Gathering NHS feedback on automated telemedicine

NHS England Priorities and Operational Planning Guidance (2023/24) states that organisations should focus on reducing outpatient appointments by 25% with clinical resources redirected to tackle waiting lists and priority high risk cohorts.

Ufonia, a medical technology company, has developed an artificial intelligence (AI) product called Dora which can support the workforce to work differently. It is programmed to carry out routine telephone calls with patients. It has been designed to make care more convenient, reliable and consistent for patients, increase hospital capacity and release clinicians to spend more time meeting patients’ needs. Dora automates clinical conversations previously carried out by clinicians for pre-assessment and post-operative follow-up. If no clinical concerns are identified by Dora’s assessment, the patient does not need routine clinician review.

NHS England South East approached Ufonia to collaborate within the cataract pathway. We undertook a scoping review throughout 2023, working with six NHS hospitals in the South East. We interviewed senior leaders and clinicians involved in the cataract pathway to gather their feedback before and after implementation.

Feedback included this comment from a Director of Operations: “We want change management that sticks, (for this) you need to build relationships, change the pathway, and have executive support”

We themed the interviews and identified five ingredients to improve adoption and innovation – these are in line with current literature:

1. Understanding the local context
2. Building relationships between the technology provider and organisation
3. Senior leaders’ engagement – executive board and clinicians
4. Open communication between companies and NHS organisations including staff involved in the pathway
5. Sustainability of the technology in the clinical pathway through business planning

Five key elements emerged for successful implementation:

1. Change management is complex and requires engagement from all key players
2. Future funding needs to be secure for organisations to be confident of the return on investment of time and finance
3. Most staff are open to change and including them from the start is important
4. Competing changes in a department should be avoided when introducing new technology
5. Full integration of the software would reduce burden on staff

• Since completion of this report, Dora has been introduced to more hospitals in the South East and further afield. Frimley Health, as one of the initial sites, was highly commended in the HSJ Digital Awards in July 2024 in partnership with Ufonia in the ‘Driving change through AI and automation’ category. Dora was also featured in a BBC South series on AI innovations in healthcare – read more in this news story, August 2024

Further information: katie.lean@healthinnovationoxford.org