Background

Currently there is a high late cancellation rate for biopsies, as patients realise late in the decision- making process that the risks of the procedure are more onerous than they thought. Late cancellations mean that slots for the procedure cannot be offered to other patients, leading to loss of the slot altogether at a cost to the NHS. 

On 26th November 2024, HISES launched a pilot project with Pogo Digital Healthcare in determining the usage of digital technology in relation to patients who are referred to have a CT_Guided Biopsy when there is a suspected lung cancer diagnosis. 

This project is to amend an existing digital solution, and to create digital questionnaires and content to improve information-sharing. This will enable clinicians to easily identify patients who need further information to support their decision-making process, and significantly reduce the risk of late cancellations.

This project aims to:

  • Create a digital solution to underpin a new lung cancer pathway, to support patients as they go through the process of deciding whether to go ahead with a diagnostic biopsy for suspected lung cancer.
  • Run a six-month pilot of the new pathway, to assess its effectiveness in supporting patient decision-making, and its impact on clinical time and costs associated with the process of scheduling biopsy procedures.

Clinical Lead

The Clinical Lead for the project is Dr Rishi Ramaesh, Consultant Radiologist, NHS Lothian & NHS Fife and NHS Scotland Innovation Fellow.

Project Objectives

  • Improve the quality of information shared with patients.
  • Provide multimedia, digital information on the lung cancer diagnostic biopsy.
  • Improve patients’ understanding of the risks and benefits of the procedure.
  • Provide clinicians with a reliable method of assessing patients’ progress with the decision- making process.
  • Enable clinicians to identify which biopsies may be at risk of late cancellation.
  • Provide clinicians with timely opportunities to follow up with patients to offer further information and support in the decision-making process.
  • Reduce late cancellations of the biopsy procedure.

Project Benefits

  • Patients have access to better information on the benefits and risks of the biopsy procedure.
  • Improved patient / clinician communication.
  • Better patient understanding of the procedure – leading to better-informed consent or non- consent.
  • Improved process for identifying biopsy procedures at risk of late cancellation.
  • Reduction in number of late cancellations.
  • Savings of up to £1,000 for each late cancellation avoided.
  • Reduction in abandoned procedures due to lack of patient awareness of requirements for the procedure.

Delivery Partners

Health Innovation South East Scotland (HISES), NHS Lothian, Macmillan Cancer Services and Pogo Digital Healthcare.

MyTailoredTalks is a digital solution currently supporting people living with Long COVID in NHSL. The system enables clinicians to create libraries of multimedia “Talks” providing high-quality medical information that can be shared with patients by email, as PDFs, or to a dedicated patient portal. Patients complete registration, which trigger the system to share specific “Talks” in response to the concerns they have reported. Upon completion of viewing the procedure and its risks, they are given a questionnaire to determine if they are fully aware of the procedure, its risks and benefits and if they require further information, they are directed to a specialist clinician to answer any questions they may have.

An evaluation on the outcomes will be published and contributed to an overall business case for future development.