Organisation develops an app to enhance management of wounds, enabling clinicians to view images when convenient and thereby reducing unnecessary appointments

* Please describe the challenges or problems your solution set out to solve. 

Working with our Practice staff we were aware of the challenges faced by clinical staff, in logging and recording of wounds/moles. From staff meetings and repeated IT logs, we were aware of issues with Digital cameras and the loading or rather not uploading images, poor quality images, resulting in the need for copious notes to be taken for patients where there was lack of continuity, not being fully aware of how the wound was developing and if there was improvement. Limited records depending on the quality/availability of images and or notes meant that the appointment was limited in providing answers.

 * Please describe the actions you took to achieve your result. 

Our experienced IT team, created a user friendly app which provides a visual timeline of healing, providing patients and healthcare professional with a baseline to be able to review the development of a wound/mole. By working together with experienced practice and community staff we were able to create an app that could be used by all regardless of their technical abilities. One which was quick, safe, secure, and user friendly, which could be accessed via any device, with both online and offline solutions.

 Our IT team sought to gather opinions and thoughts of the staff and. This partnership with staff and patients, ensured that the solution put in place was one which was useful and one that would speed up the process offering a simple, safe and reliable solution, one which also records patient consent prior to an image being taken, ensuring the patient is involved in their care from the onset and if the treatment plan was working.

With regular feedback and the opportunity for staff and indeed patients to add suggestions/comments throughout its development, keeping all involved, we managed to create and design an application that healthcare professionals would want to use. Initial outlay on the project has been £11,000 IT time and software development. In the pilot sites we have seen a saving of nurse time dealing with wounds due to the high quality data we have utilised. When rolled out to all practices we will realise savings in excess of outlay within 12 months.

 By the end of the pilot our practice was regularly able to offer (on average) around 15.77% more Nurse appointments a month than before using CareSnap. Working out annually the practice could offer 708 more Nurse Appointments. The surgery would have one or two Practice Nurses working a day. This roughly worked out at one or two extra appointment slots per day, per nurse.

Additionally, due to the Nurses taking photographs of other complaints during their consultations (of moles, rashes etc.), these were being photographed and sent electronically to the GP to review in their own time, potentially preventing between 11 - 14 unnecessary GP consultations per month. The annual monetary saving/gain obtained by Cranbrook since the implementation of the App is estimated to be in the region of £6,500 (or £13k annually). Please see attached graph.

 * Please list the most significant results

 By integrating the application with SystmOne and Emis automatically reducing the time required to log and record notes, freeing up nursing staff and GP appointments to enable photos of concerns to be taken and viewed later by a clinician when most convenient.

By giving real time results and the ability to compare the development of a wound, patients are able to be involved in their treatment plans and to be assured of the treatment plan, regardless of what staff member they see. The app is safe and secure and no images are stored on staff personal mobiles or other devices.

 * Describe how your project has spread to other teams, departments or organisations

 Due to the success and the positive feedback from our pilot practice Cranbrook, we have now rolled the application out to all nine of our practices. Following these successful pilots and positive feedback from staff, patients and clinicians, we are now in discussions with other GP practices and organisations who have been impressed with the application. We are in discussion with organisations including community nursing teams, GP practices, tissue viability services and nursing homes. We also plan to meet with a local acute trust to explore usage in their burns unit.