Re-designing the health review for patients with long term conditions
There are 15 million people in the UK with long-term conditions. They are the most frequent users of health care services, accounting for 50 percent of all GP appointments, with 70% of the total health and social care expenditure being spent on their treatment and care. Self-management is particularly important amongst this patient group as they spend less than 1% of their time in contact with health care professionals. Health reviews are viewed as a proactive approach to care, complementing existing self-management strategies.
Apollo
Apollo is a digital service, which allows people with long-term conditions to complete their health review in an easy and flexible way, helping them to play a more active role in their health.
Apollo has been initially designed to replace the annual asthma review amongst patients with well controlled symptoms. It is flexible and easy to use, personalised, provides a consistent experience, and promotes learning.
For healthcare professionals it provides a broader and more accurate picture of how patients are managing their health condition and also has financial and time benefits
Research
Long-term conditions are conditions for which there is currently no cure, and which are managed with drugs and other treatment, for example diabetes, asthma and high blood pressure.15 million people in the UK have a long term condition, which is roughly 20% of the population,2.9 million (20%) have 3 or more long term conditions. They are the most frequent users of health care services, accounting for 50 per cent of all GP appointments and 70% of the total health and social care expenditure is being spent on the treatment and care of these patients. The NHS has set out its priorities for the next 10 years, which includes its commitment to increasing support for helping people with long-term conditions manage their own health, which has shown to have benefits for both the individual and the healthcare system as a whole.
Self-management
From the interviews we realised that effective self management is made up of 4 key components.
The first of which is Behaviour- in particular how motivated a patient is, which is affected by their beliefs around their illness and treatment as well as their mood, The second component is skills, which is about having the tools and techniques to choose healthy behaviours. Thirdly it’s about relationships and the need to have a collaborative partnership between the healthcare professional and patient- which we explored further to understand that there needs to be honesty and trust between both parties.Lastly it’s adherence to the treatment regimen, which covers taking medication, attending all appointments as well as taking advice related to lifestyle behaviours, such as diet or exercise. And if all four components are in place then a patient is in a good position to effectively self manage their condition.
Case study - Asthma
Having explored the landscape of long-term conditions we decided to focus on asthma and use it as a case study. It affects over ⅓ of all people with long-term conditions and can affect people of all ages at different points in their life. Self-management programmes amongst asthma patients have been shown to reduce unplanned hospital admissions, yet the figures around these admissions are currently very high despite the manageability of the condition.
Mapped the journey once they get into the cycle of self management, and we realised that like most other people with long-term conditions they spend most of their time managing it outside of a clinical setting, with intermittent interactions with healthcare professionals. And we discovered that most of the pain points were during the annual asthma review and because of the poor experience during the review, the cycles of ‘before’ and ‘after’ within the self management phase remain the same and are repeated every year.
So we understood that people weren’t satisfied with the review as it is now, and what the good review is, we realised that both patient and healthcare professional are striving for the same thing. They both want the patient to become empowered and more active in their health.