S5: EP009 - EIDO Healthcare: Redefining Informed Consent

Speaker A: Foreign,

Speaker B: Uh, health tech listeners. I'm your host this week, Paul Johnson. This is the podcast where we tackle some of the trending topics, ideas, best practice in health and social care. Today's episode is a special one. We're chatting about our strategic investment in IDO Healthcare, a global leader in digital informed consent and patient information solutions. I'm joined by Matthew Ravenscroft, CEO of ido, um, to talk about what partnership means, how it will benefit healthcare organizations, and why collaboration, um, is key to driving safer, more effective care. Welcome to the podcast, Matthew.

Speaker A: Thank you.

Speaker B: Okay, so a few questions just to try and dig in a little bit and get your view of the world in from an IDO perspective. Um, to kick us off, can you start by giving our listeners a brief overview of IDO Healthcare and its mission?

Speaker A: Yeah. So EIDO was set up around year 2000. So we've got a good 25 years of history. And we were founded by a clinician who was a frontline NHS clinician, so knew the problems he faced every single day. And he too often found himself needing to obtain consent from patients on a corridor in the minutes before a procedure. And he just knew that that wasn't best practice, it wasn't a safe way to treat patients. He saw it was a common problem in the hospital and realised there was a need for improving that process. So ido's mission is to support the patient doctor relationship and in particular focusing on shared decision making. So that's why we exist and our products and services are all around furthering that aim.

Speaker B: That's so, uh, I mean you hear it all the time as to, uh. It's become like a phrase now, isn't it? The why? Yeah, I mean that, that's pretty powerful stuff. So, so there was. What would be the process pre this then? It just, I mean, you kind of described that there was a bit of frustration and challenge. Were there no systems or, uh, things in place at the time?

Speaker A: A lot of consent was done as a conversation because consent is a process, it is a conversation. Um, even today still, most hospitals will use a paper consent form and it requires the clinician to take time out from what they should be doing, which is speaking to a patient and, um, treating, um, the patient to getting information down on form as quickly as possible so that they can make sure the patient is ready for their procedure. And that just leaves too much variation for an organisation who's want to manage the risk of consent not being done brilliantly by allowing one clinician not enough time to do consent. So there's quite a different mix, um, of how hospitals are doing it at the moment. And, um, before that it was really reliant on the communication skills of the clinician to make sure that the conversation they had with the patient was properly understood and documented. So that when the patient gets home, having maybe received some really quite shocking and upsetting news, how do they recall what has been talked to them about, what options they were presented, what could go wrong, what should go right? So helping the patient to be able to recall that was something that was very variable across the nhs.

Speaker B: So this effectively started in one hospital, one system, from a very personal experience and then grew out from there.

Speaker A: Uh, exactly, because around that time there was the Bristol Royal Infirmary scandal, which had a big element of informed consent as part of that. So quite quickly Simon, um, Parsons, who was the founder of IDO at the time, realised there was a need for this, not just in his practice, but it was something that we could make a real impact across the whole of the UK by delivering a better solution.

Speaker B: Yeah, I think you've kind of answered the next question, which is, you know, you've just mentioned it there. Informed consent is such a foundational element of patient safety. So the question is, you know, how has ido, uh, helped healthcare providers improve this process over years? Yeah, I think the piece I would probably pick up on is the informed element. If you can talk to us a little bit of, you know, how important and the impact that's had from a clinician. Because you're right, it's the clinician and the patient. It's all of that journey, isn't it?

Speaker A: Yeah, absolutely. So, like the NHS should be and, um, mostly is, IDO is also a patient focused company. So that's. The patient's at the heart of what we do it. If the patient doesn't understand what could go wrong, what should go right, what are the options available to them, then you're not giving them the full picture. And usually a lot of the consent related claims that the NHS are still facing is not really because the clinician has done anything wrong with the actual procedure, but it's because the patient's expectations weren't met. They were thinking that after their procedure they'd be able to get back to this particular lifestyle or to be able to start doing this thing again. Um, and that's not a case then their expectations, uh, are not met and they're shocked and upset, feel the need to talk to somebody, a complaint could begin. And it's often around the information sharing and it is a Shared decision, after all. So in order to help to resolve that, we can help to give the clinicians a tool to inform patients about the bits that are quite uniform for most patients. So what does a hip replacement involve? You know, what are the, the typically accepted risks, complications, benefits of the procedure? A lot of that can be safely standardised and given to the patient. All patients can get the same information. So that means you're raising the bar from no or poor information to a very high standard, gold standard information to support that consent process. And then that allows the clinician, who may only have a few minutes with that particular patient, to focus in on what's meaningful for that particular patient. So understanding that this patient is a, uh, professional footballer versus this patient's an 80 year old person who just enjoys doing a bit of gardening from time to time, their perception of certain risks will be quite different. Even though the risk of that complication could be the same for everybody, the significance that that person places on it could be different. So by empowering clinicians with the right tool, they can have a single meaningful consultation with the patient and make sure that they're not, um, doing something to the patient which they weren't expecting to happen or not getting the intended benefits.

