We recently spoke with Sue Harvey, Clinical Quality Partner at Ramsay Health Care UK (Ramsay UK). Ramsay UK is one of the leading providers of independent hospital services in the United Kingdom, with a network of 34 acute hospitals across the country. 

In our conversation, Sue shared Ramsay’s 14-year journey of implementing and evolving Patient-Reported Outcome Measures (PROMs) across their UK network, transitioning from crude paper-based methods to a transformative digital approach.

Watch the video below or read on for a summary of what Sue shared!

Before taking on the clinical performance manager role, Sue accrued almost two decades of experience in frontline nursing roles, followed by a role as a hospital Head of Clinical Services. This mix of rich on the ground experience and an insightful operational focus gave her a unique perspective to bring to Ramsay UK’s patient reporting programmes. 

It was no surprise when she became the National Clinical Performance Manager, where one of Sue’s responsibilities was building on the initial implementation of PROMs programmes across the Ramsay UK group. This focus on PROMs, reflecting Ramsay UK’s commitment to patient-centricity and inclusion, aimed to achieve three main objectives:

As with most outcome focussed roles, Sue found there were complex interdependencies: 

A big role already, but there was also an additional need. It wasn’t just the Department of Health that was demanding compliance data - insurance companies, CMA and PHIN (an independent, government-mandated organisation publishing performance and fees information about private consultants and hospitals) and CQC had additional requirements about evidencing outcomes.

Commendably, Ramsay UK was an early adopter of PROMs. However, they were harnessing patient feedback through paper-based approaches that created huge inefficiencies internally. Sue soon discovered that using this methodology created as many challenges as it overcame - reports were delayed, data wasn’t organised enough to be able to dive deep into it, and benchmarking and compliance were practically impossible. In short, the data really wasn’t actionable.

“We were getting limited value from the data we could get back from that paper process. We would have quarterly reports produced by a third-party organisation, which could be up to six months down the line. We were unable to really dive down into the data to interrogate and analyse it and understand what we could do as an organisation to make changes to improve our outcomes going forward.”

Sue felt there had to be a better way. So she went looking for a digital solution. 

In 2019, Ramsay UK successfully piloted a digital PROMs programme for their hip and knee surgeries at selected sites, working with their existing digital PREMs provider Cemplicity. This site-specific trial was enough to give Sue and the Ramsay UK team confidence to expand the digital initiative to cover all sites and extend it out to additional specialisms, including hips, knees, cataracts and carpal tunnel. Additional specialisms, including TURP, nasal septoplasty, breast augmentation, and shoulders, are soon to follow.

For Sue, this move to digital PROMs was a game-changer:

“We found loads of benefits from this change. We've now got near real-time data in the dashboard. We're not having to wait for six months to get a bit of a report and a part story of anonymised sort of data."

Alongside intuitive dashboards and real time data, Sue highlights a multitude of other benefits derived from the shift to the digital:

Empowering staff and consultants to make data-driven decisions has transformed data collection from arduous, long-term studies to immediate and visible improvements.

Patient engagement and response rates increased with more relevant touchpoints and wider options for PROMs completion.

“Patients can now complete it in the comfort of their own home, increasing engagement and saving time and resources at pre-assessment or on admission. And we've got different capture points, like QR codes, email and SMS alerts, all the way along the patient journey to really improve on our response rates”

Visual reporting engages patients by showcasing their individual scores, post-op progress and overall improvement over time.

“Consultants are able to pull up visual reporting while they're consulting with patients. It’s accessible for patients to understand and track. It demonstrates all of the measures within the PROM. These are your scores, this is how you've improved over time within every measure of the PROM, not just this is your overall health gain.”

Consultant and site-level benchmarking provide Sue with a visual representation of outcomes, fostering healthy competition and improvement.

“It's allowed consultants to interact with the dashboard reports and see their outcomes as a consultant compared to their peers. Obviously anonymised, but it's always good to have that little bit of competition to see where you are against others. And it's of value to the consultants now because they are able to interact and do something with that data.”

One of Sue’s highlights was winning over the Group Medical Director, who initially doubted the benefits of PROMs due to the limitations in analysing outcome data before going digital. However, after witnessing the tangible benefits of going digital, he has become a strong advocate for PROMs and embraces a data-driven decision-making approach.

Sue reports that the improved data quality has made it far easier and faster to submit data to external bodies.

Digital PROMs is set to play a big part in the future of Ramsay UK, and Sue’s excited about what’s ahead. Far from seeing the job as done, she’s constantly looking for ways to unlock new value and has a pipeline of new features and functionality lined up. The first in the queue is the exciting launch of a fully integrated action log. This will provide the next level of actionability for her PROMs data, alerting hospital staff when a patient's post-operative self-report indicates minimal improvement. This will empower the operative teams across Ramsay UK to deliver active intervention rather than being stuck in a cycle of passive reaction.

“We're about to launch an action log that will send out email alerts to nominated individuals at the hospital site if a patient hasn't improved. The patient can then be seen by the consultant or physiotherapist who, if required, can review and change their treatment plan. That's going to be a game-changer for us. It's not just about demonstrating good outcomes and using that as marketing… it's about picking up those patients that need extra help and improving the journey for them and for future patients.”

**update! The action log has now been implemented and utilised across many Ramsay UK hospitals. Joanne Milton, Head of Clinical Services at Woodland Hospital, shares their process for managing patients who record less than expected outcomes following procedures via their PROMs action register.

It’s been a long journey for Ramsay UK to get where they are now, but thanks to Sue Harvey’s vision and perseverance they now have a PROMs platform that’s delivering rich insight, benchmarking and imminently action registers that can all drive better outcomes. Thanks to a transformative shift to digital PROMs, Ramsay UK are experiencing significant benefits that have turned non-believers into PROMs advocates. 

We’ve done a deep dive into one of Ramsay UK’s sites, North Downs Hospital, to learn more about how digital PROMs are delivering value to their patients, quality and clinical teams. Those teams, initially anxious about the transition to a digital platform, have enormously enhanced their patient response rates, earning recognition for their exceptional 95% response rate for hip replacements. You can read more about North Down’s story of PROMs success here.