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PKB is a data source for a virtual ward and can be used to remotely monitor patients who no longer need to be in the hospital but require medical support. This page will go through the key features teams can use.
Current problems
NHS England and Improvement has recommended that all Clinical Commissioning Groups (CCGS) set up remote monitoring models to help support people at home to enable Emergency admissions and readmissions
Early supported discharge of patients into the community
Patients feel lost after discharge from the hospital and after outpatient appointments
PKB solutions
For stable patients and those who don't need to be in hospital, patients can be cared for at home (access to the internet and smart device
A central, secure place for information and healthcare data to sit in the hands of the patient
Empowers patients to contribute to their own goals and care plans
Provides access to prevention and health promotion resources
Access to management advice, with patients being fully involved in their care through shared decision-making and self-management
Enhanced recovery care plans for elective recovery
Supporting patients at home
Universal messaging, the ability for patients and teams to send messages in a timely, flexible way and all in the patient's record
PKB benefits
Individualised care plans
Appropriate resource library specific to the patient’s condition
Timely and flexible messaging between patients and team
Digital appointment letters and appointments
Access to laboratory results
Symptom and measurement tracker
National quality of life questionnaires
Digital consent
The ability for hospital PAS to add patients to the relevant team in PKB (i.e. pain/surgical/rehab team)
Usecase
Chelsea & Westminster Hospital NHS Foundation Trust’s Heart Failure team has pioneered the use of PKB to enable remote monitoring and self-management and reduce unplanned hospital admission/attendance.
Patients have embraced PKB with almost 60% of registered heart failure patients being over 65. Care plan usage has increased, with around eight plans created a week. Patient entered symptoms and measurements have grown by 200% in the last year. Secure messaging is replacing calls to the office, with usage across the Trust up 7% since launching the pilot projects. Click here to read the full case study.
PKB Features
There are key PKB features all virtual ward services can use with their patients to support them while they have their care and support delivered virtually while at home. A list of them is below.
Messaging
Patients have access to message their healthcare team (saving time on the phone)
The Admin team can triage messages. Either resolving or passing onto another speciality team
Universal Messaging is the ability for patients to message clinical and non-clinical teams
Team-based messaging allows teams to automatically receive secure messages and questionnaires/consultations as a group rather than as individuals
Library
Disease and condition information with advice and resources
Treatment plans, for example, a rehab program with videos and advice a patient needs to watch and read each week
Rehabilitation information
Advice on Living well, including exercise, healthy eating, quitting smoking and alcohol recommendations
Details and links to National and local support groups and website
Professional alliance information
Treatments options for orthopaedic conditions and pain management
Care plans
PKB care plans can be used at every stage of a patient's condition journey, below are some of the care plan templates being used and templates that can be created.
Condition information and resource care plans
Orthopaedic monitoring condition plan here is an example of a cardiology monitoring care plan
Rehab, physical activity and musculoskeletal health
Enhanced recovery care plan
One of PKB's customers, CMyLife in the Netherlands, wants to have a virtual hospital to reduce travel / in-person appointments and increase medication compliance and manage related symptoms/side effects remotely. They are using PKB as part of this project, allowing patients to see their blood results and ranges and track and record symptoms and measurements.
Questionnaires
/ConsultationsPKB allows patients to complete any forms, surveys, or questionnaires (collectively called 'Consultations'). Consultations . Questionnaires can be sent on an individual basis or sent to a whole cohort of patients. The output of the consultations questionnaires can be aggregated and anonymised and is available via the API or as a CSV download.
Teams can get patients to fill in consultations questionnaires periodically, in some cases these are pre-appointment or post-operative assessments. Below are some of the consultation questionnaire templates being used by teams.
Annual Review and Flare-Up Questionnaires
Symptoms and Quality of life questionnaireLife Questionnaire
Pain questionnaire
Add and view data
Patients can view hospitals and GP data where an integration with PKB has been set up
Data can include blood tests, x-ray reports, clinic and appointment letters, appointments and discharge summaries
Patients can add information themselves, including operations and conditions
Patients can track key measurements and add any symptoms related to their orthopaedic condition
Further information
The digital first approach enables self-management and reduces admissions among older heart failure patients: how Chelsea and Westminster Hospital NHS Foundation Trust Heart Failure team has been pioneering use of PKB to support an often underserved cohort of patients for two recent pilot projects.
Example of how PKB is used by peri-operative teams
Luscii & PKB partner: Patients to get access to advance remote patient monitoring within their personal health record