Within the last 18 months, the healthcare industry has had to adapt to rapidly changing conditions at a pace not encountered before. The surgical backlog is now at record highs with over 5 million on operative waiting lists in England, meanwhile, the pre-pandemic pledge of a paperless NHS by 2024 is approaching.
The changing legal and regulatory landscape of consent and shared decision making has led to a perfect storm challenging the traditional paper-based consenting methods. In contrast to the outdated Bolam principle, the “Montgomery” case law requires patients to be given information that a reasonable patient would expect. There is also now a requirement that elective consent is undertaken before the day of surgery (Thefaut v Johnston).
In response to these demands, Concentric, a digital patient consent application for procedures and treatment, offers a 21st-century solution to the requirements of consent and improved theatre efficiency, particularly relevant in these challenging and turbulent times.
Paper consent processes can cause delays in several ways, not only in being time-consuming to complete on the day but also in terms of the risk of lost consent forms with increasing cross-site work. Consent issues are a key contributor to on-the-day cancellations.
A recent study published in the British Journal of Surgery revealed over 51% of traditional paper-based consent forms reviewed contained errors. These errors included illegibility, missed sections or failure to provide a full list of potential outcomes and side-effects for patients. This alarming statistic highlights the need for improvements in accuracy. In a busy and demanding environment, it is not surprising that such human errors are made, however, these errors t can be eliminated by digitising the process.
In a pressurised environment where time is at a premium, completing a form by hand is impractical and time-consuming. This means that information provided is likely to contain no more than essential details. However, using a digital consent form allows practitioners to provide additional information for patients, ensuring a full understanding of a procedure, its risks and benefits before consent is given. “Digital consent has an extra level – you’re able to include multi-media information” says St John. In this way, patients are presented with a complete picture during the consent process, ensuring they fully understand the potential consequences and complications of a procedure before it takes place.
Another advantage of digital consent is that it enables remote consent, reducing the need for face-to-face contact. Consent can be discussed over the phone or via video call with information shared digitally between parties, and signatures delivered on-screen. This offers benefits both to practitioners and patients, reducing the need for in-hospital appointments and saving time, travel and reducing CO2 emissions.
Storage and security
As well as being time-consuming to complete, paper consent forms must also be stored and retrieved, both of which carries a cost to a healthcare provider. Physical forms are at risk of being lost, leading to a potential confidentiality breach and delay or cancellation of the operation. Digital consent forms are available for practitioners securely, quickly, and easily without the need for physical filing solutions or the risk of loss, saving both time and money. Concentric can securely integrate with all existing electronic health records.
Some have expressed concern that those patients unfamiliar with technology may struggle with the digital consent process. However, the level of technical expertise required to read a digital consent form on a screen is minimal and many users have found unexpected advantages when using digital consent. Daisy* 75yrs old, who recently used Concentric before an operation on her breast, said: “In the past, when I’ve been asked to sign a consent form, I’ve felt pressure when reading knowing that someone was in the room waiting for me to finish – it was nice to be able to read the document at my own pace.”
Concentric is already a proven solution across a number of NHS Trusts, including Imperial College Healthcare NHS Trust, Chelsea and Westminster Hospital NHS Foundation Trust, and Royal Cornwall Hospitals NHS Trust. Concentric can be confidently introduced across a Practice, Trust or ICS, supported by EMIS experienced implementation team.