Speaker B: So I suppose there's a, there's a lot in play there and, and maybe you can talk to us how the system helps with it. So if I'm having a conversation, I'm going to have a knee replace. You just mentioned there that I'm, you know, I'm a sportsman, so it's quite important to me.

Speaker A: Yeah.

Speaker B: You know, I might have underlying health condition and I suppose there may be. At, uh, what level am I at now in terms of my mobility versus what will I expect at the end of this? It's not going to be a miraculous cure. I suppose all that must come into play. So how does the system draw together all of that information? I've got medical, you know, underlying health conditions, I've got my baseline as to where I am now and what am I expecting at the end of this is all that brought together to inform the clinician. So when they're having that conversation, they can articulate as to what life's going to be at the end of this.

Speaker A: Yeah. So informed consent is a medical legal process and it is always the legal duty of the clinician to ensure that the patient is informed and to make sure they've presented everything the patient should need to know, a reasonable patient should need to know around this particular procedure. But it's important that the patient also understands their role in this shared decision making process. Just like when we're driving around in our cars if uh, it's the driver's job to not hit a pedestrian, but it's the patient that would have or the pedestrian that would have the biggest impact uh, to their life, um, if that did happen. So the patient is an important part of the decision making process and needs to understand what does the clinician need to know about them in order for them to be empowered to make the right decision. So to telling them about other issues that might be going on in their life. Us tapping into things which might be shared as part of a pre assessment process. For example, understanding the outcome that previous patients have had when they've had that particular procedure. All of that information comes together to help the clinician feel like they're able to make the right recommendation for the patient in front of them. And we can draw on things like published data and evidence to help us to understand complication rates and then present that to the way to the patient in a way that they can understand and weigh up for them. What's their perception of that relative risk, uh, are they prepared to take a 1 in 10 risk of this happening so that they can get back to a certain lifestyle? So all of that needs to come out in that conversation so we can capture some of that through our direct interaction with the patient through our digital consent system. Some of that might happen via other systems the hospital's using. And so interoperability between us and other hospital systems becomes a really important part because all of those bits of documentation together form the consent record. Remember consent isn't just the signature at the very end of the process, like you grab from the patient maybe minutes before the procedure. It's the whole process that has maybe taken months to happen. And all of that is really valuable information.

Speaker B: So I suppose that's going back to Simon right at the start of this. We've gone from a box ticking legal requirement to uh, ensuring and delivering to the clinician and the patient as much information for them to make those informed decisions. And I suppose, yeah, it's taking that from a box ticking to the gold standard of all relevant information in order for people to make those choices.

Speaker A: Yeah, and you'll hear phrases like, you know, consenting a patient or making sure the paperwork is done. You know, that that still happens today. Conversations, um, still happen where those sort of words are used. And it doesn't really bring out the spirit of what consent is. It's the dialogue between two People who are trying to get to a better understanding of each other's viewpoint. So the clinician needs to know everything they can about that patient. The patient needs to know as much as they can about the procedure. So together they feel like they're making the right recommendation for the patient. So all of that works together to create a consent audit trail, if you like, and where the part that IDO then plays is making sure we can support that with gold standard patient information to help, um, raise that bar to a really good, solid, um, base. So, uh, patients understand what it means to have a procedure. And then the clinician can add information around what they've added about this particular patient. And then we can do some quite clever things in the background around tracking a patient's engagement with what has been provided to them so the clinician can understand how active this particular patient is in the consent process. Is this the first time the patient has rocked up and read anything about a, uh, hip replacement? Or has this patient spent a long time reading the information and even made notes of questions, uh, that they want to make sure they talk with the clinician about? All of that joins together to create, um, a much more robust medical, legal consent process.

Speaker B: Yeah, I suppose it almost informs the clinician as well as to how much do they need to engage and questions that might need to be asked because there hasn't been any engagement up to that point.

Speaker A: Yeah, that is the legal duty they've got. It's their job to tease out of the patient what they need to know rather than relying on the patient coming to say, here's everything you know you need to know. Because the patient might not understand the consequence of certain things in their life that the clinician just immediately thinks, ah, ah, I know what that means, and I need to advise the patient something differently. So it's a clinician's job to tease that out. But it's a time consuming process. Consent is not easy. It's something which clinicians spend years and years and years training to do as part of their treatment of patients. It's very complicated. So everything, every little step we can do to make that more simple can actually have a really big impact in the outcome down the line.

