How digital is at the heart of rehab goal-setting

Back in late 2018, Dr Penny Trayner launched Goal Manager® into a healthcare and rehab world which had yet to fully appreciate the need to adopt digital technology into its ways of working. 

As a platform which made use of the gold standards in goal setting and software, Goal Manager created, for the first time, the means to set targets, monitor progress and generate meaningful outcome data around a client’s ongoing recovery. 

Crucially, through digitalising the process, clinicians were able to save significant amounts of time spend on admin – Goal Manager statistics show goal setting time is reduced by 43 per cent – through the paperless system, and avoid hours of travel for a meeting which could now be held virtually. 

Even in a pre-COVID healthcare world – and despite the scepticism and often reluctance from the sector to adopt digitalisation – Goal Manager’s offering was warmly welcomed. Although created for Dr Trayner’s own business, Clinical Neuropsychology Services, its commercialisation and expansion into a host of other businesses was demand-led. 

Now, given the seismic shift in attitudes towards digital and remote technology from healthcare as a result of the pandemic, Goal Manager is on a path of significant growth, and is even set to secure its first public sector commission later this year – a process which, pre-COVID, was known to take many years. 

And for Dr Trayner, who recognised the need for technology and the role it could play years before it became a necessity, the huge shift in adoption and attitudes are factors she believes are crucial to the future of healthcare. 

“I think, during the pandemic, two things have happened,” paediatric clinical neuropsychologist Dr Trayner tells NR Times. 

“One, people no longer necessarily see technology as a lesser option. I think there was a public perception that perhaps if you were not seeing someone face to face, you weren’t getting the same quality of service. 

“But I think what’s also happened is we have recognised there are some things that are not best delivered remotely, and we’ve got a lot better at delineating what things should we be doing remotely, and when we should be dedicating in-person clinical time.”

Both of those factors were crucial in the foundation of Goal Manager. Dr Trayner recalls a period where she was travelling up to 1,000 miles each week to attend meetings across England and Wales – something that remained ‘the norm’ for many practitioners until March 2020.  

“We’ve seen there’s no reason to do that anymore, and we can be far more effective and more efficient,” she says. 

“Zoom allows us to share our screens so we don’t have to come with documents, everyone’s got everything available in their own workspace, if people can’t attend because of the weather or whatever else, the meeting still goes ahead. 

“It’s very costly in terms of expense and time to meet face to face, but we don’t always need to meet that way anymore. There will be times for some teams where it’s appropriate; but for a lot of teams, it won’t be. I think we’ve got much better getting this working – people are accepting it, embracing it and seeing it as an acceptable offer.”

And as well as the travelling time – and its additional carbon-cutting benefits – Goal Manager also frees up significant amounts of time spent traditionally on paper-based data collection and analysis, compiling information from multiple sources and having to assess it manually. 

“My view was that there has got to be a better way to do this,” says Dr Trayner, who hails from a family of engineers. 

Goal Manager team members Dr Penny Trayner (left) and Merryn Dowson

“Having such a family background makes you see that actually, if we can harness technology in the right way, we can make it help us make our lives more efficient. 

“Goal Manager is an administrative tool which is there to speed up something that takes a long time to do in a manual way. But the idea of it is to create more clinical space, so you can then dedicate the time you have free to doing the good stuff, actually seeing your patients and doing the important clinical work, whatever it may be.

“And I think people can reflect on that in our everyday lives. I don’t think there’s many of us that don’t use our smartphone. And if we actually apply that to our workplace setting, ‘where can tech can make my job better?’, then that’s going to improve our working practice.”

One issue Dr Trayner was quick to identify on rolling out Goal Manager in late 2018/early 2019 was the need to train people properly in using the system, particularly those who aren’t adept in using technology, to avoid it being something they feared. That is something which still hasn’t been tackled more widely within healthcare and wider society since the onset of the pandemic, she says. 

“It wasn’t a stepwise progression when the pandemic came, it was a giant leap, we made years of progress extremely quickly. But with such rapid change, some people will need support to catch up,” says Dr Trayner. 

“We identified early the importance of not just giving people technology, it’s actually the training and support that goes with it that really makes a difference. If people feel confident and competent, and can get on with it themselves, then they’ll get on board with it and use the tech with maximum benefit.

“Alongside Goal Manager, we have designed CPD-accredited training courses that look at goal setting and how to embed the gold standard techniques in your routine practice by using the software, so they’re getting the training and learning opportunity alongside being able to use it. In general we find that people know the principles, it’s really just learning what buttons to click. 

“But I think, more widely, that’s where a lot of tech gets let down. Proper support isn’t there, and then the fear factor comes in. If you’re going to introduce something into a team, what training do they need to help them? How confident do they feel in using it? What are you doing to support them? That is crucial in this.”

But as well as appropriate training and support, a crucial factor for Dr Trayner is that the platform is fit-for-purpose for the healthcare sector and those working within it – and highlighted the roles healthcare professionals have in enabling that. 

“The problem with a lot of technology is, particularly in healthcare, it is often made by external companies, sometimes really top IT companies, but ones that that have absolutely no experience within healthcare on the frontline,” she says. 

“People get tired of the tech. Tthey try it but it doesn’t work and it doesn’t do what they want it to do. So, they move on, and that’s a real shame and a missed opportunity. 

“I think what we need to do as healthcare professionals is to be the driver of technology that works for us. We need to say what are our needs, what do our services and our service users need, and work in partnership with technology companies to design those solutions, rather than it being the other way around – them designing a ‘solution’ which we then shoehorn into our services. 

“Goal Manager was supposed to be internal, to manage a challenge we had, and it just organically grew from there. We identified a healthcare app developer and worked very closely with him, and still work with him now on the continuous roll-out of updates to the system. We really hit gold there, as it can be very challenging to find a developer with that level of expertise to work with. Once you start and you can see the process taking shape, it becomes a lot easier. 

“It was an idea I had, and I’ve got a load more, but I can’t be the only person with them – there are loads of ideas out there. We’ve got staff teams out there with buckets of ideas, and tapping into those really could mean positive change for your service and many others.

“I think that is a really important part of this journey we are all on. Things have been accelerated massively and the infrastructure is now there, people have access to laptops, computers, tablets, whatever they need to be able to do this. We’re much better resourced now from an IT perspective, and the ideas are there. 

“It’s there to be done. We’re not in a place now where you have an idea and it sits on the shelf, you can make it happen if you want to. That’s what I did with Goal Manager and it has been incredibly effective for us, and also for others.

“Clearly there are structural limitations and it all costs, but I think this is such a great time for ideas. No longer do these things take ten to 15 years to come to into use – the world has changed and we can all help to play a role in the future.”

• Dr Penny Trayner is among the speakers at Virtually Successful, a five-day conference which runs throughout this week which looks at the contribution and potential of digital tech to the world of neuro rehab. To access the presentations, which are available online, at an NR Times discounted rate, visit here