Introduction


People are living longer and the need for health care is rising. One new way of providing health care is with the use of technology to provide physiotherapy treatment via the internet, and so save people from having to travel to hospital appointments. This will be especially useful where specialist services mean travelling considerable distances. Research has been carried out along these lines, to determine how technology can help patients get the care they need. This research showed that even though technology was found to be useful, it has not yet been incorporated very much in clinical practice.

Patients from all over the country attend the Royal National Orthopaedic Hospital (RNOH) at Stanmore, a national specialist centre for physiotherapy. They often find that the trip to get to the RNOH is a challenge. We have already looked at how technology can be used to help patients consult with their physiotherapist and occupational therapist. For the purposes of the study we have looked only at shoulder problems. Some patients chose to take up the option of using a video call and others did not. Patients who chose to use a video call found that this negated the need to travel and its use greatly improved their experience.

It is important to now look at what patients like and dislike about the use of technology. From this research we hope to design a new way for patients to use available technology for the purposes of physiotherapy treatment. This will support them in getting the help they need for their health problems. Our research aims to design, implement and evaluate a technology supported consultation process so as to enable access to care without the need for repeated hospital visits.


We will do this in four phases

Phase 01

Review of Previously Published Research

We will search for previously published research, looking at how technology can help people with bone and joint problems get the healthcare they need. We will then look at the work both patients and staff will need to do to use this technology.


Phase 02

Interviews with Patients and Hospital Staff

We will speak to patients and staff in structured interviews to find their view on how technology could be used to achieve the best health outcomes, and whether or not this technology would make it easier for patients.


Phase 03

Patient Survey

We will ask patients to choose, from a list of options, their preferred consultation method for physiotherapy treatment. Some of the survey options will be those using technology to support the consultation. Patients will be asked to choose which options they prefer, as if they had those options to choose from for their own treatment.

Phase 04

Design a New Way of Working Using Digital Technology

Using the information gathered in Phase 3 we will design a new way for patients to access the treatment they need.




Following the conclusion of Phase 4 we will survey both patients and hospital staff to evaluate their experience with the use of the proposed technology.

The results of the above detailed research will be presented in journals, at research meetings, on the CONNECT Project website, and using social media such as Facebook, Twitter and online blogs.

We have set up a patient and public involvement group that will be actively involved in helping drive the research forwards at each research stage. The steering group consists of 10 members (made up of RNOH patients & members of the public), a technical author to support the plain english summaries, and two steering group co-chairs consisting of a member of the public and an RNOH Physiotherapist. To our knowledge, no previous work has explored the role of patient choice and its role in the uptake of technology.

It is believed that knowledge of patient preference will help clinicians, researchers and policy makers to better understand how to lead the introduction of technology supported appointments. This project will focus specifically on orthopaedic physiotherapy appointments, but it will assist in supporting the take-up of technology in other areas of the NHS. This will provide a better patient service and reduce costs to the NHS and patients.

Project Plan

The research is split into four phases:

Phase 01

Effectiveness of Communication Technology (months 1-6)

Research Question: What is the Effectiveness of Communication Technology in reducing patient workload?

Phase 02

Burden of Treatment (months 7-12)

Research Question: How does the change in workload impact on the burdeN of treatmeNt?

Phase 03

Care in Orthopaedics (months 13-21)

Research Question: What are patient preferences for the use of SKYPE for their Care in Orthopaedics?

Phase 04

The CONNECT Project (months 22-30)

Research Question: How can these preferences be incorporated into clinical practice? – a pilot of Modified Clinical Practice.

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We will conduct focus groups consisting of patients and physiotherapists to support the design of a clinical pathway using SKYPE. We will pilot this pathway with 20 patients and clinicians and interview them afterwards to determine the acceptability of the pathway.

The final six months of the research will be reserved as a contingency and for preparation of manuscripts and the final PhD thesis.

Patient & Public Involvement Steering Group


The CONNECT Project Patient and Public Involvement (PPI) Steering Group is an important part of the overall project. The purpose of the group is to provide a patient perspective for the design and delivery of the research. The first group meeting was held in August 2016 (see picture) where Anthony Gilbert presented the initial outline for the research plan.

Minutes of all meetings will be recorded and published on the CONNECT Project website.

The Group

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Discussion

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Clinical Area

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Outcome

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The Role

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Location

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PPI Steering Group Members

There are a number of PPI group vacancies, please get in touch below if you would like more information about dates and joining the steering group.

Helen Harte

Co-Chair

Anju Jaggi

Co-Chair

Geoff Buckley

Lay Summary Lead & Technical Author

Vandana Luthra

Group Member

Colin Le Quesne

Group Member

Charlotte Day

Group Member

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Start of Phase 01

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Start of Phase 02

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Start of Phase 03

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Start of Phase 04