Speaker B: Yeah, I mean, you just mentioned that you know the outcome on the patient from a radar healthcare perspective. That's always been a mission and something that the organization has tied itself to is how do you make organizations deliver better, safer health care and better patient outcomes? Clearly you know the same mission. So I suppose from your perspective, why, why do you Think now is a good time for Radar Healthcare and ido, you know, to come together and what, what excites you about that partnership and, you know, the potential realization of innovation or whatever that might be from, from an IDO perspective. Yeah.

Speaker A: So we've been, before the merge with Radar, we've been on our own digital transformation journey. So when we began providing information to hospitals, it was a library of PDFs which were printed off, given to the patient as part of that consultation. But from IDO's point of view, that was a little bit of a black hole really. We didn't really have an insight into the end user's use of the information. So which clinicians were using them, how often were they using them, which patients were getting them, what, how many patients were using that, uh, information as part of their treatment in hospital? So we started to change the delivery mechanism so we added a cloud based solution to be able to track that information and that gave us really great insights for us to provide back to our partner hospitals so they could understand how they were performing against their own guidelines and policies and procedures to make sure consent was done properly. So we could now show them which departments were using lots of information versus which weren't. And then now, as we're moving into the digital consent platform as well, we can bring in patient level usage stats to help inform hospitals around the performance of their departments in providing that information. So where the link with Radar gets really exciting is you've got really good dashboards and analytics and ways of visualizing that trends and data so that hospitals can get better insights into what is actually happening on the ground, whereas there's some risk that is still there, which hasn't been removed yet. And rather than waiting for a complaint from a patient to be the trigger for a hospital to say we need to do something about this, we can now get some insights to the hospital to say this specialty isn't using information as much for consent as we would expect. What can we do now in advance to prevent potential patient harm occurring? So that's where things I think will start to go. That's why it's particularly exciting for us to merge with Radar, uh, because we both are here to fight that patient safety corner. That's exactly why we are, uh, uh, up and running. It's about improving outcomes, the experience, removing risk, but actually not for one particular patient. It's about using what we've learned to reduce that risk for future cohorts of patients as well.

Speaker B: Yeah, I mean, you mentioned there about the insight. I Mean insight and data has just become, I think people have always captured data and they've kind of looked back and it's been historical and now with the introduction of machine learning AI, um, to be able to push that into data sets to visualize and understand and I think it was something became very obvious from a radar healthcare perspective that when we started to join those data sets. So to give an example we would be able to help an organization visualize a specialty has a higher uh, level of risk and that may be related to the level of acuity or whatever. But now that there's another layer of data that's below that, that actually the reason that there is an issue with that specialty is that actually is linked to consent.

Speaker A: Yeah.

Speaker B: Or that you know, that the patient outcome is related to the fact that they weren't properly informed and may not have gone down that road. Does.

Speaker A: Yeah.

Speaker B: That another layer of data is very relevant and when you start to feed it back up the chain and visualize it and make suggestions as to how you improve. Yeah, I think that's been super powerful.

Speaker A: Huge amount of the litigation out there, we're talking billions that the NHS is still facing. It's around failure to warn. It's not that the clinician was negligent and did something wrong in the actual procedure, it's, it's that failure to warn. It's the conversation, the dialogue and that's where helping uh, to use that data to inform conversations. I think that's where we've got a real strength between IDO and radar.

Speaker B: Yeah, I think we've probably answered this next one as well which was you know how to, from an IDO capability, how does that complement the existing platform? I think that's probably there's some integration from a technology perspective but surfacing the data and the intelligence that sits behind there to uh, integrate that into the platform. But again from your perspective where you see uh, complementary functionality and opportunity to integrate.

Speaker A: Yeah. It's about helping hospitals to become proactive rather than reactive to consent related problems. So we were making head roads ourselves with that. But teamed up with radar we get this idea of the two plus two equals five scenario where we can bring a lot more benefit than separately we would be bringing by giving those insights to hospitals.

Speaker B: Yeah, yeah. I mean um, I think again I can't speaking from a radar healthcare perspective. Again, it is what we're starting to see and as I think healthcare organization, you've probably been more involved than radar. Uh, healthcare was to some respect, which is the pre. Operative, pre Health care experiences, how do you engage with that uh, patient. There is then the, you're in the care.

Speaker A: Yeah.

Speaker B: And then that you're. Unless you're in long term care of course. And then you're, you're, you're post care. So I don't know. Can you talk about what happens after and how you, you uh, know how you capture and learn from, you know, how have we been informing people and made these decisions but it isn't the outcome that they wanted.

