CHFT expands patient choice and care with virtual visits using Microsoft Teams

Right care, right place, right time

The United Kingdom’s National Health Service (NHS) sees 1 million patients every day and is the fifth-largest employer in the world. Since its founding in 1948, it aims to offer comprehensive care for everyone from cradle to grave. But as the UK’s population ages, providers have to deliver more complex and costly care than ever before. This forces local NHS trusts to find new ways to deliver care that keeps the patient at the heart of the experience while managing resources efficiently.

In West Yorkshire, Calderdale and Huddersfield NHS Foundation Trust (CHFT) is licensed with 8,000 Microsoft 365 E3 to empower their 6,000 full-time and 2,000 part-time employees that work from two main hospitals providing acute care, many smaller community health centers, and at patients’ homes. In 2019, the trust looked after more than 100,000 people staying at its hospitals, held more than 400,000 outpatient appointments, and delivered 5,000 babies.

Although CHFT’s two main hospitals are in large towns, much of the area it serves is rural. Patients can travel up to 30 miles for appointments, even for short checkups. In some disciplines, like epilepsy care, the trust noticed problems with nonattendance for appointments, especially among teenagers focused on exams who didn’t want to miss school. For families, taking time off work or catching unreliable rural busses factored into cancelled or missed appointments.

Chief Technology Officer Keith Redmond says, “In 2017, 3.5 percent—around 9.5 billion miles—of all travel on UK roads was related to patients, visitors, staff, and suppliers to the NHS. One of the key goals of the NHS is to reduce the need for patients to come to hospital and devolve care to the community, where possible. It’s about the right care, in the right place, at the right time.”

CHFT’s digitization makes this goal possible. When Redmond started in 2004, the trust had 400,000 paper case notes. Today, it has a single source of truth for patient information: a central electronic patient record (EPR) system with integrated divisional subsystems. Redmond says, “Our goal is to be as digital as we can be. This means digitally empowering clinicians to carry on delivering the care they give in more efficient, patient-friendly ways.”

Microsoft 365 migration ensures data protection, sparks ideas for better care

Each missed appointment costs the NHS taxpayer dollars. CHFT needed a way to reduce absenteeism and saw an opportunity in technology. The project began in 2019, when the trust moved its email systems to the cloud with Microsoft 365.

“Moving to Microsoft 365 was one of the easiest software deployments I’ve seen in more than 15 years at the trust,” says Redmond. “It just worked. And we know we can rely on Microsoft 365 to protect our data in line with our own policies and procedures. We have confidence that we can keep patients and their data safe.”

Not long after, Richard Hill, Senior Collaborations Lead for Health Informatics at the trust, identified the Microsoft Teams and Microsoft Bookings apps as ways to help streamline communication between staff and patients. “Our patient groups and membership foundations told us about the issues patients face around travel, parking, availability of appointments, and the admin back-and-forth required to book them. We wanted to address these issues with technology that simplified admin and removed the need for patients to travel if they didn’t want to.”

CHFT rolled out Teams along with its Bookings integration—starting in 2019 with the child epilepsy and oncology units. Today, 1,200 staff at the trust use nearly 300 Teams channels to communicate among themselves and with patients. Hill says, “The minutes of chat time are increasing, the minutes of virtual meeting times are increasing, and the number of people attending meetings is increasing.”

Redmond adds, “We’ve tried to introduce video, voice, and instant messaging services in the past, but Teams has proved the most popular platform by far with our staff. I don’t have to go out and sell it to them. They come to me and ask me for it.”

Clinicians or administrators use the Bookings app in Teams to schedule virtual visits or consultations with patients. Previously, a consultant would identify that a patient needed a follow-up appointment, flag it in the hospital’s EPR system, and then an administrator would type up a letter with a time and location, which the patient would receive in the mail. The entire process could take a week. Now, a clinician or an assistant can do it all in seconds with a couple of clicks after an appointment.

Virtual visits improve patient care 

In the coming year, the trust aims to hold 5,500 virtual consultations. Speaking to a consultant online makes an immediate difference in areas like epilepsy. Where previously patients had to wait 6–12 weeks to attend a clinic in person, they can now use Teams to talk to a consultant the day after a seizure.

“If a caregiver has managed to video the seizure, they can send it to us via Teams so our consultants can quickly determine next steps with our patients,” adds Hill.

The importance of this is not lost on Hill. His own daughter, Holly Smith, was diagnosed with epilepsy in 2010 at the age of 14. Now, Holly works as a nurse for the trust and has seen the difference Teams makes from both sides of the table. “If we’d had virtual visits when I was younger, I think my treatment would have progressed much quicker,” she says. “I wouldn’t have had to come out of school, and my parents wouldn’t have had to take time off work. The experience with Teams feels the same as it does to sit in front of your doctor. And if you want to message your doctor and ask a question, you can do that rather than going through the secretary to then pass it onto your doctor. It’s just an efficient and patient-friendly way of delivering care.”

Judith Vincent, a Children’s Epilepsy Specialist Nurse, looks after some 400 cases and travels around the county to visit families. Sometimes, she can only get to one or two patients in a day, but now her capacity has greatly increased. “Virtual visits mean that I can see perhaps three or four patients in the time that I would normally spend traveling in the car to see one,” she says. “And you’ve still got that face-to-face connection. You can still pick up on visual clues from your patients and families just as you could do if they were in a clinic with you.”

Virtual visits help oncologists provide emotional support 

Consultant Medical Oncologist Jo Dent runs several clinics for cancer patients at the trust—many of them young women with busy lives, jobs, and children to look after. Previously, patients could choose from appointments at fixed times of the week and often travelled with their families for up to an hour for a five-minute check-up. Now, Dr. Dent can contact a patient using Teams at a time that suits them both.

Dent says, “We can have a quick chat over video just so I can check that the treatment that I’ve prescribed is working how I would expect. It gives them the chance to drop the kids off at school and lets the appointment happen on their time, not our time. With Teams, we offer the patient the choice, and it’s less stressful for them.”

“Oncology requires a huge amount of empathy, and you can’t show that empathy if you’re constantly watching the clock. If you can take that time pressure out, like we have done with virtual visits, then you can give the patient the support and the emotional help that they need.”

Hill summarizes the experience of Teams as “hands-down better than any other service we’ve had.” He adds, “From the patient’s perspective, virtual visits are unique. They benefit the environment, let us deliver care within the patient’s community, and help us provide a better service to our patients.”

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