Lisa is now marking her 10th year working with Florence as part of the Simple Shared Health Care team. With new exciting development and investment brought through the partnership with psHEALTH, Lisa has reflected over these years sharing her thoughts and experiences, as well as what’s next for SSHC.
2020 marks my 10th year working with Florence, from the very start of her journey in 2010 through to where she is today having helped over 100,000 patients to improve their health outcomes.
My passion was ignited from day one. Having already worked across the NHS in service redesign roles at local and national level, I often felt like a small cog in a very large wheel, but I could clearly see the potential that Florence had to change real clinical outcomes, for real people, in real everyday life at what can feel like a very vulnerable time.
Empowering patients to become active in their own healthcare fully aligned with my personal objectives, developed during childhood as the daughter of a non-compliant patient. Watching the clinical and emotional impact of declining health, and how a sense of overwhelment and loss of control quickly removed any motivation to engage in positive health behaviours meant that I was fully committed to help bring Flo, who was just an idea at the time, to life. I knew from my personal experience how individuals can influence their own health outcomes, for the better, or for the worse, and I wanted to help more patients to feel empowered and confident enough to take a more active role.
People may think that recognition by the US Government’s Veteran’s Health Administration by inviting a delegation of 16 NHS Clinicians to Washington DC for a two day conference focussed solely on their outcomes with Flo would be my proudest moment; it certainly was one of them.
However, probably my proud moments happen most days, when I hear a brand new patient story or read a service evaluation, case study or publication that I wasn’t aware of – I feel a sense of accomplishment that Flo is delivering what we set out to do all those years ago. Even after 10 years, I am inspired daily by the commitment of busy clinicians to harness innovative best practice to improve quality and safety for their patients.
Unlike many commercial companies motivated by profit, our goal was never to create dependency on us as a social enterprise. Our objective has, and always will be to invest our time working in partnership with organisations for the long term. Focussing on the continual increase in local capability, whilst ensuring that both patients and organisations benefit from evidence based implementations for the lowest possible cost ignites clinical creativity; handing over control of this flexible and adaptable tool allows clinicians to recruit Flo as a member of their own team independently.
Our commitment to do the right thing, for the right reasons for the benefit of patients is what I am most proud of.
Why do you think Flo is so effective?
Thinking back, and of myself as a patient, there is a limit to the impact that even the best practice healthcare can have for me unless I, as a patient, take an active role. Flo transforms patients from being ‘receivers’ of healthcare to becoming ‘partners’ in their healthcare; from being passive to active.
My GP cannot guarantee that I will take my medication as prescribed, nor can a physiotherapist force me to comply with an exercise plan to prevent exacerbation of my bad back. My Community Nurse does not know when I need further clinical input if I have not followed my self-management plan and taken action by recognising the signs and symptoms of my deteriorating COPD. My health literacy dictates if I appreciate the role of diet and exercise in determining if my pre-diabetes turns into a diagnosis or if my unmanaged blood glucose leads to longer term comorbidities.
Flo bridges the gap.
There have never been more available healthcare related gadgets, apps and websites for us all to consume at will and yet adherence is still low.
Florence, or Flo to her friends, “feels” like a person, she interacts with you like a friend about your healthcare via your mobile phone, at times agreed with you. The guidance she offers is based on you as an individual as prescribed by your healthcare team. Your clinician can review your readings and/or symptoms at any time and with this extra insight tailor your treatment based on your condition or give you permission to reach out to the right place in your best healthcare interests.
Flo brings self management plans to life, real time nudges gently encourage patients to take action outside of face to face care, the actions that only a patient can take for themselves. Actions that make a significant difference. Patients feel like they are still connected to their clinical team and levels of accountability increase as Flo starts to interact.
I’m excited for this next phase. The first 10 years have delivered more than we could have expected thanks to the commitment and passion of NHS clinicians to make this happen. I am proud to say that Florence is now proven, evidence based and respected amongst clinicians and endorsed at the highest level such as the Kings Fund, Nuffield Trust and Health Foundation.
We started with Florence in the UK, then were asked to work with the Veteran’s Health Administration (VHA) to bring Flo’s cousin ‘Annie’ to life in the USA. The next generation of Flo’s family, ‘Nellie’ in Australia is delivering the same better and faster outcomes for citizens in Melbourne, all enabled by the passion and commitment of our NHS. Leveraging the last 10 years learning with Florence, aligned with the exact same methodology that activates patients, Nellie uses sophisticated technology and the team in Melbourne are firmly members of our Community of Practice. The VHA are also active members and as part of their COVID-19 response recognising Annie’s proven techniques in delivering a rapid public health response, have recently published how Annie helped Veterans to monitor their symptoms safely in the Journal of the American Medical Informatics Association delivering both clinical benefit and substantial resource saving. I am confident that this has helped to expedite similar applications in the NHS with Florence during the pandemic.
Our next phase, partnering with psHEALTH will further develop Florence and bring back into the NHS the capabilities of our third generation platform currently being used in Australia, opening up even more opportunities to accelerate the benefits that Florence brings to patients and clinical teams alike, helping more patients to help themselves.
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