Speaker A: Yeah. So right from the very beginning we've, as I said before, we put patience at the heart of what we do and we've always had a clinician and patient feedback process in how we produce the information. So clinician feedback is really valuable to help us make sure that we're reflecting localization variations on how certain procedures might be performed. But patient feedback is really valuable because it gives us insights into the sort of information need that patients have to help them come to the right decision. So one of our early pilots, ah, with patients identified a requirement for more information about the future, what happens after the operation and you know, information for consent is obviously given pre op. So it's all about um, what does the procedure involve and what risks could happen. But patients seem to also want information about long term recovery and getting back to a lifestyle and what happens in the longer term future, what's the risk of recurrence. So as a result of that sort of feedback we can enhance that information in our library to meet that need. And our information is often used, used potentially months or even years after the procedure as a reference point still for patients to look back on to understand are there any late complications or recurrence issues. I need to be thinking about that. That information can still support me with. And then we can start to do um, exciting things around prems and proms so we can monitor patients experience and their outcomes. You use that information to understand um, the value of an organisation to pay for that sort of procedure because some procedures may be commissioned and most patients don't report the outcome that everybody expected to have. And that can really help commissioners to be more proactive in picking and recommending the right procedures. So that kind of virtuous circle of feedback where we get from one set of patients, feeding that back into the future cohorts of patients. So we're iterating towards a more patient safe solution rather than treating every patient separately as one discrete exercise and not learning from what they needed and telling future patients that same gap in knowledge.

Speaker B: Yeah, you just mentioned their prems and proms for the benefit of the listeners. What does that actually mean? Um, and then from an ideal perspective, what is that interaction? From a, you know, a consent perspective?

Speaker A: Yeah. So patient reported experience measures or patient reported outcome measures. So these are important because they're giving us the perspective of a patient. So the experience measures in particular are helping us to understand what's the patient's perception of how that procedure went. Um, did they have a satisfying and satisfactory procedure? Did they get the um, uh, treatment that they expected? Were they unduly worried or frightened? Were they reassured? All that information is really important because it helps an organization to protect their reputation and to deliver excellence in their care to their patients. So gathering that sort of information, we've done pilots through the IDO platform directly with patients, helps us to understand how we need to keep evolving the product to meet that expectation. And then the outcomes is also helping us to um, inform future patients around the risk rates in particular, so helping us to monitor the incidences of where particular complications could happen, what sort of patients do they happen more to. So again, we can inform future patients better by asking the right questions in advance. So then tagging things like prems and proms along with pre assessment questions as well can help us to create a really holistic approach to getting informed consent. Perfect. So you're asking the right questions in advance, giving the patient the right information that they need and then checking did the expected outcome, um, materialise and did they have what they wanted to achieve when they had the operation?

Speaker B: I suppose it's going to be more prevalent now. Uh, we'll see which direction it goes. But an aspiration of this current government is that, and from an NHS perspective is that we're going to need to push higher levels of acuity out into more social care healthcare settings. So I would imagine that having that prems PROMS consent locked down is going to be absolutely critical to, for the government and the NHS to realize that expansion of, you know, those operative procedures getting pushed out into, into different settings.

Speaker A: Yeah, and the healthcare sector has been trying to digitally transform for a long time. You know, Certainly the last 10 years there's been a bit of an explosion in health tech companies, uh, and resources out there which are, uh, designed to try and help improve, uh, certain processes. But the public wasn't always ready to be able to receive that. And I think this is where in the last five years, with the pandemic that we've been through, Covid was a bit of an accelerator in the public's digital Readiness. If you think about six years ago, uh, QR codes were like something that geeks knew about. And then five years ago, millions of us were scanning QR codes from the comfort of our home. We were doing a little medical test. We were using some health tech to be able to communicate with a provider to tell them something about us and they could then advise us back to say, this is what you need to do about that. So all of a sudden the patients understood the value of technology and how it can help their particular care and how they can do that remotely from home. And that's where EIDOS consent system is designed to work perfectly. So we can support patients at home with information about the procedure, start to help them with the education part around what it means to have that procedure. The patient could then start to feed information back into the hospital through either through our platform, uh, by answering certain questions or it may be we have some interoperability with other systems or hospital already using that information is fed into the hospital remotely. The hospital can then advise the patient what's the next step? Here's your appointment. This is the procedure we're recommending. You could even then move the patient to remotely give their part of the consent process completed, uh, from home, answering um, some questions and making some statements. So again, when the patient and the clinician are together, which given the uh, size of the waiting list these days hospitals are really focusing in on how quickly can we reduce that waiting list. We need to make sure that we're not introducing any new safety risks by trying to really rapidly reduce the waiting list. So using the health tech that we've got in the system, we can really help to safely guide a patient through their part of the consent journey. So when they're together with the clinician, maybe for the only time before the procedure they can have that really important personalised conversation. And um, then after that follow it up again remotely with other processes that the patient might be able to go through to help the clinicians understand I can safely discharge this patient because we've done a virtual follow up clinic with them, we've asked them certain questions, we flagged which ones need to be telephoned by the hospital for a conversation with a specialist nurse or something. So the possibilities are limitless. Um, and that's where our exciting future with with Radar is going to take us.

