By Naeem Sheikh

I am a Patient and Public Involvement and Engagement (PPIE) Lay Leader and contributing to the work of NIHR Yorkshire and Humber Patient Safety Translational Research Centre (PSTRC) – Digital Innovations Theme. The Digital Innovations Theme manages various projects concerned with developing digital interventions for health improvements. Smart-ER is a digital development designed to improve the way Emergency Departments work in NHS Trusts. The Smart-ER is currently being trialled at the Emergency Department, Doncaster Royal Infirmary (DRI).

I was offered an opportunity by Carolyn McCrorie Research Fellow at PSTRC to visit DRI, which I accepted and we both visited the Emergency Department on 16th May 2018.

The purpose was to observe and experience from the perspective of PPI&E. I was very keen to see how Smart-ER is taking shape in the Emergency Department. We arrived at hospital at 9am and were welcomed by Amjid Mohammed (Consultant in Emergency Medicine) who is also the Project Lead.

Amjid offered me a demonstration of the software. I pretended to be a patient and sat in front of the terminal and Amjid assisted me to complete the digital form on the computer terminal which was simple interactive questions and answers about my injury details.  I proposed I had a broken arm, and then there was a series of questions and pages to go through.  To my surprise it was like a Doctor face to face asking me the questions and I would have answered those questions.

It also asked some other questions for example if I was a smoker. I thought that this had nothing to do with my arm injury.  It took about ten minutes to complete the digital form. By the time I had finished the form I had a number of questions, which Dr Amjid explained to me. For example, the number of questions asked and a lot of pages with options to go through were a bit heavy; he reassured me that the newer version will be a simple to use. What about the smoking question? He explained that in the future, with the consent of the patient, we could send their information to relevant departments/agencies that can help to quit smoking therefore it can also help with prevention and health promotion. By completing this process, patients can explain the reasons of their visit. The patient provides their own health details and the injury details which becomes their health records. So, it is not produced by a doctor taking notes, it is done by the patients and therefore patients are saving their time as well as clinicians. After completing the form patients/carers/family members wait in the waiting room.

What about serious injured patients? Amjid said they are taken straight for assessment and treatment; otherwise, at initial assessment nurses decide which patient will be completing the forms.

The computer terminal can be accessed to complete the form in any language. Regular collection of evaluation forms is helping to gain feedback from patients that use the system.

Now I was wondering what happened to the information given by the patients. To answer this Amjid took us to the other side where clinicians were in action treating the patients.

He showed us the one of the computer screens which was showing the details of a patient’s injury, and it was details submitted by the patients. These were looked at by the clinicians, and then they see the patients and they do not necessarily to take the notes as the patient has already provided the information.  This potentially can save clinicians and patients’ time, and increase efficiency.

We were informed by Amjid that he was expecting a VIP visitor Dame Gillian Morgan who is a Chair at NHS Providers (Foundation Trust Network) accompanied by DRI Board Chair and Chief Operating officer.  On their arrival we were introduced with them and Amjid did another demonstration for their benefit.

I was wondering, it was an excellent blend of digital and human touch and hope this balance is maintained in the future for a long time, for the safety and wellbeing of the patients. This trial will continue, and future road testing will inform the outcome. With this note we left and Dr Amjid was busy with the VIP visitors. It was great experience to visit and see for myself the work in progress. For further details, please contact Carolyn McCrorie.