Patient Engagement Governance Assuring Standardised User Support
The PEGASUS Team
Dr Julian Brown
Clinical Lead
Dr Brown is a General Practitioner in West Norfolk and founder of Eclipse Solutions. His web-based systems are now protecting more than 28 million patients.
Dr James Ferguson
Core20PLUS5 Lead
Dr Ferguson is a GP in a Deep End surgery in Cambridge, he currently hold a Deprivation Trailblazer fellowship with NHSE and also spends time working for the Cambridge and Peterborough mental health trust.
Dr Sebastian Brown
Digital Transformation Lead
Dr Brown is a hospital clinician who was part of the award-winning COVID PROTECT team, providing the optimisation and support for healthcare in vulnerable patient groups through virtual hubs.
Catherine Green
Patient Engagement Lead
Catherine is passionate about patient engagement advocating for and empowering patients to reclaim ownership and decision making in their healthcare journey.
Karen Kendle
Health Care Assistant
Karen has worked as the lead HCA for Dr Brown’s team for the last 10 years and has helped to develop the enhanced use of HCAs for healthcare implementations and engagement with vulnerable patient groups.
Rosie Hucklesby
Patient Engagement Support
ECLIPSE has had centralised Department of Health contracts for patient engagement and access since 2014. Our system has systematically protected over 30 million patients and is there to ensure equality of care, improved patient outcomes and improved NHS efficiency.
Our latest interface PEGASUS takes patient engagement to the next level of innovation and assurance.
The system is specifically designed to digitally engage with patients whilst maintaining absolute patient privacy. PEGASUS empowers patients to be involved in decisions about their own clinical care and allows them to receive personalised education in relation to their needs. Patient engagement is further enhanced through the ability for personal preferences to be dynamically captured.
For those patients for whom English is not their first language the system will automatically translate the communication into over 100 different languages.
Where patients have visual impairment enhanced accessibility is available through a single click on the interface including the ability for the system to read the information in over 50 differing dialects.
Why You Need It
Current NHS workload is at an all time high. Systems that can use population health management to automatically identify, contact and risk stratify patients without the need for the involvement of clinicians can transform clinical pathways.
Unfortunately at times of reduced capacity it is those most in need of NHS care services that fail to receive support. This is particularly applicable to those who live in deprived regions, have mental health issues or from Core20PLUS patient cohorts.
Pegasus addresses this by allowing systematic communication with those vulnerable patients identified to be at increased risk utilising differing forms of engagement.
How It Works
Pegasus is unique in having the ability to identify at risk patients suitable for a service whilst keeping their identity anonymised. It is directly linked with the NHS spine to communicate confidentially with patients allowing communication through implicit consent.
Patient preferences are then captured and consent attained to enable direct access for support services without needing to increase workload for NHS clinicians.
The insights and preferences attained further power the risk stratification to ensure that vulnerable patients are identified and supported.
Sophie Renno
Patient Engagement Support
Leading on Evidence-based Usability
Eclipse is currently considered one of the leading organisations in the delivery of evidence-based usability testing and is currently supporting multiple NHS Universities and NIHR programmes in the design, evaluation and implementation of patient engagement tools. Our tools have continually outperformed all other NHS providers in relation to utilisation, feedback scores and patient participation which has resulted in our system being adopted by 23 ICSs and the National NHSE CYP team for digital patient engagement.
The key to Eclipse’s success is that it has a team of health care professionals and academics who work in partnership with patient groups on our PEGASUS patient engagement programme. Co-development with citizens creates prototype patient engagement modules that are then formally assessed and academically appraised prior to launch. As of November 2023 we are currently working formally on projects with UEA, Cambridge University, University of Exeter and Nottingham University relating to patient engagement and usability analytics.
The foundation of our approach is centred in understanding the unique needs of diverse patient groups, particularly those with moderate to low digital confidence, low literacy, protected characteristics, and complex health conditions.
Eclipse operates a standardised development process that is difficult to include within the allotted space so we have included a high level outline of our research design and testing processes, providing specific evidence of activities undertaken with different patient groups in NHS England.
Research Design
Use of Detailed Demographic Profiling for initial Development
We begin each cycle by creating detailed user personas, incorporating demographic information, digital literacy levels, health conditions, and any relevant protected characteristics. This forms the basis for understanding how to effectively engage, educate and communicate with the desired end user cohort.
Recruitment Strategy
Our recruitment process for each module is meticulous, ensuring representation from diverse patient groups. We have established two consented citizen groups for patient feedback. The first enables us to reach out to communities with lower digital confidence, low literacy, and those with limited digital infrastructure. These are engaged through phone consultations and in person group meetings. The second is citizens with complex health conditions, non-english speaking citizens, and those from vulnerable patient groups including relevant protected characteristics and mental health patients. Here we use digital feedback to gain insights in relation to the effectiveness of our system in relation to access, usability and impact. Finally we employ various channels such as community centers, healthcare facilities, and third party patient advocacy groups (eg Community Voices).
Our approach to supporting the clinicians is undertaken with a similar process. We have over 20,000 NHS clinicians utilising our software and it is essential that we have representation from diverse clinician groups, in particular those that struggle with digital solutions. We have 86 beta testing surgeries that provide essential insights and recommendations to refine our system.
Inclusive Research Methods
We utilise a mix of qualitative and quantitative research methods, such as interviews, surveys, and usability testing, to gather comprehensive insights. All research methods are designed with simplicity in mind, accommodating participants with varying levels of digital literacy. By digitally tracking the 6 processes in digital engagement we can identify which citizens were unable or unwilling to complete a defined action ensuring prioritisation of feedback from these individuals. Using these research methods in tandem with a cyclical approach to continual refinement of the engagement process allows for objective longitudinal evaluation of the usability of the system in relation to diverse patient groups. For clinicians we measure the efficiency in relation to utilisation of the system and allow for feedback from the end users on an ongoing basis.
Usability Testing Process
Scenario-Based Testing
Our PEGASUS multi-disciplinary assurance team evaluate each digital clinical support programme. Each word used, placement of links, utilisation of support videos and translation modules are validated prior to the implementation of usability testing. We then utilise real-world scenarios to assess the product's functionality and usability. For patients with complex health conditions, we simulate relevant situations to understand their interaction with the product in context. This is then repeated for the Clinicians with a similar level of scrutiny.
Observation and Feedback
Each testing session is observed by our PEGASUS team, capturing both verbal and non-verbal cues. We collect feedback on pain points, confusion, and areas of success, emphasizing the participant's experience.
Quantitative Metrics
In addition to qualitative insights, we gather quantitative data on task completion rates, error rates, and time-on-task metrics. This allows for a comprehensive evaluation of the product's usability. . By digitally tracking the 6 processes in digital engagement we can identify what percentage of citizens were unable or unwilling to complete a defined action, how long each action took and the percentage of patients that completed a successful remote consultation following the process.
Usability Development
Feature Iterations
Key findings from usability testing directly inform feature iterations. We prioritize enhancements that address the specific needs of patients with low digital confidence, low literacy, and complex health conditions.
User Feedback Loops
We establish continuous feedback loops with users, including those with diverse needs, to validate ongoing improvements and address emerging issues.