Speaker B: I think that you've got a really good point. Are you uh, you highlight a really good, good point which is waiting lists.

Speaker A: Yeah.

Speaker B: And I suppose, does that get factored into all this information? And data that gets collected. So, and I suppose where I'm going on this is, if I've been on the waiting list for a long period of time, I may have developed other, you know, underlying conditions. I might. My condition may have deteriorated. Um, so therefore, when I had my initial assessment, you know, is that. Is that brought into this solution as well, so that information is presented.

Speaker A: So when we were going through the first waves of the pandemic, we updated our information, I think, 17 or 18 times in a year. But to keep reflecting the latest Covid guidance and, uh, extra information patients needed to get as part of that process, because many of them were on a waiting list waiting for a procedure. And then what needed to happen was to help patients understand that their profile of risk could be changing. If they've had Covid, their likelihood of certain complications is greater. If they've been on the waiting list for longer, the procedure that was recommended to them may no longer be the most appropriate one. Maybe they've now reached the point where a different procedure is recommended. So that changing risk profile is something that's really important. And by being part of a digital consent process, we can flag up to the clinicians when they're viewing a consent form that a certain, um, length of time has elapsed and they might want to revisit the information with the patient. You might want to invalidate the consent form and mandate that a fresh consent form is undertaken by the organisation. With a paper consent form, you're allowing hospitals to fill it in badly because there's no control on that piece of paper. But by digitizing it, the hospital can take more ownership of the governance of making sure that process of consent is done uniformly, consistently, every time, with every. Every patient.

Speaker B: Yeah, I mean, you've got. I think you've kind of answered, um, that. Which was, you know, we spoke about reducing litigation and litigation risk, you know, and how does digital consent play a part in that? I think we've pretty much, you know, by you, uh, are. It's not only that engagement and informing people so that the right procedure is done and the expectation outcomes. But you mentioned a couple of times about that reducing the risk profile for the patient, the procedure, whatever that might be. So I think that's kind of. I don't know if you want to elaborate anymore, but in terms of how that. I suppose they go hand in hand. If we're more effective in the way we're informing patients, the procedure itself is locked tight and we are worrying about the prems, the proms, that pre and the post operative feedback, you would expect there's going to be a reduction in litigation. Is that something you see as a demonstrable benefit to the customers?

Speaker A: So it's difficult because litigation is always rising. So you know there is more litigation faced by the NHS today than there was five years ago, 10 years ago, and it's continuing to rise. Um, however, there is a recognition that good information and a rigorous um, consent process is helping to reduce the exposure to large uh, payouts for hospitals who've got good consent practice. Um, a number of our customers um, mandate the use of IDO information across the organisation because they see it as a way of reducing their exposure to risk. We supply some insurers who recognise that a better informed patient is less likely to bring a claim. So therefore they can insure a clinician more efficiently because they understand that that clinician has got good consent practice. So there are quite a few things that we can help our customers and uh, partner hospitals with to help them know where to put their energy to reduce their exposure to risk. Because, um, IDO's main focus has been on educating patients and getting through consent. But we're also there to support clinicians because a lot of clinicians will be performing the procedure absolutely brilliantly. Not m making uh, clinical risk errors, but sometimes a communication breakdown might happen or there may be a misunderstanding along the line, some complaint might happen. Um, and it's not because the clinician's done anything wrong in particular, but by being able to support them with establishing the baseline of what information was shared. What did the patient rely on to make their consent decision, then we can help to not just inform the patient but protect the clinician and also the reputation of the organisations that we supply. So we've always tried to be holistic in the way that we provide our products. Not just for um, the benefit of one particular group, but remembering our initial mission to support the patient doctor relationship around shared decision making because the patient's got as much to learn as the clinician has to make sure the right recommendation has been made for that patient.

Speaker B: I suppose there's a softer side as well that. And um, what I mean by that is if I, and you'll know this from any walk of life and any interaction you have, whether it's healthcare or not, if you have a conversation with somebody and you feel they understand you and your situation and it's an informed conversation, I don't know, you feel more connected to that person. Um, not that it should still be measured on outcomes, but you're also less likely to complain about if you felt that was a positive experience. So I suppose there must be a. You say about supporting the clinicians. Do they feel actually this helps me engage with the patient more? Is that feedback that you get?

