a digital pathway. Definition Health provided training across the Royal Surrey team including administration, nursing staff, anaesthetists and surgeons, together with on-site guidance throughout the build-up and go-live phase of the project.

Within 4 weeks of the contract signature, Definition Health’s solutions were successfully deployed, going on to support over 750 patients per month in their surgical journeys. Over 90% of patients agreeing it is important that part of their surgical pathway can be completed in the home. To date, Definition Health’s solutions have supported over 200,000 patients across the NHS and Independent Sector.

 

What was the impact? 

Royal Surrey is now using the three interoperable solutions offered by Definition Health:

  • Definition LifeBox; a digital pre-operative assessment tool

  • Definition Connect;  virtual consultation and secure file-sharing platform

  • Definition Recovery; allows the hospital to operate a post-discharge virtual ward

The independent study showed 99.5% patient compliance with the electronic pre-assessment pathway. The hospital experienced a 95% reduction in did not attend (DNA) rates from 6.3% to 0.6%, and a 34% reduction in face-to-face appointments. In addition, it was calculated there had been a 210t reduction in CO2 emissions from utilising file upload and avoiding unnecessary patient travel.

As well as the obvious patient benefits, the financial implications have been calculated as an efficiency cost-saving over 5 years for Royal Surrey of £428,000, cash-releasing savings of £132,000 and a 39% ROI. Extrapolated across the NHS Surrey Heartlands ICS shows the potential efficiency savings of £1.94 million and £480,000 over 5 years, a 40% ROI.

 

The project was positively received across the healthcare sector, winning 2 HSJ awards and an NHS Innovation Award for collaboration with industry.

 

"Triaging of the high-risk patients has become streamlined as the preop nurses send the POA summary to the anaesthetic consultant, who can access the patient’s profile electronically and give suggestions for further workup if needed."

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Consultant Anaesthetist Dr Harsh Saxena

“Importantly for those patients coming back to hospital for the first time since COVID, they don’t have to sit in waiting rooms filling in forms – they can fill in the pre-assessment questionnaire comfortably at home.”

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Clinical Pre-Assessment Lead Michelle Dudley

 

The project’s biggest challenge was the introduction of their new Electronic Patient Record system shortly after the Definition Health solutions went live.  At the height of this challenge were periods whereby the Trust’s patient management system was ‘frozen’ – however it became clear that throughout that period the Trust relied heavily on our Digital solution which indeed remained functional and accessible throughout.


What happens next?

Following the introduction of the Definition Health Total Digital Surgery Tool at Royal Surrey NHS Foundation trust, the objective will be to roll out to Ashford and St Peter’s Hospitals and others within the ICS. Definition Health also works with other NHS partners including, Homerton, SWLEOC, Luton and Bedford, Mid-Yorkshire and North Cumbria.

As Definition Health’s relationship with Royal Surrey extends into 2025, a primary objective is to complete the integration with Cerner Q2 2024 driving even greater efficiency. The results of the Real World Validation study will serve as a best practice model for other hospitals in the UK. If deployed across the NHS, Definition Health solutions would deliver over £540m of efficiency savings over 5 years and over £130m in cash release savings, all of which could be reinvested in the services provided to patients.

Partnerships with the NHS also support Definition Health’s development pipeline, feedback from patients and clinicians is encouraged to ensure the solutions continue to evolve and respond to emerging clinical regulations and guidelines. Any changes made to health questionnaires or assessments within LifeBox and Recovery are subject to a rigorous clinical approval process. The solutions are web-based rather than native app, therefore any updates are immediately available to all customers without the need for software outage, this ensures all customers are accessing the most up-to-date version of the product.

This work was commissioned and funded by SBRI Healthcare. SBRI Healthcare is an Accelerated Access Collaborative (AAC) initiative, in partnership with the Health Innovation Network. The views expressed in the publication are those of the author(s) and not necessarily those of SBRI Healthcare or its stakeholders.



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