Use Cases

• Situation
  A study found that one hospital’s patients spent 3 hours 12 minutes for each pre-operative assessment (POA) appointment. Nurses spent 1 hour 30 minutes for each appointment. In 2018, this equated to 16,320 hours of patient time and 7,650 hours of clinician time.


• Aspiration
  The hospital wanted to streamline the POA process by sending and receiving key information earlier in the pathway. This included receiving patient health information & delivering health and procedure information.


• Solution
  • The POA service was redesigned to increase efficiency for patients and staff.
  • Patients have a face-to-face appointment with a surgeon. They then visit a drop-in POA for essential tests. At this point, it’s identified if the patient needs help with the digital questionnaire.
  • Patients receive a LifeBox login to complete the health screening questionnaire.
  • They can watch informative videos related to the questionnaire at home and can submit questions if they need more information.
  • The LifeBox dashboard and comorbidities questionnaire support clinical decisions.
  • Patients are allocated face-to-face or telephone appointments with a POA nurse and anaesthetist if required.
  • If a patient has not completed the questionnaire or watched the videos, they receive a prompt. When patients watch a video, LifeBox creates a record.
  • Videos are in English and patients who need translation can attend a face-to-face appointment with an interpreter.
  • Telephone appointments last an average of 13 minutes and face-to-face appointments last an average of 30 to 40 minutes.
  • Up to 3 POA clinic nurses work on patient follow-up each day. They review test results and optimise patients promptly.
  • The LifeBox dashboard informs daily POA safety huddles and Friday progress report meetings.


• Impact
  • Completed POAs increased by 800 patients per month.
  • Previously, only 33% of patients attended a preoperative information group. Now 100% of patients receive the same information through videos.
  • 7.8% of patients need help with the digital POA and attend a 15 minute face-to-face appointment with a nursing associate. The information is then validated by a registered nurse. The nurse also supports patients when they watch the information videos and can answer questions.
  • Printing and postal costs for patient information have reduced by roughly £11,000.
  • Before COVID-19, the system reduced face-to-face outpatient appointments by over 3,000. It saved the unit over £96,000 for every 5,000 patients.
  • Following COVID-19, all 7,000 appointments are virtual with no face-to-face outpatient appointments. This has reduced costs and CO2 emissions.


• Definition Health & Cerner
  • Digital Pre-operative Assessment - Patients provide information about their health, medical history, medication and lifestyle from the comfort of their home via a user-friendly digital health questionnaire. Answers are then validated by a clinician before being automatically transferred to Cerner Millennium’s Problems/Diagnosis list, removing any need to manually populate this information pre-surgery.
  • Pre-operative Documentation - Upon completing a digital pre-operative assessment, LifeBox generates a set of clinical documents containing vital information about the patient’s health and suitability for anaesthetic and surgery. These documents can be transferred to Cerner Millennium and made available for Anaesthetists, Surgeons, Physios and any other clinician in the hospital to view.
  • Medication - LifeBox collates a structured list of medication via the patient’s health questionnaire and, following nurse validation, can automatically transfer this essential pre-operative information to the Medication list in Cerner Millennium.
  • Allergies - The LifeBox health questionnaire gathers detailed information on a patient’s allergies, including the substance and reaction, and automatically transfers this to the Allergies list in Cerner Millennium using SNOMED codes.

Available in These Countries

• UK

Supported Devices

• Desktop
• Tablet
• SmartPhone

Version Details

Compatible with Cerner