Speaker A: Um, yes. Yeah. We deal with quite a few different people in the hospitals that we supply. So some will be clinicians, you know, on the front line, so to speak, who feel the need to give something to a patient to take home with them to be able to reflect the conversation that they've had. We're not here to replace a patient clinician conversation, we're here to support it. So the patient goes home with something that they can use to rely on to say, this is, yes, I remember we talked about this with the clinician and this has helped me to remember that, uh, conversation. So we can remove that headache from the clinician to need to produce, update, maintain, make sure the information is readable and understandable. It's a, uh, guiding GMC principle. The patients need to be able to understand the information you provide them. So we can do that with making sure it's readable and plain English and available in multiple languages. All of these are important factors to help empower the clinician to do their bit of the job, which is making the right recommendation for the patient based on all the information they've been provided. So that's quite an important part of what we do.

Speaker B: Yeah, I suppose, uh, again, you've just highlighted something there. We talked about language. I suppose, again, feeding in cultural considerations. You know, there'll be a social determinants which might have an element on somebody's condition. There'll be religious, cultural things that may have to be factored in. I suppose all of that information, I'm saying, assuming there's all that pushed into the system as well, and that's the

Speaker A: sort of thing that comes out through the clinician and the patient feedback processes. So making sure we're understanding that we're not creating an information document that that's too specific around a particular cohort of patients. It's designed to reflect how is the national average picture for the patients receiving that information in the uk but then we supply hospitals in other countries and so we establish an international editorial advisory team to help us to reflect local variations that might need to be captured. Sometimes it's a simple spelling or a few different ways to phrase certain words, but other times there are quite different procedures that need to be mentioned. Sometimes there are procedures that are, ah, not permitted to be performed in that country. So we have to reflect that in the way that we phrase certain bits of information. So we're very focused on making sure we tailor the information to, uh, the end user, the patient, the clinician, the organisation. And we can do that with our, uh, international editorial board.

Speaker B: There's a lot of talk. I mean, obviously it's something we discussed in other podcasts as well, which is around machine learning. AI. And AI is the, the big buzzword at the moment. But I suppose just even at a foundational level, what's next for ido? IDO radar. Uh, in terms of, you know, what, what can clinicians patient expect to see, what's the direction of travel, you know, even a view on the kind of. Because there's immense benefits and you can certainly see how they could be applied to this process from an AI perspective.

Speaker A: AI is going to be an amazing and fundamental part of future healthcare. Absolutely. Um, right now people are learning what it could do and AIDO are quite focused on making sure our, uh, partners understand where there's new risk if they're using it. An example that, uh, we saw recently in a news article was around a patient who turned to AI. Well, he wasn't a patient at first, but he became one. A member of the public went to AI to ask how he could reduce his salt intake and AI told him to reduce, to swap his sodium chloride for sodium bromide and he poisoned himself and ended up in hospital. And that's because AI right now is brilliant at making something feel readable and expert and you could read that information and it feels like some knowledge has been put behind that statement. Whereas we need to help our partners understand that there's still always a place for an expert pair of hands. We can't remove the clinician from the patient and clinician conversation. Just like in producing good information for a procedure, it needs that clinical expert to make sure that the information is actually the gold standard informed consent information and not something which just reads like it. It is. So we're very focused on harnessing AI in how we're going to be taking things forward. Right now you could use it for things like translations, which is quite good. However, one in ten words is still mistranslated. So if you've got a five page information leaflet, half a page of junk could be on there. So you need to make sure that you're still involving the right people to validate what AI is doing. Over time, it may well get there and we are, uh, keeping a close eye on that and it definitely will be part of Our future evolution, it'll be on our roadmap and I'm sure it's on the radar roadmap and it become part of the joint IDone radar roadmap of features and how we can really revolutionize what, um, we are doing together, bring new efficiencies in the process, but not undermining, but supporting what patients and clinicians need to do together to have a truly safe health care.

Speaker B: Yeah, I think that human element is so critical. I mean, you flagged up an example there of somebody's ultimately poisoned themselves by taking directive from, um, AI.

Speaker A: Yeah.

Speaker B: And so as people are using ChatGPT and it's becoming commonplace now for people, I think something that I've seen, and I've seen, I've seen it, especially in the us, is patients are now coming into the care settings, being informed not by the gp, but by AI.

Speaker A: Yeah.

Speaker B: So people now have a, you know, higher level of expectation and perceived knowledge and understanding of something. So, for example, if I was to go into ChatGPT now, I could type in, I'm thinking of having a knee replacement op list me all the risks and complications. And the way that information is then collected might not be relevant to me, but going through an ido, you know, consent process, then that's going to draw out that interaction at a human level to make sure that the right questions, information is being passed and asked.

