A mixed-methods evaluation of Clera, a web application designed to support communication between clinicians, patients, and families.

How we worked with Clera Healthcare and Health Innovation West of England

Clera is a web application, created by Clera Healthcare, that allows clinicians to message patients and their families. The application can involve patients in their care, improving their medical information recall. Clera can also free-up staff time by making updates patients and families more efficient. Unity Insights were commissioned by Health Innovation West of England to conduct an evaluation of the Clera app. The aim of the evaluation was to gain feedback from North Bristol NHS Trust (NBT)’s patients and families, to inform functionality and pathway integration needs of Clera.

First, a logic model workshop was completed to identify impacts, outcomes, and metrics for measurement, forming the key evaluation questions:

1. What is the impact of Clera on patients and families?
   • To what extent do patients and families feel more informed about their care due to Clera?
   • Does Clera allow for more equitable access to care updates?
   • Do families receive more frequent contacts following the implementation of Clera?
   • Does Clera lead to an improvement in patient recall?
2. What is the impact of Clera on staff members?
   • Are staff satisfied with the Clera platform?
   • How does Clera impact the time spent by staff updating patients and families?

To answer the evaluation questions, quantitative and qualitative analytical methods were used to analyse several datasets, comparing pre-Clera implementation data with post-Clera implementation data. Statistical testing was conducted to identify whether differences in pre- and post-implementation periods were statistically significant, and hence whether findings were due to chance or likely due to Clera implementation.

What is the impact of Clera on patients and families?

Quantitative data surrounding the number of care updates provided to patients and their family members was analysed, alongside qualitative survey data surrounding the patient and family experience of receiving updates.

“For someone like me who finds it difficult to contact and works full time it was gamechanging [sic] and put my mind at rest.”

Patients and families reported improved understanding of care plans, with positive responses increasing for themes such as understanding care plans, ease of obtaining information, and being able to ask questions.

Clera contributed to reducing disparities in access to care updates when examining age, IMD, distance from the hospital, disability, and employment status of family members.

Clera’s implementation significantly improved communication between staff, patients, and families, addressing previous gaps in communication and enhancing the overall experience for families. The app demonstrated its potential to make care updates more accessible and inclusive across varied groups. Effective, regular communication between healthcare staff and patients is associated with improved satisfaction, understanding of conditions, treatment adherence, and clinical outcomes among patients and families.

What is the impact of Clera on staff members?

Staff surveys were analysed through frequency distributions to understand the impact of Clera on staff satisfaction and perceived value of the application.

of staff felt sufficient training was provided for Clera’s use, though inconsistencies in training access were noted

of staff spent time providing updates to patients and relatives during Clera implementation, compared to 27% before implementation

of staff reported ease in integrating Clera into their existing work, aided by its intuitiveness and efficiency

of staff valued Clera’s impact on their work and saw its potential for future use, citing increased communication and efficiency savingsA mixed-methods evaluation of Clera, a web application designed to support communication between clinicians, patients, and families.

Clera improved communication and efficiency for staff, enabling them to provide more updates to patients and relatives and integrate the system into their routines. Despite some training inconsistencies and lower management support perceptions, staff largely appreciated Clera impact on their work. For healthcare professionals, communication tools such as Clera can contribute to reduced cognitive load, fewer communication-related errors, and increased job satisfaction.

What value did this evaluation add?

The current evaluation showcased the potential of Clera to improve communication between healthcare staff, patients, and families. In the pilot, Clera was deemed easy to use and had a positive impact for patients, families and staff members. Grant funding should be sought to improve Clera’s capabilities further, alongside evaluating a longer period of implementation with a larger patient group. This will help solidify Clera’s position as a valuable asset in diverse healthcare settings.

“Clera was born from our daily frustrations on the wards – families lacked updates, and staff lacked time. It’s a project shaped by our experiences as doctors, but having the idea was the easy part. Finally seeing it being used by our colleagues on the wards we used to work on was a huge milestone for us.
Hearing even just one piece of feedback from a family member who felt more connected and reassured has given us a renewed sense of purpose and shown us just how much impact we can have when clinicians and tech come together to solve real problems. Our pilot shows that digital tools, when developed by the clinicians who use them, can be used to bring patients and families into the conversation, rather than push them further out. We owe a huge thank you to NBT, Health Innovation West of England and Unity Insights, who brought everything together into a pilot and evaluation that will help guide Clera’s development and demonstrate its impact“

Alice Appleton, Clera Healthcare