Asking questions in hospital
Designing a new digital service to encourage self-management in healthcare for Guy's & St. Thomas' NHS Foundation Trust
With more people living with long-term health conditions than ever before, equipping people with the confidence, knowledge and skills to manage their health is essential to reduce pressure on the health service. In collaboration with Guy’s & St. Thomas’ NHS Foundation Trust, this project set out to identify opportunities to personalise and streamline outpatient appointments to use face-to-face time most effectively.
How might we make the most of time-limited hospital appointments to give people the confidence, knowledge and skills to manage their health?
Ask Me Anything is a digital platform that encourages patients to ask questions in hospital appointments.
Patients can create a list of topics to discuss and send it to their clinician, thereby setting an agenda for the consultation. It is anticipated that this will result in confident, informed and engaged patients who are proactive in managing their health for the future.
2 in 3
reported improved understanding of their health
tested a prototype
in six live hospital clinics
4 in 5
were reported to be more engaged
4 in 5
were noted as being more confident
A discovery phase was conducted to understand:
- The needs of patients with long-term health conditions
- Barriers to self-management
- The needs of medical professionals
- The competing pressures of working in a hospital environment
User research methods included:
- Semi-structured contextual interviews
- Card sorting activities
- Shadowing outpatient clinics and team meetings
- User journey mapping - identifying pain points and opportunities
- The power imbalance between medical professionals and patients is not conducive of enabling people to manage their own health
- Clinicians are extremely time poor and are resistant to the introduction of new tools and processes
- Asking questions in consultations can improve ‘patient activation’, a measure of someone’s confidence, knowledge and skills to manage their condition
- Effective interactions between patient and clinician can lead to knowledge sharing and consequently better health outcomes
Following a synthesis of insights, the project brief was refined:
How might we encourage patients to ask questions in face-to-face hospital appointments?
An online platform was conceptualised that would enable patients to create shortlists of questions and share these with their clinician, in order to set an agenda for consultations.
The USP of the online platform was the link with the hospital’s IT system; clinicians would see a patient’s question shortlist as they reviewed their medical record before an appointment. In turn, this would give the patient confidence to lead the conversation.
A paper prototype of the platform was developed to test the concept.
Patients were mailed a form that enabled them to build a list of questions to ask, which was shared with their clinician before the consultation.
This paper prototype was piloted in six hospital clinics and yielded encouraging results:
- 65% of patients said they learned more about how their condition affects their life
- 76% of patients were reported as being more engaged than usual
- 76% of patients were noted as being more confident
There were encouraging signs that encouraging patients to prepare for their consultation could reduce the ‘did not attend’ rate at appointments. This ‘DNA’ rate was lower than expected during the prototype testing.
Backed by user research and user testing, a backlog of user needs was created to prioritise features for development.
Working closely with Mindwave Ventures, a design and development company specialising in healthcare, the platform was built using agile methodology.
Regular user testing was conducted with the hospital team to ensure the platform responded to the needs of this complex environment.
Supported with Bright Ideas Funding from Guy’s & St. Thomas’ Charity, the Ask Me Anything platform continues to be built, tested and iterated upon.
An extensive process of stakeholder engagement is underway to gain widespread support internally:
- Presenting the project to different hospital departments
- Liaising with the hospital IT and information governance teams
- Building support of senior management
It is the work of these internal champions and supporters that will enable Ask Me Anything to be integrated into the hospital service in a sustainable way.