When used in a strategic way, technology helps to foster accountability among clinicians and enhance patient care. Feedback Medical’s Managing Director for India Rohit Singh explains how the right tool can help achieve this goal by improving communication between healthcare professionals and making inter-departmental referrals in hospitals more effective.
Consistent, coordinated clinical working
Effective multidisciplinary working among clinicians is one of the most powerful ways to ensure care is delivered at the highest level. In Britain, where Feedback Medical was founded, multidisciplinary working has been a key element of high standard care since the mid-1990s. Its importance has only increased, as the UK population lives longer, but with multiple chronic conditions.
Here in India, many patients who visit hospitals, clinics and health centres seeking treatment are also managing multiple comorbidities. Sadly, referral processes within and between hospitals and other healthcare providers are too often inconsistent. At worst, this poorly coordinated care can cause great harm to a patient. For example, avoidable delays to vital diagnostic tests can mean certain cancers are not identified at a stage where early intervention can provide better outcomes. But, thankfully, we are beginning to see meaningful change.
Earlier this year the Indian Government’s Ministry of Health and Family Welfare recognised the challenge arising from a lack of consistent, co-ordinated clinical working. In response, it issued a set of clinical guidelines in June 2024 to improve inter-departmental patient referral processes in hospitals and to establish effective, uniform and transparent mechanisms to promote effective multidisciplinary team working, especially when providing care to comorbid patients.
The consequences of poor referral practices
In presenting these fresh guidelines, the Ministry’s Director General of Health Services (DGHS) Professor (Dr) Atul Goel has outlined the problems that he sees stemming from inconsistent referral processes, based partly on his own considerable experience as a clinician. These include:
- Poor communication and coordination between specialties and departments.
- Inadequate training for healthcare professionals.
- A lack of defined roles at various levels, resulting in gaps in patient care.
- Non-standardised referral document and clinical imaging formats.
These guidelines are designed around a series of general principles intended to promote more effective care: Prompt referrals where medically necessary; clear communication, not only between clinicians but also with patients themselves; efficient clinical pathways that harness the right medical expertise at the right time; and accountability between different members of a clinical team through greater visibility of available capacity.
Responsible hospitals will be examining these guidelines closely and will overhaul their organisational practices to meet these requirements and create a more effective and accountable process for providing patients with access to the care they need.
An innovative solution to create effective collaboration
There will be practical considerations, of course. For example, how can a hospital best meet the guideline’s demands for confidentiality to be the first consideration when sharing patient information? How can different team members quickly and safely access comprehensive records to make clinically effective referrals? What practical tools need to be adopted to facilitate clear communication for better, collaborative care?
Facilitating better collaboration, both within multidisciplinary teams and between specialties, has been Feedback Medical’s core focus since its core product Bleepa®’s birth. Through Bleepa®, our clinical communications tool, we have empowered healthcare providers in the UK to safely, efficiently and conveniently work at a multidisciplinary level across clinical settings, while ensuring that the right patient information is available in the right place at the right time.
Confidentiality first in patient information sharing
The DGHS guidelines stress the importance of ensuring confidentiality and privacy when sharing patient information with other departments in a hospital or with other healthcare providers. Bleepa®’s workflow, which can be securely accessed on a smartphone, tablet or computer workstation, creates an individual ‘room’ for each patient within the platform.
These ‘rooms’ each have three sections – one for clinical chat, one for viewing clinical imaging and radiology modalities and a final section for storing and viewing diagnostic results and other clinical documents. Through this system, no unauthorised individual or clinical department is able to access or share this information. Furthermore, although this patient information can be viewed from a securely logged in device, no data is ever stored locally on the clinician’s device.
Timely referrals for expert care
As we have seen, unnecessary delays to referrals can compromise patient care and lead to adverse outcomes for the patient and increase healthcare costs. Bleepa® makes it easy and fast for clinicians to initiate referrals promptly as and when patients require specialised care, diagnostic evaluations or consultations that fall beyond the scope of the admitting department in a hospital or professional attending the patient.
Through the clinical messaging app, a clinician can select a doctor or department in the clinical chat section of a patient ‘room’ to refer that patient to them in real-time. Once a doctor or department is selected, the relevant doctor is placed in the patient’s clinical ‘room’ and can review all necessary documents relating to the patient’s case.
The time savings are clear to see. An independent review of Bleepa®’s use by leading UK care provider the Northern Care Alliance NHS Foundation Trust found a dramatic reduction in referral and clinical response times. The review was able to identify a reduction of almost 75% in average referral times in comparison to paper-based systems, across three of the Northern Care Alliance’s clinical specialties using Bleepa® to manage inpatient referrals.
Comprehensive records for clear referrals
Documenting referrals accurately and comprehensively avoids breakdowns in communication and are essential for effective, well-coordinated care. Organisations that rely solely on verbal communication for referrals are much more likely to make mistakes in the care of their patients. This can be particularly dangerous if a referring clinician does not have relevant information to hand such as the referral’s expected outcome, patient preferences and consents and other relevant clinical information (such as allergies or current medication courses).
An effective way to avoid these errors is to ensure that all referrals are documented in the patient’s paper medical record, their hospital information system (HIS) record or electronic medical record (EMR) for accuracy and accountability.
Bleepa® enables a referring clinician to share all relevant information throughout the referral process. A patient referral summary is then back-synced to the relevant patient’s HIS or EMR as a central record.
In addition, each patient ‘room’ contains an audit log of activity, which enables any authorised person to trace back decisions in the course of a referral for future learning or comparison.
Clear communication for better and collaborative care
A significant pillar of the DGHS guidelines concerns ways to promote effective communication for more collaborative care. Clinicians are urged to “promptly acknowledge referrals and keep referring providers updated on their status and patient appointments”.
Elsewhere, care providers are told to collaborate with receiving departments and specialists to ensure continuity of care and shared decision making.
Bleepa® enables simple, secure clinical chat between a referring clinician and a receiving department to discuss patient cases and provide swift updates in a patient’s status to reflect the stage the referral has reached. The options ‘accepted’, ‘rejected’, or ‘released’ can be easily changed as required.
When seeking to escalate urgent referrals or get help from senior colleagues in the event of a delay or barrier to timely referral processing, a referring clinician or department can also update a patient’s status within the platform from a series of options to reflect the level of urgency (‘immediate’, ‘watch’ or ‘routine’) and, if required, trigger escalation protocols.
The ultimate goal: Efficient clinical pathways that harness the right medical expertise at the right time
These recent guidelines sketch a path to a future where effective multidisciplinary team working can be carried out safely and effectively in order to improve care outcomes for patients seeking help with complex conditions.
They are anchored around a series of general principles that, when applied elsewhere, have been shown to improve the care outcomes for those patients who require the care of a multidisciplinary team.
Among them, prompt referrals where medically necessary, clear communication between clinicians and accountability between different members of a clinical team are the gold standards in safe and effective patient care.
Furthermore, the tools that enable these efficient clinical pathways will be key to helping knowledgeable and experienced clinicians provide their expertise to the right patient at the right time. As India’s healthcare system continues on its journey up the global rankings, we look forward to helping hospitals and healthcare providers across this country move to the gold standard of multidisciplinary care.
Contact us to learn more about how Bleepa® can help healthcare providers provide joined up care pathways.