How is Concentric used?
Written onboarding guide to be read if the in-depth video demonstration has not been viewed.
This is an optional written user guide, similar to the walkthrough presented in the in-depth demo video.
The process is that the consent information is prepared for the patient, and then that personalised information is shared with the patient. Concentric can be used in all three main consent scenarios: adults with capacity (consent form 1), agreement to treatment from an individual with parental responsibility (consent form 2), and treatment in the best interests of an adult without capacity (consent form 4). You can read more about the specific workflows here: consent form 2, consent form 4.
Preparing consent information
Clicking 'new episode' in the patient banner takes you to the treatment search page where you can select the appropriate content template. As you start to use Concentric your most commonly selected templates will show as a quick-select option on this page.
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. If there are no appropriate templates consent information can be prepared from a blank template.
The consent elements are then presented in the 'clinician view' page. The 'responsible clinician' is the senior clinician with overall responsibility for the patient’s care, who will most often be the consultant in charge of the patient. This must be assigned correctly as the information is used in communications to patients and is often used for other purposes (integration, dashboards etc.).
For each of the elements - such as indications, alternatives, risks, patient information (external signposted resources) - clinical concepts / resources can be added. This is supported by template concepts and resources, except in the case of blank templates.
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 with patients and giving consent
There are two key elements to the consent process within Concentric from the patient's perspective, the consent information and the consent flow. The consent information is the information selected by the clinician in clinician view, and the consent flow includes the consent statements, additional consents, and documenting of a signature.
Where possible, a consent conversation including the sharing consent information through Concentric should occur prior to the day of treatment, during a face-to-face or remote consultation. However, where this is not possible such as in emergency surgery scenarios, Concentric can still be used.
To walk through the consent information most clinicians use 'consult view' - a patient-facing version of the information selected. Consult view can help structure the conversation, ensuring discussion through the different elements, and also presents the information in the same way as patients will have access to it in their patient app. After viewing the different sections in consult view you will see a page titled 'Are you ready to consent?' - this is the start of the consent flow. Some clinicians prefer to talk through the information without using Consult view.
Information can be translated into another language using in-browser translation tools. However, if the patient cannot speak English professional interpretation services must also be used.
Sharing with patients
Patients should be provided access to their consent information so that they can consider it in their own time. Consent information can be shared with patients from a number of different places within the application. Most patients receive this digitally via email/SMS, but if the patient does not have digital access, printed consent information should be provided. Read more about sharing information with patients here.
Whenever consent information is being shared (as long as the sections marked 'required for consent' have been completed in clinician view) there is an option to enable remote consent if appropriate.
- Following review of the consent information in consult view (and stating that consent is not to be given at the time) there is an option to share information with the patient.
- Consent information can be shared directly from clinician view by clicking 'Share with patient'
The consent flow can be completed in person with the clinician or remotely, and patients should be comfortable that they have had time to consider the consent information prior to completing the consent flow.
The consent flow is accessed in one of three ways:
- Following the consent information in consult view if the 'required for consent' section have been completed then the page 'Are you ready to consent?' will show, this is the start of the consent flow.
- At the bottom of the patient app page is the option to proceed into the consent flow if remote consent has been enabled.
- The consent flow can be directly accessed from clinician view by clicking 'Skip to consent' (only visible if the 'required for consent' section have been completed) in the episode bar.
The consent flow goes through the consent statements, any additional consents, and records a patient signature (clinician is automatically electronically signing). If using a touchscreen device the patient can simply sign on screen. If using a device without a touchscreen then a QR code will appear - follow the instructions on screen with any touchscreen device to add the patient signature, before continuing on the original device.
Confirmation of consent
Where consent has been given prior to the day of treatment 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.