Concentric is the digital consent application used at Imperial College Healthcare NHS Trust. This page has all you need to get started with using Concentric.
If you are reading this page you have probably just been set up with access to Concentric. Welcome! We hope you really enjoy the move over to digital consent.
On this page you’ll find:
- a video demonstrating how Concentric works
- the reasons for introducing digital consent
- a guide to getting started
- a description of the different ways it is used
- how Concentric integrates with other systems at Imperial
- frequently asked questions
- contact details if you have any questions
3 minute video of how Concentric works
Why introduce digital consent?
Having used Concentric, the vast majority of clincians state that they prefer digital consent to the paper process, that the quality of the consent process is improved, and that their time is better utilised. The quality of consent documentation is significantly improved supported by evidence-based templates, and the flexibility to personalise to the patient reduces medico-legal risk.
Patients appreciate that their consent information is increasingly accessible, clearly presented, and allows them to revisit the information in their own time.
Concentric is a flexible solution that can be used whenever you would previously have used a paper consent form, regardless of whether consent is being given on a ward, cinic or remotely, and across elective and emergency care.
In the new account email from Concentric there will have been a ‘Set your Concentric password’ button. Make sure you’ve done that so that your account is set up and ready to use.
You can then access Concentric at app.concentric.health.
Concentric can be accessed from any device that can access the internet and from anywhere - not just within the hospital. The integrations with other systems work the same regardless of where you are accessing from.
It is recommended that you use a modern browser such as Chrome, Microsoft Edge, or Safari rather than Internet Explorer as some features may not work properly on older browsers such as Internet Explorer.
To get comfortable with using Concentric, most clinicians try it out with a ‘test patient’ first for a few minutes. Search for patient 31072645 (or 30935740 for the child test patient where the ‘Consent Form 2’ process can be seen).
How Concentric is used
Using Concentric is simple, and most clinicians take only a few minutes to get accustomed to how it works. The process is that the consent information is prepared for the patient, and then that personalised information is shared with the patient. The 3 minute video in the section above is the first thing to watch if you haven’t done so yet.
To prepare the consent information, log into Concentric, search for the patient using their hospital number, then click ‘New episode’ in the patient banner.
You will then select the treatment, or combination of treatments. This video shows how treatment search works, how combinations can be selected, and modifications such as setting +/- or giving a treatment a custom name can be done:
The template information for the selected treatment (or merged information for a combination of treatments) is then presented and can be selected. Some are marked as ‘required for consent’. For each of the elements - such as indications, alternatives, anaesthetic options and risks - suggestions from the template can be selected, or custom things can be added.
Whilst information can be walked through or shared at any point, in order for consent to be given there are some ‘Required for consent’ fields that must be completed. Once these are done, the action bar at the bottom of the page will say ‘Ready for consent’.
Sharing the information with the patient can be done in a number of different ways. The three most common scenarios are:
Where possible, the aim should be to start the consent process through Concentric prior to the day, during a face to face or remote consultation.
To walk through the consent information with the patient in person click ‘Switch to consult view’ as seen in the action bar above. Consult view is the patient facing version of the information selected, with additional descriptions and resources, and is the same as patients get access to following the consultation. In consult view you can add notes to document the conversation as you go through the sections with the patient.
On reaching the section titled ‘Are you ready to consent?’ there is an option to either proceed to consent, or not to consent at the time but rather to share the information with the patient digitally (with or without remote consent enabled).
If giving consent during the consultation, when the patient has gone through the consent flow - such as reviewing the consent statments and additional consents (e.g. blood transfusion) - then a signature can be added. If using a touch screen device then simply sign on screen. If using a device without a touch screen then a QR code option will appear. Follow the instruction on screen with either clinician or patient’s phone to add the signature before continuing on the original device.
Around 30% of Concentric patients give consent remotely. To allow patients to do so, click ‘Share with patient’ in the action bar (or from consult view as described above) then click ‘I’m happy for consent to be given remotely’.
This will send a message to the patient with a secure link to access their information, and the ability to sign their consent when they are ready to do so. For the majority of patients an email address and/or mobile number will be known for the patient and this will be shown in Concentric. If this is not the case it will need to be added.
It is important to remember that Concentric should be used alongside a consent conversation and not in its place, so remote consent should only be enabled when a consent conversation has already taken place.
When consent is given the episode record will be updated in Concentric, and the consent form generated.
Day of treatment and confirmation of consent
Whilst consent should be given prior to the day of treatment, there are situations, such as emergency surgery where this is not possible, but Concentric can still be used.
The process of preparing information and sharing is as described in the clinic consultation section, and usually either ward computers are used or the clinician’s own device is used at the bedside.
Where consent has been given prior to the day of treatment, or remotely, then consent should be confirmed on the day of treatment. This can be done by clicking ‘Confirm consent’ and any discussion or questions raised can be documented.
WHO Surgical Safety Checklist
Completed consent forms are usually brought up on screen in theatre, and do not need to be printed out. These are usually reviewed in Cerner, within ‘Structured Notes’ in the ‘SurgCons’ folder.
Where there is an issue in accessing Cerner (e.g. if the system is down) there is the option of reviewing the consent form within Concentric on the Theatre’s screen.
Integration with other systems
Concentric is integrated with other clinical systems at Imperial so that the workflow is straighforward for clinicians and theatre teams. The integrations include searching for patient details and storing documents. The integrations work the same regardless of where you are accessing Concentric from.
To search for a patient you can do this by hospital number and this will return the patients details and Concentric consent history.
Consent forms get stored into Cerner whenever a consent form is generated, and a further document is added when it is updated. Note that this means that a consent form will be visible in Cerner if consent is given in clinic, prior to consent being confirmed and therefore prior to the process being complete.
Frequently asked questions
- Can I add new content, or edit existing content?
- Can I use Concentric for paediatric patients?
- Can I use Concentric to complete a best interests decision / Consent Form 4?
- Will the patient be told my work email address?
- Something isn’t working! What shall I do?
Can I add new content, or edit existing content?
If you have any queries regarding content please contact the team at email@example.com. We will explain the process for making and approving changes.
Can I use Concentric for paediatric patients?
Yes, Concentric has consent form 2 functionality which requires the parent/guardian’s consent, as well as the ability for the child to sign in parallel. For young people aged 14-17 there is an option to complete a consent form 1 or 2 depending on their capacity to consent.
Can I use Concentric to complete a best interests decision / Consent Form 4?
Not currently, this is expected to be added in May 2021. At the moment please complete paper documentation.
Will the patient be told my work email address?
No, the communication to the patient comes from Concentric, rather than from any clinician’s email, and so clinicians’s email addresses are not made visible to patients. Read more about patient communications here.
Something isn’t working! What shall I do?
If there seems to be an issue with Concentric and it’s an urgent clinical situation, revert to using a paper consent form. To report a problem, email firstname.lastname@example.org.
Support and contact details
If you are having any issue in getting started with Concentric, a problem arises, or you need an account setting up, please let us know so we can quickly get things sorted for you.