THE consultant will see you now – from their house.
IT staff at Swansea Bay University Health Board have set up a new system which enables home-bound hospital consultants to see their patients on a daily round.
Two such consultants are shielding at home from the coronavirus but have been transported into three wards at Neath Port Talbot Hospital.
It’s all thanks to a nifty PC with a camera, which is pushed along on a trolley by junior doctors, and a link-up via Microsoft Teams.
Consultant in medicine, Dr Moustafa Elkhatieb, was phoning medical colleagues and looking at patient information on a screen at home before the virtual ward rounds got underway.
“It was okay,” he said.
But the PC on a trolley system, he said, was “a completely different story”.
He said: “It’s a very good way of working – much better than I expected.
“I am able to interact with the patients and the medical team.
“It gives me access to results, X-rays, CTC scans and the doctors can also show the observation charts for things like blood pressure.
“The computer camera also allows me to zoom in to a specific area of a patient to see if there is perhaps a rash, or ulcer.
“I am able to communicate with patients, and discuss any concerns.
“They can tell me about any symptoms, and if they have issues with their medication.”
Dr Elkhatieb, whose specialities are stroke and geriatric medicine, said he has remotely diagnosed two particular issues while on a virtual round.
He said he was also able to carry out the teaching side of his role, discussing case management with the junior doctors and locums and giving advice.
And that, he said, gave them confidence.
Dr Elkhatieb, who lives in Cardiff, said he wasn’t sure when he would be back at the hospital in the flesh.
And he said nothing quite replaced direct face-to-face contact between consultant and patient.
“But in the current situation, every one of us is having to work differently,” he said.
“So you either don’t see the patient, or there is this option.
“I look forward to doing the round. It’s good to see the patient and the staff, and you are able to solve problems.”
The virtual ward was set up by health board IT project manager Jo Abramson.
“I got the hardware in place, and made sure everyone knew what they were doing,” he said.
Two consultants are currently using the system in three wards at Neath Port Talbot Hospital.
“Other wards are interested in the technology,” said Mr Abramson.
He said it benefited patients by allowing a consultant they’re familiar with to keep managing their cases.
And he reckoned virtual consultations could have wider applications.
“In the future, you could be looking at cases where you need a doctor from another country with a particular speciality, and you could use it then,” said Mr Abramson.
“Like with any project, there are always ways we can improve it. This is what the pilot is for.”
The health board’s head of IT operations, Carl Mustad, said the roll-out of digital ways of working had been “incredible and unprecedented” in the past couple of months.
Under a scheme called Attend Anywhere, outpatients can attend video consultations for several services, including dermatology and rheumatology.
Mr Mustad said: “You get put into a virtual lobby, then you get called in.”
Electronic whiteboards have replaced conventional whiteboards in Swansea Bay hospitals, and more than 130 iPads given out to patients to allow them to communicate with relatives who have been unable to visit.
Sharron Price, of Neath Port Talbot Hospital delivery unit, said: “I think the most impact is with our patients who are ‘end of life’ in the hospital.
“Having the tablets has enabled us to be able to spend time with the families virtually and for the families to say goodbye, and tell their loved ones how much they mean and how loved they are.”
Meanwhile, more patients have been given access to their medical records via digital technology, which can help them better manage conditions from home – with the support of clinicians – such as diabetes.
Mr Mustad and his colleagues also had to arrange NHS network and telephone systems in the two new field hospitals at Bay Studios and Llandarcy Academy of Sport.
Connecting up Bay Studios, he said, would normally have taken around six months.
It was done far, far quicker, thanks in part to the efforts of BT.
My Mustad, who runs a team of 80 staff, said some people weren’t overly keen on new technology, like in any organisation.
And he said systems had to be safe and resilient.
But he added: “I think what the Covid situation has done is show the importance of digital technology.
“And it would not have been possible without the funding to do it – the Welsh Government has been very supportive in that.”
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