NHSX Facebook Portal Pilot

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29TH MAY 2020

AGENDA 01 EXECUTIVE SUMMARY 02 BACKGROUND 03 PILOT DELIVERY 04 USER INSIGHTS 05 OPERATIONAL LEARNINGS 06 COMPETITOR ANALYSIS 07 RECOMMENDATION 08 APPENDIX

Executive Summary

As part of the COVID-19 response, Facebook donated 2,050 Portal video communication devices to support the NHS. NHSX and Facebook, with support from Accenture, have piloted the Portals across various care settings and regions within England between 23/03 and 29/05.

Portal features X3 Use Cases Tested

1. Connecting Patients with family and/or friends (97% of Portals) Connect via WIFI

Multiple screen sizes + + + Patient Care Setting Portal Family Home

2. Connecting patients/residents with necessary clinical support (2% of Portals) Touchscreen

Multiple users per device + + + Patient Care Setting Portal GP GP Practice

Smart Camera & smart sound 3. Enabling clinical care providers to deliver remote consultations (1% of Portals) + + + Other daily uses GP GP Practice Portal Patient Care Setting Copyright © 2020 Accenture. All rights reserved. 4 Center Type Area End Content Area

PORTALS “I’m really grateful, it “They (care home EFFECTIVELY really matters, in a big resident) are a lot way. Being told at a happier and they are a CONNECT PATIENTS time like this that you lot more reassured can’t speak with that they (relatives) are WITH THEIR FAMILY someone at the end of at the other end of the their life, it’s awful.”, portal.”, AND FRIENDS Family Member Care Home Staff

“The sound is so much better, and the screen is bigger so they can focus more. So instead of a minute call like it used to be on the phones, some calls now go on for 20 minutes.”, Care Home Staff Copyright © 2020 Accenture. All rights reserved. 5 Center Type Area End Content Area

KEY TAKEAWAYS AUDIO & VIDEO QUALITY ENABLE COMBINATION OF DEVICES PRICE HIGHLIGHTS UNIQUE USER EXPERIENCE SENSITIVE & EFFECTIVE

The audio and video quality of the The Portals are priced competitively. Portals differentiate them as a means Using them in combination with a to connect patients/residents in tablet device could be an effective isolation with their family and friends. and price sensitive solution to support all use cases.

KEY TAKEAWAYS FUNCTIONALITY GAPS FOR DEPLOYMENT PROCESS MUST BE CHALLENGES REMOTE CLINICAL CARE DELIVERY CHANGED TO SCALE SMOOTHLY

Challenges around portability and If the Portals are to be rolled out at a limits in supporting other applications wider scale solutions must be put in and web browsers make the Portals place to develop a deployment an unlikely solution as a means to process ready for enterprise scale. deliver remote clinical care.

ESTABLISH EXACT BUILD DETAILED REQUIREMENTS FOR SERVICE MAPS TO REMOTE CLINICAL ESTIMATE COST AT CARE DELIVERY WIDER SCALE

Less feedback was We can understand more collected for the clinical about the service created care delivery use cases. in each care setting to More research should be accurately estimate directed to define what devices needed per site functionality is required. and the human resource to serve. Copyright © 2020 Accenture. All rights reserved. 8 Center Type Area End Content Area

Background

COVID-19 & HEALTHCARE DELIVERY

A TRANSFORMATION IN THE ELDERLY SECTOR IS REQUIRED TO PROTECT LIVES AND REDUCE THE IMPACT OF SOCIAL ISOLATION

MILLIONS OF CHANNELS OF DIGITAL CARE HOME PEOPLE COMMUNICATION TECHNOLOGY STAFF NATIONALLY SHIFTING INFRASTRUCTURE FOCUSED ON TOLD TO SELF- EXCLUSIVELY TO BASIC IN ELDERLY PHYSICAL ISOLATE ONLINE CARE SETTINGS TASKS

Copyright © 2020 Accenture. All rights reserved. 10 Center Type Area End Content Area FACEBOOK & ACCENTURE SUPPORT NHS As part of the COVID-19 response, Facebook donated 2,050 of their Portal video communication devices to support the NHS.

Accenture have donated a team to support NHSX and Facebook to test and pilot the Facebook Portals across various care settings, providers and between individual users.

The principle aim of the Pilot was to understand if and how the Portals can be used to deliver remote clinical care and individual support to those in self- isolation. The initial pilot took place across regions in England between 23/03 and 22/05.

