CASE STUDY

KLICK

Klick is a digitally-enabled HIV care pathway conceptualised by Chelsea and Westminster Hospital Foundation Trust (CWFT), Avegen and a major pharmaceutical company. Klick was designed and built by Avegen to integrate with and enhance CWFT’s outpatient service model, whilst delivering a positive experience for patients. It aligns to the 2021/22 NHSE priorities to: improve access and health outcomes, address health inequalities and build on the learnings of the COVID pandemic to transform the delivery of services and manage increasing demand. Klick involves people living with HIV (PLWHIV) in their care, supporting them to live independently with their long-term condition, and allowing them to navigate healthcare according to their changing needs.

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Problem

We know that developing products is complex, time consuming and often expensive for innovators in digital health. Converting the data into actionable insights, staying ahead of the ever-changing regulatory requirements, continually optimising the product as the user base grows — we understand these challenges and our proven 7 step process helps you solve them.

CWFT wanted to

  • ease the patient’s interaction with their clinical team
  • improve the quality of HIV and/or sexual healthcare offered by their clinics.
  • Relieve capacity pressures within the outpatient service
  • improve patient outcomes
  • provide quick response and information to patients in the most efficient manner

KLICK is built on HealthMachine, Avegen’s proprietary, cloud-based, product development platform. Avegen’s expertise in designing and tailoring digital health products coupled with HealthMachine’s complaint, bespoke modules ensure high quality, secure and compliant digital health programme.

Approach

Klick is a HIV care pathway underpinned by technology, and conceptually designed during a sprint in 2017 by a collaboration of CWFT and a leading pharmaceutical company’s innovation unit.

Step 1 –

Avegen supported them in building the sprint concept which was piloted as ARC (annual review clinic) at Kobler outpatient clinic by 92 patients between April and October 2018. The evaluation demonstrated high patient satisfaction rates and did not attend (DNA) rates were lowered by 80%. Moreover, an audit using BHIVA’s HIV care monitoring standards revealed the piloted care had performed significantly better than previous local and national findings. During the sprint a significant amount of baseline research was conducted to explore patients’ views, experiences and preferences. These included a review of previous annual departmental patient surveys, online patient surveys that were distributed to all Kobler patients, several in-depth one-to-one interviews with patients and a review of historic themes coming through from complaints and incidents affecting patients. Collectively these informed the concept design. Difficulties scheduling appointments dominated complaints and “missed” abnormal pathology results were a recurrent theme amongst incidents.

Step 2 –

At the end of the pilot, further in-depth patient evaluation interviews were conducted with a small group of participant volunteers and an online service evaluation questionnaire was distributed via SMS to all 92 pilot participants. The pilot’s success prompted ongoing investment to further enhance and upscale the service.
Combining these enhancements with further iterations of the product in response to COVID, a finalised product was launched in August 2020, initially just at Kobler Clinic, before being adopted by the team at 56 Dean Street in July 2021.

Step 3 –

Eight months after Klick launched, an online evaluation questionnaire was distributed to all registered users exploring feedback about the Klick care pathway as well as the individual features of the Klick service. There was also good evidence of patient engagement e.g. completion rates for pre-visit questionnaires to enhance and focus the consultation.

The virtual aspect of Klick meant it played a key role in enabling uninterrupted care for PLWHIV during the pandemic, for example when patients were dispersed across the country or living abroad and when restrictions were in place on hospital attendances.

A designated Klick support email inbox has been available to the patients since launch which responds to queries and requests for support with the Klick service. This is accessed daily and common themes feed into regular meetings. User feedback has been further incorporated by adding the Klick app to non- UK app stores as requested and monitoring the reviews logged on this external platform.

Our solution

Klick is a nurse-led, technology-enabled solution available for people living with HIV (PLWHIV) who attend Chelsea and Westminster Hospital Foundation Trust (CWFT) for outpatient care. Avegen worked as a technology partner with CWFT and a major pharmaceutical company to develop Klick.

The solution comprises of a patient-facing app and a clinician-facing portal, both built on HealthMachine®, Avegen’s proprietary next-generation, cloud-hosted platform for building and deploying high-quality, safe digital health products.

The Klick app allows patients to remotely manage their HIV outpatient appointments, complete health assessments, view routine results and receive communications from their healthcare team. The Klick pathway enables patients who are stable on HIV treatment to access a virtual annual (or six month) review consultation with an experienced HIV nurse working as part of a specialist, consultant-led team. Clinical staff use Klick’s clinician portal, to conduct and capture virtual consultations, share documentation with the host EPR and communicate results and care updates to the patient.

Impact

Klick has improved the engagement of 5000+ patients, keeping them connected to the clinic during COVID 19, improving the patient care experience and their adherence to the care pathway.

  • 91% overall patient satisfaction (very satisfied/satisfied)
  • 93% felt positive about technology playing a role in their care
  • 84% wanted to continue the same care pathway

For the clinicians, it has

  • relieved the capacity pressures within the outpatient service by automating numerous tasks and broadening the workforce conducting HIV consultations.
  • Leveraging the advanced data analytics functionality of HealthMachine®, the clinical team has been able to demonstrate that their services meet the British and European standards for HIV care, as well as support the delivery of the NHSE standards.
  • Efficiency: 84% reduction in DNA rates compared to the mainstream Kobler clinic during the same period.
  • When compared to mainstream/pre-pilot service, patients received better care on every standard audited and showed 60% improvement compared to the national audit findings.
  • enables patients who are stable on HIV treatment to access a virtual annual (or six month) review consultation with an experienced HIV nurse working as part of a specialist, consultant-led team. Clinical staff use Klick’s clinician portal, to conduct and capture virtual consultations, share documentation with the host EPR and communicate results and care updates to the patient.

Key takeaway


Klick has made a considerable impact on the NHS workforce: it has become an integral part of the Band 6 Nurse training and as such offers them a structured pathway to grow into higher Bands. This has been possible by creating a DHP by understanding the client requirements and constantly iterating and improving the product.

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