For Organisation/Trust-wide and population-wide deployments, PKB uses the 'train-the-trainer' approach. The Organisation/Trust will need to identify staff to become PKB superusers/trainers and PKB will train them to become expert users of the platform. The Training team/trainer will then be able to roll out the training to all the clinical and admin staff that will use PKB.
PKB Organisations and Teams
PKB environments are set up as Organisations that can have many Teams. To understand the user roles it’s important to first understand what this means. The training requirements can then be understood in relation to the set up and the roles.
A typical organisation will be an NHS Trust, with the first team being a ‘Patient Records Team’. We call this the umbrella team, as all patients are created here, and then smaller cohorts can be easily brought into other clinical specialty teams when necessary. The image below represents this setup.
What this means for a patient, is that on the ‘Sharing’ section of their record, they may see multiple teams, within the same organisation. An example is below.
Note that a smaller organisation, such as a GP practice, may simply have one team. A team in PKB can be any size and contain any number of patients and professionals.This structure allows a great deal of flexibility and allows us to design effective solutions for our users at any scale.
Overview of PKB User Types
Within each organisation, there are four basic groups of individuals who will need supporting, with different levels of training required for each. We are continually adding to our remote training resources to enable a rapid roll out of PKB. All current supporting processes/documentation/videos are provided below in this document.
The Organisation Admin is responsible for performing 3 key tasks for all patients within all teams in the organisation.
Typical number of users: 1 or 2 users per entire organisation
Typical training time: 2 hours of online resources
Typical usage time: <5 hours a month
The coordinator is the first person invited to a PKB team, they are key team members and help drive successful use of the system. They ensure the right people are added to the team's PKB site and are responsible for inviting the professionals to the team as well as the patient cohort.
The coordinator is often the most technically expert member of their team, and so coaches and catalyses their colleagues’ adoption of patient-centred PKB usage. PKB staff spend a lot of time training and helping the coordinator because healthcare professionals ask the coordinator for training and help. We help the coordinator to become a local ‘expert superuser’. The coordinator also manages each team’s settings and resources, including care plan templates, symptoms tracked and patient communication materials within the library.
Typical number of users: 2 or more users per team
Typical training time: 1.5 hours of online resources and virtual support from PKB staff.
Typical usage time: <1hr a week after initial set up.
The team professional is invited to register on PKB, along with their colleagues in the team, by the coordinator. A team professional automatically has access to all patients sharing with the team, and any patient in the team can message any professional in the team provided they are set as contactable. This mirrors the set up that exists with paper records, where any professional working within the team would be able to pick up and read any patient's file.
The professional is able to add other people and contribute data to the record on behalf of the patient as well as exchange secure messages with their colleagues, patients, carers and any individual professionals added to each patient record. The professional has the ability to send consultations to patients to be filled out as well as adding and editing any relevant care plans in a patient's record.
Typical number of users: 5-30 per team (highly varied, dependent on team type and usage)
Typical training time: 2 hours of online resources
Typical usage time: >1 hour a day (highly variable depending on planned benefits/use of PKB)
The patient is the focal point for the entire PKB record; PKB puts the patient in control of all information about them, and who gets to use that information with them.
Everyone, including doctors, nurses and carers, use the Patients Know Best record with the patient because the patient gave them permission to do so. At any point, they can give more people access, increase or decrease their access level, or remove permission from those previously granted it. The patient is able to initiate and participate in secure messages with any combination of members in their network at any time.
The patient is encouraged to contribute their own information to the record including tracking their symptoms, adding lab test results or measurements, and filling out consultations or care plans in collaboration with their clinical team.
Typical number of users: 100,000s per org, 10-1000s per team
Typical training time: 0 input from customers, PKB online resources available
Typical usage time: >1hr a week (highly variable depending on planned benefits of PKB)
Summary of Resource required
Train the trainer model
PKB provides Face-to-Face (F2F) training for Training teams/trainer and either F2F or remote training via Skype or Google meet screen sharing software for any professional and coordinator users. The training can be delivered to groups or at one-to-one sessions as required.
We estimate that initial training team/trainer training will take four hours - possibly separated into 2 hour sessions over two days depending on staff availability.
The training team/trainer will be fully trained (using a test site) on how to use PKB as a patient, professional, and coordinator and will receive tips and ideas on how to train others in PKB use. They will receive full support from a PKB Success project manager throughout their time in this role including regular meetings, and any refresher/top-up training for themselves that are necessary. The Success project manager will accompany and support the training team/trainer during the first training sessions they run.
Organisation Administrator training
The organisation administrator is responsible for:
Viewing patients from across the organisation that have missing demographics or identifiers in PKBand updating accordingly
Checking for demographic mismatches between PKB and incoming HL7 feeds e.g. from the laboratory and correcting them to allow the queue of HL7 messages to flow
Managing their organisation network
Viewing the code sets that their organisation are using
All relevant documentation on this role can be found here.
Team Coordinator training
There needs to be at least one coordinator for each team that is created. Each organisation must have at least one team.
The coordinators take on the majority of the platform administration and management tasks and will need training on the following:
Registering professionals at scale https://manual.patientsknowbest.com/coordinator/professionals
Creating patients’ records at scale https://manual.patientsknowbest.com/coordinator/records-mass
Updating the welcome message for patients regularly with the latest instructions eg to complete new forms or read new resources https://manual.patientsknowbest.com/coordinator/institution
Authorise and apply care plan templates such as the COVID-19 one page profile. https://manual.patientsknowbest.com/coordinator/plans
Sharing patients’ records with affiliate teams - https://manual.patientsknowbest.com/coordinator/organisation-networks
Individuals who use PKB to work with patients (for example the Link Workers) need to understand these basic functions:
How to register
How to find a patient’s record
How to manually add an email address if the patient has not yet registered
How to add the care plan to a record if the patient has not already done so
How to message a patient
How to do a virtual consultation (video)
How to add a carer
All these have supporting videos which can be found here:
Patients generally need minimal instruction on how to use the system as it is intuitive and they have already been trained to use the internet as consumers. There are however ways to support their use of the system including:
A full manual - https://manual.patientsknowbest.com/patient
Many other ways to keep patients updated and informated are listed here - https://deploy.patientsknowbest.com/clinical-transformation/digital-emergency/keeping-patients-updated
These include instructions that can be put in the welcome message and built in resource library with instructions.
Ongoing Training and Support
In addition to the training above to get started with a mass roll out, there is additional training and support that can be offered to support specific teams with clinical transformation of their processes and expanding their use of PKB as required.