This report details the initial findings from the Pilot to inform future decision making.

FACEBOOK PORTAL FUNCTIONALITY

The Facebook Portals are designed as consumer devices. They are simple to use, fulfil everyday consumer needs and ensure video and audio quality to enable fantastic communication.

CONNECTS VIA MULTIPLE SCREEN TOUCHSCREEN WIFI SIZES

The Portals work in a range of The Portals are available in three The Portals are similar to other environments because they screen sizes (8 inch, 10 inch and smart devices on the market and connect to WIFI. 15.6 inch) to suit different users. navigated via touch for ease of use.

MULTIPLE USERS SMART CAMERA & OTHER DAILY PER DEVICE SMART SOUND USES

The devices can be used to support The camera and volume adjust with The Portals can be used to also play four users at once building their user movement and tone ensuring music, frame photos, provide potential as a scalable solution. consistent video and audio quality. weather updates and tell the time.

USE CASE 1

Given the features of the Facebook Portals, we sought to test three use cases. Primarily we tested if they could support convenient and good quality communication for patients or care home residents in isolation to contact family and friends.

USER USER DEVICE RECIPIENT RECIPIENT LOCATION LOCATION

8 inch (mini) + + +

• Patient or • Care home • Family member • Private residence • Care home • Hospice 10 inch (Portal) • Friend resident • Community Site

USE CASE 2

The second use case we tested was whether they could support convenient and good quality communication for patients or care home residents in isolation to receive necessary clinical support remotely.

USER USER DEVICE RECIPIENT RECIPIENT LOCATION LOCATION

8 inch (mini) + + +

• Patient or • Care home • GP • GP Practice • Care home • Hospice 10 inch (Portal) • Nurse resident • Community Site • Care Professional • Allied Health Professional

USE CASE 3

The final use case we tested was whether the Facebook Portals could support convenient and good quality communication for clinical care providers to deliver remote consultations.

USER USER DEVICE RECIPIENT RECIPIENT LOCATION LOCATION

8 inch (mini) + + +

• GP • GP Practice • Patient • Care home 10 inch (Portal) • Nurse • Care home • Hospice • Care Professional resident • Community Site • Allied Health Professional

Pilot Delivery

PILOT APPROACH

The principles below were followed wherever possible. The aim was to deliver at speed, deliver using a lean core team that collaborated with other parts of the organisation and to deliver compliantly.

01 Use simplest option wherever possible

02 Speed of rollout more important than fully integrated experience 03 Run parallel rollouts across regions

04 Use logistics providers to ship devices directly to homes

05 Use NHS/trusted workforce to deploy in homes or train local staff to set up

06 Private information of staff should not have to be shared with general public or vice versa

07 Solution should support remote consultation as well as supporting with social isolation

WORKSTREAM OVERVIEW

As part of the pilot we delivered four workstreams. Initially we went through a phase of mobilisation. Subsequently we supported the deployment of Portals to individual sites, evaluated how the Portals were initially experienced by different user groups and performed a competitor analysis.

MOBILISATION DEPLOYMENT EVALUATION COMPETITOR ANALYSIS

Identified CCGs and Supported Facebook Developed Mapped competitor individual sites to adopt to process site evaluation strategy and technology Portals orders to capture feedback landscape

Aligned demand with Communicated with Created surveys and Compared devices Facebook for sites to check conducted interviews based on relevant deployment delivery with all user groups functionality

Documented and Maintained support Analysed and Compared devices distributed introductory where necessary post synthesised results for based on pain points comms/set up deployment presentation found in evaluation guidelines Copyright © 2020 Accenture. All rights reserved. 18 Center Type Area End Content Area

Key Ongoing

PILOT TIMELINE Complete

The deployment of the Portals took longer than anticipated and the Pilot evaluation is therefore ongoing. We have not collected sufficient data to make conclusions and this presentation conveys our initial findings which will be developed as more feedback is obtained.

w/c 23/03 w/c 30/03 w/c 06/04 w/c 13/04 w/c 20/04 w/c 27/04 w/c 04/05 w/c 11/05 w/c 18/05

Identified sites for deployment

Aligned demand with Facebook

Distributed intro/setup guidelines Mobilisation

Processed orders for delivery

Checking to see if Portals have been delivered

Provided post deployment support Deployment

Developed evaluation strategy

Created surveys and conducted interviews with all user groups

Evaluation Analysed feedback received

Mapped competitor landscape

Compared device functionality

MOBILISATION

Initially the Pilot was planned to run within one region. To deploy rapidly and meet timescales, however, allocation was distributed across multiple regions.