Speaker A: Yeah, we saw that actually, 15, 20 years ago when we were setting up, uh, our, uh, first hospitals, they were using EIDOS information and at that time, I think those big search engines were just getting going. So Yahoo and Google and all of those were just becoming really well used back 20 years ago. And clinicians told us that they were having to spend time undoing the, the work of Google or Yahoo, where a patient would come in waving a piece of paper saying, the Internet says I should have this procedure. And the clinician, because they're an expert, knows that that's not a suitable procedure for that particular patient because of years of training and experience. And whilst that document that they printed off looked like it was the right advice for them, the patient needs to speak with a clinician so they can properly understand what's relevant for that patient. And that's where we are now with AI. It can produce something that's very, on the surface, trustworthy and useful information, but without a human factor, there is potentially more risk. So it's just about understanding the value and the risk of it and making sure we are managing that risk in how we're Harnessing that technology.

Speaker B: Yeah, I think, um, for sure it's going to be an interesting phase and I think where we're starting to see, and certainly the application of AI from a radar healthcare perspective. And a radar, uh, healthcare idle perspective is also upstream a little bit because we're capturing, and we mentioned it before, about surfacing data, different layers of data actually to inform a clinician or a patient that actually, for this specialty, this type, and the profile of the patient I've got using all that data, uh, I may want to ask these questions. And AI, I think, is excellent at, uh, bringing that information to the front. Rather than being prescriptive about saying, this should be the consent process, and these are the risk for this particular thing that is almost pulling all those data sets, saying, well, actually, the run rate for this hospital for knee replacements, we're seeing this complication. Therefore, uh, we should be open and transparent to be able to communicate that. Yeah, I think that's where AI can be.

Speaker A: And I can see it put myself into the patient's perspective. I could see how I might, um, ask AI to suggest to me some questions I should ask my clinician before I go in to see them for a particular procedure and tell it a bit about me. And I would. You'd put some level of confidence behind what it gives you back. It will give you some quite decent questions. But I know at the other end, uh, I need to ask somebody who's an expert, uh, those questions. Yeah, I wouldn't then rely on Google or the AI to then give me the answer to those questions. So it's understanding the place where this technology is right now, where it's going, and making sure we are responsible users of that technology in the way that we deploy it. Because that's why hospitals have trusted IDO for 25 years. Because we are the experts in consent. We produce good information that they can rely on because we manage all of that really rigorous development, accreditation review process. That's not happening. If you just go to Google to search for something and AI generates it, that rigorous process isn't happening. So we need our customers to understand that they still need a safe pair of hands to make sure that patients are being given the right information.

Speaker B: Yeah, I mean, I keep circling back to this human element. I suppose it comes down to almost, of course, AI will be able to do it at some point, but that's sentiment analysis. Because I can read a document that says, says, oh, these questions were asked, these box were ticked, the consent was given. Yeah, but actually wearing it as you say then when I was asking their questions, there was lots of Umzas. Ah, I'm not sure. Oh, God. What do I. Is it that you think it's the right thing? You know, how do you capture all that information? They were actually. Yeah, there's a. Another level of assurance or question that needs to be carried out here, which invariably would be pick up. Picked up on a one to one. Yeah. Whereas if we're relying on AI and just general sentiment and malice, that might be more challenging.

Speaker A: Yeah, that's right. And many of the people listening to the podcast will be using elements of AI. Now you'll do a teams meeting. AI will summarize the meeting. It will say, this is the summary of the conversation we've just had. And it's a really good starting point for producing some minutes of a meeting. But you'll know that it'll often misassign minutes, actions to various people. It will misphrase things. So there are limitations that we're aware of, but we check them and we make the change and we make sure we validate what's been provided to us. And I think that's where we are right now. That will reduce over time and we'll be able to trust it even more over the coming years.

Speaker B: You mentioned years. So, coming to the final question, um, the next three to five years, ido, Radar, uh, what does good look like from your perspective? Um, and focusing in, I suppose, on the, from a patient consent perspective, you know, what does amazing and good look like and what can we expect to see over those coming years?

Speaker A: Yeah. So I think one of the great benefits is we've, we've been a bit of a meeting of minds in that, uh, patient safety is the heart of what we've both been trying to achieve here and drive up improvement in. Um, we've already blended a lot of what we know, a lot of our experience and knowledge, um, particularly around supporting our mutual customers. So helping both of them to get the biggest benefit out of the product that we have together. And then I think what we're doing right now is using user groups with our customers to really tease into what is important to our customers. And I think that will shape our next three to five years. Customer need, what they're asking for. Um, what is it that could make the real difference? So 2 plus 2 doesn't equal 5. It's 6 or 7 or 8. What real big benefit could we bring? What future interoperability or partnerships could IDO and RADAR bring into the mix to even make that Greater and then importantly also consolidating our, uh, spread internationally. We've got a footprint in different countries and making sure that we're bringing that same benefit to all of those territories that we're looking to support. I think that'll be a big part of the three to five years. And then aspirationally, I think what we want to do is to, to be able to demonstrate that we've made an impact in making patient care safer in our home markets.

