Dale Smith, Business Development and Customer Services Manager for population health management.
Ideas are great but in the complex world of healthcare execution is everything. What Vision is great at is solving problems that are stopping the NHS operating efficiently.
That’s why the Vision team were keen to help Hywel Dda University Health Board’s TOWARD research study (sTep dOWn inhalers in the reAl woRlD) get around a problem that is vexing academics, Clinical Commissioning Groups (CCGs), pharmaceutical companies and Sustainability and Transformation Partnerships (STPs) all over the country.
Prof Keir Lewis, Chief Investigator for the study, and Joe Annandale, a PhD student and Respiratory Nurse Specialist at Prince Philip Hospital, Llanelli, Wales, were given approval in 2017 to carry out a “real world” study to investigate the 'stepping-down' of patients with COPD from steroid inhalers to non-steroid inhalers in one consultation.
The Problem: Recruiting for Academic Studies
To deliver the study they needed to recruit 80 patients with a defined profile but how do you do that efficiently without visiting every GP surgery and writing dozens of search scripts?
Sarah Rees, the study co-ordinator, found the whole experience a challenge.
I’ll let Sarah explain:
“I didn’t have much experience of GP IT systems. We started working with a nurse in the community who knew her way round EMIS systems. She wrote the script for the first GP practice we went into and then showed me. But it seemed like every time I went into another practice there was always something slightly different about the system’s set up. Then when you factored in I had to physically go to each practice, which were scattered all over the place, it became very time-consuming.”
The searches of GP systems needed to find people taking a combination of inhaled corticosteroid (ICS), long-acting beta agonist (LABA) and long-acting muscarinic antagonist (LAMA) who were stable and had few exacerbations.
The solution: Introducing the team to Vision’s Outcomes Manager system.
We were able to create a search script we could send to every practice who wanted to take part, via Vision. Practice managers or visiting research staff could then press a button and run the search so that the study team could invite patients. Vision was able to get over the issues of system differences and dramatically cut the team’s travel time and increase their productivity.
After that, the hard work really began. Patients had to be contacted and asked if they wanted to join the study. Some patients were keen to take part in a research study and others were not interested at all.
On average the study team spoke to 5 patients for every one enrolment.
Sarah explained: “That ratio is completely understandable. Remember some of these people are really unwell, some don’t want to jeopardise the stability of their health, others are looking after family and just couldn’t commit to the check-ups.”
“Recruitment can be difficult. What Vision enabled us to do was to create a consistent, standardised approach that saved time and was reliable.”
Working with the TOWARD study has been great. Vision’s role has been small, but we were glad to make things that bit easier. We are looking forward to seeing the results of the project, which we will share with you soon.