Over the last few weeks and months I’ve started pondering all sorts of health and care related stuff that may help when trying to support family members a couple of hundred miles away. One of the things we picked up on was a “friendly” digital clock display (often sold as a “dementia clock” or “memory loss calendar”), with a clear screen, and easy to read date and time.
The clock supports a variety of daily reminders (“Take your pills…”) and can also be programmed to display images or videos at set dates and times (“Doctor’s today”).
One of the things this reminded me of was the parliamentary annunciators, that detail the current activity in the House of Commons and House of Lords, and that can be found all over the parliamentary estate.
Which got me thinking:
- what if I could send a short text message or reminder to the screen via SMS?
- what if I could subscribe to a calendar feed from the device that could be interpreted to generate a range of alerts leading up to an event (*”Doctor’s tomorrow morning”*, *”Hospital this afternoon at 2pm”*).
(Lots of other ideas came to mind too, but the primary goal is to keep the device as simple as possible and the display as clear as possible, which includes being able to read it from a distance.)
The calendar feed idea also sparked a far more interesting idea – one of the issues of trying to support family members with ongoing health appointments is knowing when they are taking place, whether you need to go along to provide advocacy or support, whether hospital stays are being planned, and so on. Recent experience suggests that different bits of the NHS ac independently of each other:
- the GP doesn’t know when hospital surgery has been booked, let alone when pre-op assessments requiring a hospital visit are scheduled;
- district nurses don’t know when hospital visits are planned;
- different parts of the hospital don’t know when other parts of the hospital have visits planned,
and so on…
In short, it seems that the hospital doesn’t seem to have a calendar associated with each patient.
As with “student first” initiatives in HE, I suspect “patient first” initiatives are more to do with tracking internal performance metrics and KPIs rather than initiatives formulated from the patient perspective, but a personal “health and social care calendar” could benefit a whole range of parties:
- the patient, wanting to keep track of appointments;
- health and social care agencies wanting to book appointments and follow up on appointments with other parts of the service;
- family members looking to support the patient.
So I imagine a situation where a patient books a GP appointment, and the receptionist adds it to the patient’s personal calendar.
A hospital appointment is generated by a consultant and, along with the letter informing the patient of the date, the event is added to the patient’s calendar (possibly with an option to somehow acknowledge it, confirm it, cancel it?).
A patient asks the GP to add a family member to the calendar/calendar feed so they can also access it.
A range of privacy controls allow different parts of the health and social care system to request/make use of read access to a patient’s health and social care calendar.
The calendar keeps a memory of historical appointments as well as future ones. Options may be provided to say whether an appointment was attended, cancelled or rescheduled. Such information may be useful to a GP (“I see you had your appointment with the consultant last week…”) or consultant (“I see you have an appointment with your GP next week? It may be worth mentioning to them…”)
Hmmm…thinks… is this sort of thing has this sort of thing being explored (or has it been in the past?), or maybe considered at an NHS Hack Day? Or is it the sort of thing I could put together as an NHS tech funding pitch?
PS Some of the features of the Amazon Show could also work well in the context of a health/care annunciator, but… the Amazon Show is too feature rich and could easily lead to feature creep and complexity in use; I’d have “privacy concerns” using the Amazon backend and always on Alexa/Echo mic.
OUseful.Info, the blog... 
Tony, what you describe in the first part of your post sounds very like: http://www.myhomehelper.co.uk/home/home.aspx
We have set it up so three family members can add reminders etc. Haven’t suggested to the GP surgery that they add appointments directly – that would certainly be possible but I doubt they would feel able to take it on.
A simpler system for keeping relatives would just be for the NHS to email appointment details, the patient could then authorise a short mailing list for the single purpose of appointment details (or set up forwarding). I’ve never experienced the NHS emailing anything, although our GP will occasionally agree to accept information by email.
Hi Paul
That looks a lot like what I’d imagined, though some of the screen displays are rather more cluttered than I had in mind (I found it easy to feature creep ideas of what could be possible, e.g. if I was to try using an Amazon Show as a UI!)
Re: NHS emailing appointments to family members – I’ve not had much success with that despite lots of well intentioned “I’ll take you details, but can’t promise anything…” conversations with GP, consultant, etc.
There also appears to be a huge disconnect in what different parts of NHS know about an individual’s interactions (previous or scheduled) with other bits of NHS.
Aggregating administrative appointment data with maybe various levels of disclosure (eg date, date+hospital (or gp), date+hospital+unit) approved to different audience groups (privacy feature creep…!) would be really handy, I think?
One of the issues with a self-managed calendar shared with family is that it relies on someone to self-manage that , which may not be viable (unreliable patient, or patient without internet access, digital skills etc). Unless eg a patient could share personal calendar details with GP, hospital appointments service, etc, and request that they add appointment details to that calendar (or maybe email a calendar event file to an email address associated with that calendar). GMail/Google Calendar may be able to handle elements of that automagically, but I’d rather not go that route…
We touched on some aspects of this here – https://projects.doteveryone.org.uk/improvingcare/opportunities/collaborative-health-information-system/
@Laura Thanks for that – will read through the report. Issue for me is centralising and sharing appointment info, essentially, which could be as lite as possible on sensitive personal data, though giving eg ward names in hospital appointments could be revealing of a particular type of condition or treatment.
Right. There’s no reason there can’t be good person-centric systems here. The point about ward names / privacy is interesting – I can imagine some folks might want that protected, and others might (as some of those we spoke to) just say: for heavens sake share it all, anything for better coordination (I paraphrase).