Improving patient autonomy with mobile apps

Improving mental health treatment and empowering patients to manage their care, Lancashire and South Cumbria NHS Foundation Trust created its pioneering DIALOG+ app – allowing patients and clinicians to collaborate and achieve personalised, effective treatment.

Key benefits

  • Improved patient experience
  • Increased effectiveness of care according to clinicians
  • Data accuracy and reduced risk of loss
  • Time and resource savings
  • Increased job satisfaction
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The challenge

Prior to this project, LSCFT’s Community Mental Health Teams (CMHT) relied on paper-based processes when preparing for and conducting visits with patients. Information was captured manually throughout mental health appointments, then rekeyed into RiO - the Trust’s electronic patient record (EPR) system.

Alongside local and regional plans for integrated and primary care networks, the Trust researched the clinical and cost-effectiveness of DIALOG/DIALOG+ in treating chronic depression with the World Health Organisation (WHO). A clinical model used to measure the efficacy of mental health treatment, DIALOG is a scale comprised of 11 core questions relating to quality of life and treatment satisfaction. DIALOG+ builds on this model but focuses more on the areas each patient considers most important. This data is then used to plan personalised recovery goals and interventions.

In order to pilot DIALOG+, LSCFT identified the need for a digital process that could empower both patients and healthcare professionals to ensure each meeting was both effective and therapeutic. This project presented a unique challenge, as it required a solution that would allow patients to take ownership of treatment while enabling healthcare professionals to access and record data in a separate, secure area integrated with RiO.

The solution

LCSFT has worked with NDL for over 12 years, using NDL Digitise in several successful projects - such as its Community Nursing App and Electronic Referral System Bookings Process. With this previous experience, the team were able to create a complex, yet user-friendly app quickly and easily.

The app features a wide range of functionality, including the new 'My Care Plan' and 'My Safety Plan' which replaces the 'Mental Health Overarching Care Plan' and 'Crisis and Contingency Plan' for most Adult Mental Health teams across the Trust. It also includes the DIALOG+ scales and assessment questions, which patients complete themselves on mobile devices with the help of clinicians. Results are saved and can be compared with previous measures.

The app is integrated directly with RiO, though clinicians control which data and functionality is available for patients to view. Progress notes, outcomes and forms - such as the Mental Health Urgent and Useful Contacts (MHUUC) form - are recorded directly in the app and synchronised in RiO without the need to return to base and rekey.

The benefits

Following its implementation, 100% of professionals in one CMHT felt their time with patients was more therapeutic and effective. As patients fill in the forms themselves, they’re more confident and honest in their answers. One patient reported:

“The DIALOG+ app helps me identify areas of my life that I have ignored, and talking with you about it meant I could set relaxed goals and plan. It’s a personalised experience, especially being able to complete it myself, rather than having someone go away and type up their interpretation. It felt less clinical, more relaxed and not rushed.” 

Not only do patients report improvements in care satisfaction, but the Trust’s own CMHTs report they experience more joy at work with fewer professionals considering alternative roles. CMHTs also report that the app is fostering greater productivity and reduced sickness absence. These benefits are attributed to better outcomes achieved with patients, as well as eliminated rekeying and the consequent reduction of travel.

In its first six months, the app saw over 1500 DIALOG Scales, over 500 My Safety Plans and over 480 My Care Plans successfully completed by a combination of staff and patients. The Trust has seen an increase in outcome measures, with 2074 referrals having now received their first DIALOG+ Assessment. The app is now informing practice, and NHS England has recognised the programme as exemplary.

For more information about the Trust’s DIALOG+ app, or to learn how Digitise could impact your organisation, don’t hesitate to get in touch.

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For the 1st time ever, I feel in control of my care and can understand my care plan now I see it in front of me on the iPad.” - LSCFT Patient

Using the App lets me spend more therapeutic time with patients, I don’t need to return to base to update plans.” - Social Worker, CMHT

The rating scale was good as I personally find it hard to put myself into categories so I was able to look into everything as an individual and break my thoughts up. Using this helped me look at the main areas I need support and what I need to do to improve my mental health.” - LSCFT Patient

For me, the best part of the App is that it’s interactive - it enables service users to be more engaged - they have more autonomy over their care and work more toward their goals.” - RMN, CMHT