DISTRIBUTION OF PORTALS ACROSS UK 2,050 1,760 Devices donated by Facebooks 8 inch Portal Mini organised for and organised for delivery delivery to sites

>50 Portals delivered in county 285 3

<50 Portals delivered 10 inch Portals organised for 15.6 inch Portal + organised for in county delivery to sites delivery to sites

No Portals delivered in county

DEPLOYMENT

There were four bottlenecks in the Portal deployment process that delayed the Pilot. We will discuss the bottlenecks in this process in upcoming slides.

DEPLOYMENT PROCESS MAP

Await delivery Order delivered Host organisation details from host Facebook process by Facebook potentially distribute organisation/care order through to Order leaves Distribution to direct care provider shipping team warehouse Partner provider

Offer allocation to Provide Facebook Order processed Order arrives Serial numbers provided host with delivery by shipping with Facebook by host organisation/care information team Distribution organisation/direct care provider Partner provider confirming receipt of device Key NHSX/Accenture Host organisation/direct care provider Facebook Facebook distribution partner Bottleneck Copyright © 2020 Accenture. All rights reserved. 21 Center Type Area End Content Area

EVALUATION

Although the amount of survey responses was limited due to delays in deploying the devices, quantitative and qualitative insights have been obtained via surveys and interviews.

HYPOTHESES DATA SOURCES

x5 Hypotheses tested Interviews Surveys Portal Usage Stats

USER GROUPS DATA COLLECTED Patient/Care Home Resident Responses to Clinical Interviews Surveys 0 Care Provider x16 conducted x5 created Experience Survey

Health and Care Staff Interviews Interview with Responses to Set Responses to Health x12with health x2 family and 125 Up Experience 21 and Care Staff and care staff friends Survey Experience Survey Family and Friends Interview Interview with Responses to Responses to Family x1 with clinical x1 patient/care home 10 Patient 4 & Friends Clinical Care Provider care provider resident Experience Survey Experience Survey

User Insights

COVID-19 IMPACT

Patients/residents feel isolated from their family and friends as routine visits have ceased and existing means of communication are not comparable. Whilst perhaps less pronounced, it has also become more challenging to organise and deliver appropriate clinical care remotely.

Health and Care Staff Experience Survey Interview Highlights

On a scale of 1 - 5 how much more challenging has COVID-19 “A week into the lockdown – that’s when the residents started to made facilitating communication between residents/patients feel very isolated from their relatives and family“, Care Home and their family and/or friends? Staff No impact Much more challenging “Families haven’t been coming, that has been the biggest impact. It really does have an impact on the residents.”, Care Average Score 4.7 Home Manager

Health and Care Staff Experience Survey “It’s been devastating, being apart from mum, not being able to On a scale of 1 - 5 how much more challenging has COVID-19 see her. Because that tells me everything, I can judge how she’s made it to ensure that residents/patients receive appropriate doing, if anything is wrong”, Family Member clinical support?

No impact Much more challenging “The biggest challenge is not being able to examine people. For patients you have a rapport with, you can manage this with phone calls, but it can take years to build up that rapport.”, GP Average Score 3.3

PORTAL SET UP EXPERIENCE

The Facebook Portals have been considered very easy to set up. There are areas where the set up experience could be improved if the Pilot is to be scaled. Care settings in the meantime have proved resourceful in finding solutions.

Set Up Experience Survey Areas for Consideration How easy on a scale of 1 - 5 was setting up the device? 1). Care settings do not always have necessary infrastructure Hard Easy “One of the things we discovered in some of our care homes is they had quite old mobiles so WhatsApp couldn’t be downloaded”, Care Home Staff Average Score 4.3 2). Enterprise WIFI occasionally incompatible for consumer device “In a business environment it was difficult getting the devices onto our Overall Perception Guest Wi-Fi as it requires browser access.”, Set Up Survey Respondent “At first I thought, “This is another thing I’ll have to get other 3). Multiple accounts require multiple phone numbers people to do”, as I’m not so good with these things. But it’s really easy, even I can do it.”, Care Home Manager “There was a lot of faffing about with WhatsApp account and buying a SIM card to create a new account.”, Set Up Survey Respondent “They were handed to me from my manager and said we’ve 4). Set up via Facebook links to personal accounts of staff got these devices. He said they are easy-peasy to set up which they are - they are fantastic.”, Care Home Staff “It's against Facebook community guidelines to have a fake or bot account which I assume is why the accounts have been disabled .”, Email Question from Care Home Staff Copyright © 2020 Accenture. All rights reserved. 25 Center Type Area End Content Area

USE CASE 1

Use case 1 was the primary use case researched during the Pilot and significantly more data was collected for this use case than any other. There is, however, limited direct feedback from patients/residents and from their family and/or friends which must be collected to inform future decision making.