Speaker B: Yeah, I think I really like the fact that, you know, certainly from a radar healthcare and IDO perspective, because where you're engaged with the clinician and the patient, the system is going to have to move along with the times to kind of phrase. Because there'll be advancements in technical procedures which in itself will drive different consent elements. And I, uh, you know, and I suppose there'll be elements of research related, a new pioneering techniques where there's, there's potentially a higher risk that some people of a certain profile might want to accept that risk because it can have a, you know, demonstrable improvement in their condition. So I think that would be something we'll have to.

Speaker A: Yeah, yeah. And then the ever changing, um, ebb and flow and mood of the Department of Health and the structure of what their targets are helping us to make sure that we're developing a product and uh, an evolution of our products that are fit for the future market. What is it that ah, is a priority for the NHS and for our private partners, what is important to them and make sure we're shaping our product to meet that need, but at the same time not losing the exciting element of innovation and thought leadership that uh, we have both individually done over the decades of our history in actually driving forward improvement and change. Because we've got a really good insight into what, where the direction of travel is and helping us to make sure we shape that product so we're ready when the hospitals need that product. They've got something that's close to be ready to be used rather than a pipe dream.

Speaker B: Yeah. Um, at the end of, I mean you've spent a lot of time in healthcare, um, and certainly from a consent perspective, something, um, that we ask at the, at the end of these sessions is ah, what the health tech moment, which is um, a moment, a standout experience, um, something that's impacted you, can be healthcare related, personal, you know, emotional, whatever it might be. Is there something that you can share with us across your journey, across all of that that's really just stood out to you.

Speaker A: Um, I think the impact on what we do for patients has always been important to me. We produce information to support patients, but remembering that for the patient this could be a once in a lifetime decision they're making. It could be a life changing decision they're making. And over the years we've had loads of patient feedback which has quite kind of humbling to read about how they're so grateful that they've been given the right information to help them make a decision. But I think the, the standout moment for me the past couple of years is where we were mentioned in high court documents as making an impact in a consent related case. Um, that was quite heartwarming really to read how the reason that we produced our product actually was realised at the point when it was used. The clinicians were able to rely on it when it really mattered. That's something that's taken 20 years to actually happen, you know, in a court. But it's meant that we've been able to actually get really behind that phrase gold standard. You know, that people might throw that around quite easily and call themselves gold standard this and that. But to have that used of us by the legal great minds of this country in high court documents, to say IDO is the gold standard in informed consent information was a real standout moment for me.

Speaker B: Yeah, that's pretty powerful stuff I think, you know, even on a personal level, from a radar, uh, healthcare and an IDO perspective is that people use it.

Speaker A: Yeah.

Speaker B: You know, that people are engaging with that to make, you know, life changing decisions, to have that level of corroboration and sanction almost to say, no, you know, this was to the highest standard possible and therefore there is no ambiguity or, you know.

Speaker A: Yeah. Proof that it did what we made it to do. It informed patients, it protected clinicians. That's exactly what our products is there for. And to have that uh, label of gold standard given to you by somebody who's, you know, in the know, uh, is quite important.

Speaker B: Yeah, brilliant. Fantastic. I mean I, I could literally talk about this stuff for hours because I just find it fascinating. But it, you know, for me it is a, it is a sometimes often forgotten that, you know, that this is a, you know, fundamental part of, you know, uh, from a patient's perspective. You know, it's, it's no longer just ticking a sheet and signing something at the bottom of some saying. Yeah, you're going to, that the information that is available to me from a, from an idle perspective in that gold standard.

Speaker A: Yeah.

Speaker B: You know, would give me assurance, you know. You know, I would say it's about, you know, if I was an operation, I want to ask, you know, I want to see that and, um, share a little story. Actually, um, just. Just while we finish as well, is, um, somebody, um, um, Becca, who's involved with, um, running these podcasts. In fact, you know, she had to, um, was having an operative procedure and it was an IDO form. I don't know if you're aware of this.

Speaker A: No.

Speaker B: And, you know, the thing that she said was she felt assured that, oh, I've got the gold standard, you know, So I thought that was quite powerful as well. And so those little moments, I think, are really great as well. Thank you, Matthew. Um, and thanks to all for listening. Join us next time for another episode. Don't forget to rate and subscribe. If you have any questions for us or our guests, please email whatthehealthtechadarhealthcare.

Speaker A: Uh.

Speaker B: Com. Thank you very much.