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Curated by Shereen Nabhani-Gebara, PharmD, BCOP, SFHEA Associate Professor of Oncology Kingston University London (@shereenabhani)
5th July 2021
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Shereen is an oncology pharmacist and an Associate Professor in Oncology at Kingston University London. She has a doctorate in pharmacy with post graduate qualifications in general and oncology pharmacy practice. Her research in technology enabled care has attracted research funding from national and international schemes such as the European H2020 and FP7 along with InnovateUK and the International Society of Oncology Pharmacy Practitioners.
She is an elected member of British Oncology Pharmacy Association (BOPA) executive committee and leads on its audit and research sub-committee.
‘I reflected on my journey in TEC and shared some recommendations that can support a successful digital intervention: role of stakeholders and champions, a solid implementation strategy and cross sector collaborations’
Rise and Shine everyone. My name is Shereen @shereenabhani
and I’ll be curating the One HealthTech for the day. I am an oncology pharmacist and I work @kingstonuni as an associate professor of oncology. I have been working in technology enabled care for the past 10 years #TEC
When I'm not busy working on exciting new digital interventions, I teach pharmacy students and supervise PhD students helping shape their journey. A very rewarding part of my working day.
Throughout the day, I will share with you my journey working in this field, what worked, what didn’t work and what I’ve learned along the way #OHT21. Now I have to rush to campus to support my #pharmacy students with their exams. I'm nervous for them! Good luck! @kupsa
My very first project in #TEC (and the closest to my heart) was CanAdvice which is a digital platform that supports people living with #cancer who are receiving their anti-cancer medicines at home. It offers a communication mode with healthcare professionals anytime anywhere 1/5
Anyone who’s experienced any part of the cancer journey as a patient, parent or carer would tell you how scary it is to be at home experiencing a new side effect. Having to face the’ judgement call’ of ‘sleeping on it’ or reporting it. That’s where CanAdvice comes in. #cancer 2/5
CanAdvice allows people living with #cancer to report side effects and to receive advice thus providing a virtual support for the dreaded ‘judgement call’. (3/5)
Genius, right? How did we come up with this idea? Easy.. it came from the stakeholders. We conducted an in depth needs assessment to understand how technology can support people living with cancer.
This included semi-structured interviews and observational studies to understand the true needs and where such a digital intervention can fit in the #cancer journey 4/5
The needs assessment stage is a very important part of the process that is often skipped and overlooked. An idea is not enough to make a digital intervention work. You need to take the time to engage with stakeholders. This is the process that I have created for myself 5/5
Another element to the success of any digital intervention is identifying and engaging a digital champion within the organisation where you need to implement. The champion can help facilitate and support the engagement of more staff. Here’s a basic visual
Implementation strategy is also important. The design of the digital intervention alone is not enough. How will this new intervention fit into the current patient pathway? Can we simply parachute a new intervention? The short answer is ‘No’ . (1/n)
There are so many things to consider such as ‘Are all patients eligible for this?’ ‘Will it work for everyone?’ ‘Do staff need to be trained?’ ‘ Will this add extra load onto the staff?’ etc 2/n #OHT21
I remember one project that can easily demonstrate my point. We were called in to consult on a ‘new’ telehealth service that was failing. We had to play detective (3/n)
Upon conducting our needs assessment study which included semi-structured interviews with the staff and an observational study of the service, we were able to see that there was no implementation strategy. 4/n
This was a telehealth service for people living with COPD but there was no eligibility criteria (ex ability to use the kit or need for it). Another problem was the lack of planning for the added workload on the nurses who had to recruit, train and monitor the patients. (5/n)
The nurses felt overworked, sceptical of the service and resentful overall. With this study, we were then able to develop a protocol of implementation that addressed all these challenges. Technology does work but it needs to be implemented correctly (6/n) #OHT21
I'm trying to curate this feed and at the same time support my students during their online exam. There's nothing more exciting (not) than a technology fail during an online remote exam. Butterflies in my stomach. What else can go wrong?!
One of the dreaded and difficult things to navigate in a technology enabled care project is ethics. I have been a part of many research projects in technology enabled care, and ethics is always something that needs to be planned for in advance. (1/n)
In one of my past EU funded project, one of the partners had to withdraw from the consortium because they did not engage with the ethics process early on. They realised too late that they needed extra measures in place. (2/n)
It was upsetting for the whole consortium to see them leave and it distorted our sample size. Each country is different and understanding the requirements early is very important 3/n
It's recommended that in such cross country collaboration research projects, you assign an experienced lead for ethics and a legal lead as well. This is specifically important where there are data sharing agreements involved.. Navigating GDPR in such cases is a minefield 4/n
The impact of #COVID on the uptake of technology in healthcare has been very interesting to observe. I have been working for 10 years in TEC and I have always found that the uptake of technology in the #NHS has been an uphill journey.. a battle even (1/7)
However, due to the immediate and urgent need of keeping people safe at home, the uptake of telehealth was immediate and almost overnight. GPs were suddenly using virtual consultations and telemonitoring on a daily basis. (2/7) #OHT21
Secondary care and specialised clinics also turned to virtual consultations. You might ask, did it work? Short answer is yes but read on (3/7)
We conducted an evaluation of #virtual clinics in oncology with both healthcare professionals and patients. We wanted to understand how it’s working and to derive some lessons learnt for future recommendations (4/7) #cancer
It’s quite clear that virtual consultations are here to stay because both patients and health care professionals like the new approach with its flexibility, reduced travel and wait times etc .. But (there’s always a but..) we need to individualise this approach (5/7)
Our results show that one size does not fit all...We need a triage system of who is eligible for it, we need better ‘kit’ (ofcourse we do) and we need to train healthcare professionals how to communicate using this new approach (6/7)
Communicating with patients over the phone or over video conferencing is not the same as F2F. There are new skills to be learnt. (7/7)
What about digital #inequalities? What about them you may ask? Well, with all these innovations, we may need to be mindful not to leave anyone behind. Recent ONS stats show that up to 6.5% of people in the UK have never accessed the internet. (1/4) #OHT21
This includes 54% of adults over the age of 75.. These numbers might be higher in your area/country. This could be due to #connectivity or #digital literacy (2/4)
There could be multiple reasons behind that. It could be due to disability, age, language etc What can we do to address this? (3/4)
Assess the situation first.. yup, another needs assessment ..understand how many people are affected and why. This is the first step to designing an #inclusive digital intervention (4/4)
My last reflection for the day is the importance of cross-sector #collaboration. I wouldn’t have been able to be part of these amazing projects had I not collaborated with colleagues from #computing, #engineering, #law, #healthcare among others.. be open and reach out..#OHT21
It's time to sign off . It's been a great experience curating this twitter feed for the day. I would highly recommend it.. Thank you for the opportunity and I hope you have enjoyed my reflections on my experience with #TEC to date. Get in touch if I can help. I am @shereenabhani