HYPOTHESES USE CASE

x3 Hypotheses tested Connecting Patients with family and/or friends + USER GROUPS + + Patient Care Setting Portal Family Home

Patient/Care Home Resident DATA COLLECTED

Interview Responses to Interviews Surveys created Health and Care Staff x14 conducted x2 with family x3 x4 Family & Friends and friends Experience Survey

Interview with Interviews Responses to Health Responses to Family and Friends x1 patient/care x12 with health x21 and Care Staff x10 Patient home resident and care staff Experience Survey Experience Survey

Key Wellbeing Coordinator Care Home Manager SERVICE MAP Care Home Resident Family Member

Although each care setting has established a unique process to integrate the Portals into their existing operations, feedback suggests that the four steps below have generally been adopted. The activities outlined in each step were undertaken by a care home we interviewed to provide an example but they would differ depending on the setting.

SET UP EDUCATION ORGANISATION FACILITATION

Wellbeing Resident coordinator tells lets Wellbeing residents Coordinator Care Home know about who they Wellbeing Wellbeing Wellbeing Manager Portal during would like to Coordinator Coordinator Coordinator trains visits call adds slot to supports sets up call wellbeing call families by at scheduled coordinator schedule helping time and sits to use Wellbeing Wellbeing maintained them set up with resident Portals for Coordinator Coordinator for all and use if necessary calls informs emails residents WhatsApp families family to about the organise a Portal via call via the email Portal Copyright © 2020 Accenture. All rights reserved. 27 Center Type Area End Content Area

PATIENT/RESIDENT EXPERIENCE

The Portals have served as an effective means to connect patients with their family and friends. Initial findings convey that that the audio and video quality differentiate the experience for elderly users compared to other devices.

HYPOTHESIS OUTCOME

PROBLEM STATEMENT PERFORMANCE METRIC We know that patients feel less connected with their Resident/Patient Experience Survey: family and friends during the COVID-19 outbreak because On a scale of 1 - 5 what impact has the Portal had on the level of connection their relatives cannot visit them. you feel with you family and/or friends? No Change Much More Connected

SOLUTION CONCEPT Average Score 4.6 We believe that implementing the Facebook Portals in care settings will enable patients to feel more connected with their family and friends during the COVID-19 outbreak. CONSIDERATIONS 1). Exceptional audio and video quality “The camera sort of follows you. I think the picture quality is really good. ANTICIPATED RESULT I think the sound quality is really good.”, Care Home Staff If our solution is appropriate we will observe that patients 2). Simplicity to use use the Portals to contact their family and/or friends and “I suppose there is no reason why any of our patients couldn’t use them”, that they maintain or improve their existing contact levels. Care Home Staff Copyright © 2020 Accenture. All rights reserved. 28 Center Type Area End Content Area

FAMILY & FRIENDS EXPERIENCE

Less direct feedback from family and friends was collected and further research should be completed to understand their experience and test the original hypothesis. Initial findings suggest the Portals have been a source of reassurance.

HYPOTHESIS OUTCOME

PROBLEM STATEMENT PERFORMANCE METRIC We know that families and friends feel less connected Family & Friends Experience Survey: with their loved ones during the COVID-19 outbreak On a scale of 1 - 5 what impact has the Portal had on the level of connection because they cannot currently visit them. you feel with your relative or friend in isolation? No Change Much More Connected

SOLUTION CONCEPT Average Score 5 We believe that implementing the Facebook Portals in care settings will enable families and friends to feel connected to their loved ones in isolation during the CONSIDERATIONS COVID-19 outbreak. 1). Connecting wider family together “There are more family members getting involved. Its not just ANTICIPATED RESULT immediate members.”, Care Home Staff If our solution is appropriate we will observe that families 2). Some families do not have access to necessary technology and friends connect with their loved ones in isolation via “Some families might not use that kind of technology and just use the Portals and that they maintain or improve their existing contact levels. phone.”, Care Home Staff Copyright © 2020 Accenture. All rights reserved. 29 Center Type Area End Content Area

HEALTH & CARE STAFF EXPERIENCE

The Portals have successfully enabled Health and care staff to support their patients/residents connect with family and/or friends. Further research should assess the scalability of processes around the Portals and what cost this could incur the NHS. HYPOTHESIS OUTCOME

SOLUTION CONCEPT Average Score 4.6 We believe that implementing the Facebook Portals in care homes will enable health and care staff to support patients/residents to stay in contact with family and/or CONSIDERATIONS friends more effectively. 1). Portability “Only slight criticism and only very slight is the lead should be a little ANTICIPATED RESULT longer as you have to plug it in”, Care Home Staff If our solution is appropriate we will observe that health 2). Some care settings need support to scale service and care staff use the Portals as a means to connect patients/residents with their family and/or friends and “Its getting busier and busier. The longer this goes on the more calls believe it to be effective.. we are having.”, Care Home Staff Copyright © 2020 Accenture. All rights reserved. 30 Center Type Area End Content Area

USE CASE 2

Less feedback was collected for use case 2 as health and care staff prioritised using the Portals to connect residents/patients with their family and/or friends. Further research should assess the effectiveness of the Portals as a solution for this use case.

HYPOTHESES USE CASE

x1 Hypotheses tested Connecting patients/residents with necessary clinical support + + + USER GROUPS Patient Care Setting Portal GP GP Practice

Patient/Care Home Resident DATA COLLECTED

x13 Interviews x3 Surveys created x0 Responses to Clinical Care Health and Care Staff conducted Provider Experience Survey Interviews with Responses to Health and x12 health and care staff x21 Care Staff Experience Survey Clinical Care Provider Interview with Responses to Patient x1 clinical care provider x10 Experience Survey

HEALTH & CARE STAFF EXPERIENCE

Initial feedback conveys that there are challenges for the Portals to be used as a solution for use case 2. For example, the Portals must be plugged in via a power cable whilst in use preventing health and care staff to move between rooms and maintain a call with a clinical care provider. HYPOTHESIS OUTCOME

PROBLEM STATEMENT PERFORMANCE METRIC We know that health and care staff need a more Health & Care Staff Experience Survey: effective and efficient means to connect their On a scale of 1 - 5 how much easier has the introduction of the Portal made patients/residents with clinical whilst they are in connecting residents/patients with appropriate clinical support since the isolation due to the COVID-19 outbreak. beginning of the COVID-19 outbreak? No Change Much Easier SOLUTION CONCEPT Average Score 2.7 We believe that implementing the Facebook Portals in care homes will enable health and care staff to arrange remote clinician support more effectively for their CONSIDERATIONS patients/residents. 1). Portability “The only issue is the power cable, with carers not being able to walk ANTICIPATED RESULT around and see patients.”, GP If our solution is appropriate we will observe that more 2). Clinical care providers still visiting clinical support is delivered digitally and that visits from clinical care providers are avoided are avoided. “Our doctors here it is not an issue because they come in and see our patients”, Care Home Staff

USE CASE 3

We deployed very few Portals for this use case and therefore the feedback we obtained was minimal. We have used the interview we conducted with a GP to present some initial insights but this must be researched further.

HYPOTHESES USE CASE

x1 Hypotheses tested Enabling clinical care providers to deliver remote consultations + + + USER GROUPS GP GP Practice Portal Patient Care Setting

Patient/Care Home Resident DATA COLLECTED

x1 Interviews x1 Surveys created Health and Care Staff conducted Interview with Responses to Clinical Care x1 clinical care provider x0 Provider Experience Survey Clinical Care Provider

CLINICAL CARE PROVIDER EXPERIENCE

We do not have enough feedback to sufficiently test this hypothesis but clearly the simplicity of the Portals and the video and audio quality make them useful. It is, however, still unclear whether they need additional functionality to host other applications and web browsers for this use case. HYPOTHESIS OUTCOME

PROBLEM STATEMENT CONSIDERATIONS We know that GPs need a more effective and efficient 1). Video quality means (if one is already in use) to remotely connect with their patients that are in isolation due to the COVID-19 “Yes, comparatively to a phone. There’s better definition to look at a outbreak to provide clinician support rash for example, with the bigger screen.”, GP

2). Simplicity to use SOLUTION CONCEPT “I thought it was great, compact, easy to set up, a better build than We believe that providing Facebook Portals to patients other devices I’ve used. I’ve got an Alexa at home and I’m used to in isolation will enable GPs to provide them with remote similar gadgets.”, GP clinician support more effectively and more efficiently. 3). Screen size matters “This 8 inch Mini Portal device is nice, but the bigger one would be better.”, GP ANTICIPATED RESULT If our solution is appropriate we will observe that clinical 4). Privacy concerns with personal number care providers use the Portals for remote consultation “One barrier is the lead, and we’ve discussed about which account and that there are fewer visits to care settings. you use, personal or business.”, GP

Operational Learnings

OPERATIONAL CHALLENGES

Operational challenges encountered during the pilot must be addressed if the Facebook Portals are to be rolled out at a wider scale. In particular the deployment challenges must be overcome prior to scaling.

MOBILISATION DEPLOYMENT USAGE EVALUATION

Data privacy concerns Supplier shipping process Care setting technology Data collection too slow to delayed stakeholder inefficient slowing down occasionally insufficient to inform rapid decision support and slowed Pilot Portal deployment. support Portal usage via making and iteration of mobilisation. WhatsApp slowing down set up. Pilot delivery.

Device allocation delayed Package tracking WIFI connection by host organisations in information insufficient and challenging to establish with some cases to slow down causing inefficiency in Portal enterprise WIFI slowing Pilot mobilisation. deployment. down set up.

Damaged devices cause some care settings to wait longer to use devices due to redelivery.

MOBILISATION

Both mobilisation challenges caused delays in expected Pilot delivery. They can, however, be easily overcome or accommodated in the process were the Pilot to be scaled.

CHALLENGE DESCRIPTION IMPACT RECOMMENDATION DATA PRIVACY • Several queries were • Time spent discussing • Ensure there is an FAQ raised by CCGs and other queries and page that is published to partners regarding data documenting answers stakeholders in advance protection and significantly delayed the so that many queries information governance. speed of deploying would be answered These needed to be devices. easily and stakeholder answered before support obtained more agreement to participate. quickly.

DEVICE ALLOCATION • Some CCG areas wanted • Sometimes delayed • Organise distribution all Portals delivered to deployment by adding an direct to allocation sites central location before additional step in the to increase the speed of delivering them to rollout process. deployment and to allocation sites. reduce bottlenecks in deployment process.

DEPLOYMENT

The deployment challenges had far greater consequences in Pilot Delivery and restrict scaling the Portals into a large enterprise setting. Purchasing via a local reseller has been planned as a solution for a wider rollout.

CHALLENGE DESCRIPTION IMPACT RECOMMENDATION SUPPLIER SHIPPING • Issues with order data sets • Delayed Portal deployment • Local processing of orders meant whole orders were due to time taken to process would enable regular rejected due to problems orders. communication and data set with individual line items. • Time zone difference challenges to be resolved • Supplier operating in a prevented regular quickly. different time zone. communication.

PACKAGE TRACKING • Shipping system did not • Difficulty in assessing where • Ensure shipping system automatically send out in delivery devices were and provides better tracking tracking emails to either the therefore unable to provide information to both deployment management customer with a clear ETA. deployment team and end team or the end customer. customer.

DAMAGED DEVICES • A small number of devices • Those devices will need to be • Work with supplier to ensure returned as damaged or redelivered at additional local key contact from undeliverable despite correct cost. courier company available delivery information. • Customers had to wait longer for issue resolution and for device delivery. delivery discrepancy.

USAGE

The usage challenges were also significant. Nevertheless, individual sites have found workarounds for both and the best solutions should be added to the set up instructions and processes to assist a wider rollout.

CHALLENGE DESCRIPTION IMPACT RECOMMENDATION CARE SETTING TECH • Some care homes do not • Delayed set up as care • Emphasise Facebook have sufficient home has to wait for new Messenger option in set technology to support phone or SIM cards to up guidelines. Portals as they do not arrive. • Assess care home have mobile phones that • Health and care staff technology in advance of can download WhatsApp concerns over data deployment so that or multiple SIM cards for privacy when forced to necessary technology multiple accounts. use personal number. support is also delivered.

WIFI CONNECTION • Design of Portals is for • Device not compatible • There is a solution for everyday consumers not with enterprise WIFI this problem that has enterprises leading to which requires browser been identified by challenges connecting to access. This causes participating sites and enterprise WIFI in confusion in initial set up should be documented in hospitals that require and usage in hospital set up instructions. browser access. care setting.

EVALUATION

Collecting a significant volume of survey responses has been challenging. A strategy to obtain user insights without placing a burden on health and care staff must be considered.

CHALLENGE DESCRIPTION IMPACT RECOMMENDATION DATA COLLECTION • Our evaluation strategy • The volume of • Adapt evaluation required the time of quantitative data approach to place less of health and care staff to collected via surveys was a burden on health and organise data collection limited. care staff by prioritising from different user • It was challenging to interviews, relying more groups at a moment iterate the service rapidly on qualitative data and when this was already without the necessary merging surveys if stretched. data to inform decision possible to reduce making. overall number.

COMPETITOR LANDSCAPE

The competitor landscape is split into two principle categories. Tablet devices are a premium product because of the variety of applications they support. For particular use cases smart displays have adequate capability and are priced competitively.

SMART DISPLAYS TABLET DEVICES

Any voice assistant smart speaker designed to be used A tablet is a wireless touchscreen personal domestically. They connect to other domestic devices and computer built with wireless Internet and ability include a sizable touchscreen for entertainment, video chats to support a variety of applications and Web and much more. browsers.

£120 £169 £179 £349 £379

FUNCTIONALITY REVIEW

The Facebook Portals offer high quality camera for the price making them ideal for use cases 1 and 2. Tablets, however, support apps and browsers which might make them the only viable options for use case 3 despite their increased price.

RELEVANT FACEBOOK FUNCTIONALITY PORTAL VIDEO CALL • WhatsApp SOFTWARE • Facebook Messenger

CAMERA QUALITY • 13 MP (smart camera)

AUDIO QUALITY • 10w -15w

EXTERNAL APPS • No

SUPPORT OTHER • No VIDEO CALLING APPS IN BROWSER

Recommendation

INITIAL FINDINGS

Initial feedback suggests the Facebook Portals can be an effective solution for use case 1 but that to solve effectively for use cases 2 and 3 they would need to be used in combination with other devices.

AUDIO & VIDEO COMBINATION OF FUNCTIONALITY DEPLOYMENT QUALITY SUITABLE FOR DEVICES PRICE CHALLENGES FOR USE CHALLENGES MUST BE USE CASE 1 SENSITIVE & EFFECTIVE CASES 2 & 3 SOLVED

The audio and video The Portals are priced Challenges around If the Portals are to be quality of the Portals very competitively. Using portability and supporting rolled out at a wider differentiate the device them in combination with other applications and scale solutions must be as a means to connect a tablet device could be web browsers make the put in place to solve for patients/residents in an effective and price Portals an unlikely the deployment isolation with their friends sensitive solution for all solution for use cases 2 challenges previously and family. three use cases. and 3. highlighted.

FURTHER RESEARCH

The Portals have been in use for a very short period of time and whilst the evaluation has provided initial findings, there are still questions that need to be answered to inform commercial decision making about scaling the Pilot.

IMPACT OF PORTALS PORTALS ENABLING ESTIMATING COST TO ON PATIENTS AND REMOTE CLINICAL SERVE PORTALS AT THEIR FAMILIES CARE DELIVERY WIDER SCALE

Less direct feedback was Less feedback was We can understand more collected from patients collected for use cases 2 about the service created and families to and 3. Further research is in each care setting to understand their necessary to validate accurately estimate experience and more initial findings and to devices needed per site must be collected to understand potential and/or the human strengthen our analysis. functionality gaps. resource to serve.

ADVISED RESEARCH TOPICS

Given the commercial questions that must still be answered, we suggest further user research be conducted into the topics listed below.

USE CASES RESEARCH TOPIC RESEARCH METHOD USE CASE 1 • Experience of patients and families who used the • Interviews with patients and families that Portals to communicate. participated and relevant surveys. • Typical service created across care settings. • Interviews with health and care staff serving the Portals in different care settings.

USE CASE 2 • Experience of all user groups involved in using • Interviews with each user group and all relevant Portals for this use case. surveys. • Necessary functionality to deliver use case. • Interviews with health and care staff. • Typical service created across care settings. • Interviews with health and care staff serving the Portals in different care settings.

USE CASE 3 • Experience of clinical care providers using • Interviews with clinical care providers and Portals to deliver clinical support. relevant survey. • Necessary functionality to deliver use case. • Interviews with clinical care providers. • Typical service created across care settings. • Interviews with clinical care providers.

Appendix

SURVEY RESULTS

Online dashboards have been created containing the survey results. The dashboards will update automatically as new survey responses are collected. Please find the links below.

NHSX – Facebook Portal Pilot – Set Up Questionnaire Filled out immediately after Portal set up by individual that set up the Portal

NHSX – Facebook Portal Pilot – Resident/Patient Experience Questionnaire Filled out after one week of Portal use by resident/patient using the Portal

NHSX – Facebook Portal Pilot – Health and Care Staff Experience Questionnaire Filled out after one week of Portal use by health and care staff helping residents/patients use the Portal

NHSX – Facebook Portal Pilot – Family & Friends Experience Questionnaire Filled out after one week of Portal use by family and friends connecting with patients/residents via the Portal

NHSX – Facebook Portal Pilot – Digital Clinical or Care Provider – Experience Questionnaire Filled out after one week of Portal use by clinical care providers delivering remote clinical care via the Portal

POSITIVE FEEDBACK

FEEDBACK EVIDENCE OCCURENCE AUDIO QUALITY • Set Up Experience Survey • x10 mentions • Health & Care Staff Experience Survey • x2 mentions • Friends & Family Experience Survey • x1 mentions • Health & care staff interview • x3 mentions • Family & friends interview • x1 mentions

CAMERA QUALITY • Set Up Experience Survey • x9 mentions • Resident/Patient Experience Survey • x2 mentions • Health & Care Staff Experience Survey • x2 mentions • Friends & Family Experience Survey • x2 mentions • Health & care staff interview • x8 mentions • Clinical care provider interview • x1 mentions

CONNECTING WIDER FAMILY • Set Up Experience Survey • x4 mentions • Health & care staff interview • x2 mentions

OTHER FEATURES • Set Up Experience Survey • x2 mentions • Health & care staff interview • x5 mentions

POSITIVE FEEDBACK

FEEDBACK EVIDENCE OCCURENCE SCREEN SIZE • Set Up Experience Survey • x6 mentions • Health & care staff interview • x5 mentions

SELF-STANDING • Set Up Experience Survey • x3 mentions • Friends & Family Experience Survey • x1 mentions • Health & care staff interview • x3 mentions • Family & friends interview • x1 mentions

SIMPLICITY TO SET UP & USE • Set Up Experience Survey • x67 mentions • Health & Care Staff Experience Survey • x4 mentions • Health & care staff interview • x9 mentions • Clinical care provider interview • x1 mentions

NEGATIVE FEEDBACK

FEEDBACK EVIDENCE OCCURENCE CASES NEEDED FOR PROTECTION • Emails from participants • x2 mentions • Set Up Experience Survey • X1 mentions

DUMMY FACEBOOK ACCOUNTS • Emails from participants • x2 mentions BLOCKED • Health & care staff interview • x1 mentions

ENTERPRISE WIFI CONNECTIVITY • Set Up Experience Survey • x1 mentions

FAMILY TECHNOLOGY • Set Up Experience Survey • x1 mentions • Resident/Patient Experience Survey • x1 mentions • Health & care staff interview • x1 mentions

HOSTING APPS AND BROWSERS • Clinical care provider interview • x1 mentions THAT SUPPORT OTHER APPS

MAXIMUM OF 4 USERS PER DEVICE • Set Up Experience Survey • x1 mentions • Health & Care Staff Experience Survey • x1 mentions • Health & care staff interview • x3 mentions

NEGATIVE FEEDBACK

FEEDBACK EVIDENCE OCCURENCE MOBILE PHONES CANNOT HOST • Emails from participants • x1 mentions APPS • Set Up Experience Survey • x1 mentions

MULTIPLE WHATSAPP ACCOUNTS • Set Up Experience Survey • x4 mentions REQUIRE MULTIPLE NUMBERS • Health & Care Staff Experience Survey • x1 mentions

PORTABILITY OF DEVICES • Set Up Experience Survey • x9 mentions • Health & Care Staff Experience Survey • x2 mentions • Health & care staff interview • x9 mentions • Clinical care provider interview • x1 mentions

RESOURCE REQUIRED IN CARE • Resident/Patient Experience Survey • x1 mentions SETTINGS • Health & care staff interview • x1 mentions

SET UP TIME CONSUMING WITH • Set Up Experience Survey • x6 mentions MULTIPLE FACEBOOK ACCOUNTS • Clinical care provider interview • x1 mentions