DELIVERING PERSON – CENTERED CARE DONNA CANTRELL RMN / DIP NUR / BSc(HONS) HEALTH AND SOCIAL CARE

BACKGROUND  Stoke PCT has commissioned a prototype of ‘Simple Telehealth’, the mobile phone / text based Telehealth solution  The solution is 100% owned by Stoke PCT and the development is being supported by MidTech, the SHA’s Innovation Unit  Feedback from commissioners suggests that the system will be very low cost when compared to traditional solutions and will be cost effective enough to deploy patients for which there is no current affordable Telehealth solution.

AREAS LEADING ON THE DEVELOPMENT OF THE SOLUTION Community Matrons PBC General Practice Diabetes Dementia Smoking Cessation Year of Care Vascular and Cognitive Impairment District Nursing Mental Health – the first Mental Health service nationally to pilot this solution.

DESCRIPTION  Simple telehealth uses proved industry and clinical protocols to provide an automatic, bi-directional, SMS based behavioural, educational and monitoring service which automatically interacts with patients via a series of personalised, planned and timed reminders, educational information, compliance and monitoring messages to assist with and aid patient self care.  The system is extremely cost effective, free for patients, accessible to the majority of the population and can be used anywhere by both patients and clinicians.

OPTIONS SIMPLE TELEHEALTH TELEHEALTH SYSTEMS TELECARE SYSTEMS HEALTH HUB

SIMPLE TELEHEALTH OBJECTIVES

ENABLE INDIVIDUAL HEALTH CHOICES AND DRIVE PEOPLE TOWARDS A GREATER UNDERSTANDING OF THEIR CONDITION AND SELF CARE, PROMOTING RECOVERY AND INDEPENDENCE THE PERSONALISED SYSTEM WILL IMPROVE COMPLIANCE WITH ASPECTS OF PLANNED CARE, INCLUDING MEDICATION AND APPOINTMENTS, SEEING A REDUCTION IN DNA APPOINTMENTS PATIENTS WILL HAVE THE CHOICE OF USING THE SYSTEM ANYTIME AND ANYWHERE. HOWEVER THEY CAN BE AUTOMATICALLY REMINDED OF THEIR AGREED TIMETABLE IF THEY DO NOT COMPLY WITH THEIR AGREED PLAN TO INCREASE THE PRODUCTIVITY OF THE SERVICE BY MAXIMISING THE TIME STAFF HAVE TO SUPPORT MORE PEOPLE, INCREASE CASELOADS AND MEET THE CURRENT DEMAND WITH WHAT WE HAVE. THIS WILL HAVE A POSITIVE IMPACT ON THE THROUGHPUT OF DELAYED DISCHARGES FROM INPATIENT SERVICES

TARGET USAGE

THE SYSTEM WILL PROVIDE AUTOMATED MONITORING FOR PATIENT CONDITION, EDUCATION AND IMPROVEMENT OF SELF CARE THE SYSTEM WILL ENABLE PERSONAL CHOICE FOR PATIENTS BY OFFERING THE ABILITY TO HAVE MOBILE PHONE OR LANDLINE CONSULTATIONS BASED ON READINGS TAKEN AT THE PATIENTS CONVENIENCE INSTEAD OF A SURGERY VISIT THE SYSTEM CAN BE USED FOR PATIENTS WHOSE CLINICIAN WOULD BE MORE ABLE TO MANAGE THE CONDITION WITH ACCESS TO REGULARLY RECORDED READINGS INSTEAD OF RELYING ON READINGS ONLY WHEN THE CLINICAN IS PRESENT THE KEY FEATURE BEING, THE ABILITY TO SEND PATIENT REMINDERS WITH OR WITHOUT CONFIRMATION, I.E REMINDERS SENT AT SPECIFIC TIMES / DAYS TO REMIND PATIENTS TO TAKE MEDICATION, EXERCISE OR OTHER ACTIONS.

HOW DOES IT WORK

LETS’S HAVE A GO!! SEND THE FOLLOWING MESSAGE TO SUBSCRIBE84433

THE CLINICIAN SENDS AN SMS TO A DEDICATED SHORTCODE NUMBER, I.E WITH THE PATIENTS MOBILE NUMBER AND THE CONDITION TO BE MONITORED, I.E ‘BP’ FOR BLOOD PRESSURE AND THE SYSTOLIC / DIASTOLIC THRESHOLDS AND THE FREQUENCY / TIME READINGS SHOULD BE TAKEN

THE CLINICIAN GETS CONFIRMATION THAT THE REQUEST HAS BEEN ACCEPTED THE PATIENT IMMEDIATELY RECEIVES A TEXT TO CONFIRM THAT A REQUEST HAS BEEN SENT TO THE SYSTEM TO ENROL THEM. THE PATIENT SENDS AN ‘OK’ TEXT BACK TO THE ‘81234’ AS CONFIRMATION TO ENROL THE PATIENT RECEIVES A WELCOME TEXT INCLUDING INSTRUCTIONS

WHAT HAPPENS NEXT

ONCE THE PATIENT HAS TAKEN A READING IT CAN BE SENT IMMEDIATELY TO THE SYSTEM VIA THE TEXT MESSAGE THE PATIENT WILL RECEIVE CONFIRMATION EACH TIME A READING IS ACCEPTED BY THE SYSTEM ALONG WITH A SUMMARY OF RECENT READINGS IF A PATIENT DOES NOT SUBMIT READING WITHIN THE DEFINED PERIOD, THE SYSTEM WILL SEND OUT A SERIES OF REMINDERS

POSSIBLE USES  MEDICATION REGIME – REMINDERS TO TAKE AND COLLECT  APPOINTMENTS REMINDERS – TO REDUCE THE RATE OF DNA’S  MOTIVATIONAL AND BEHAVIOURAL CHANGE TOOL -  PHYSICAL HEALTH MONITORING – LONG TERM BP, BM  HEALTHY OPTION REMINDERS – DIET / EXERCISE  CPA REMINDERS / INFO – ADDRESSING KEY PERFORMANCE INDICATORS  SOCIAL INCLUSION – GROUP ACTIVITIES AND PLANNED AGREED CARE

TELEHEALTH SYSTEMS

VITAL OBSERVATIONS A VARIETY OF EQUIPMENT WHICH WILL ALLOW THE PATIENT TO RECORD THEIR VITAL OBS AND THIS INFORMATION IS SENT TO THE CONTROL ROOM FOR ANALYSIS / MONITORING – ALERTS CAN BE SENT OUT WHEN NEEDED AND CLINICANS WILL BE ALERTED IN THE EVENT OF PROBLEMS

TELECARE SYSTEMS

WHAT IS TELECARE  TELECARE IS MADE UP OF A RANGE OF DETECTORS / MONITORS WHICH ARE LINKED VIA A TELEPHONE LINE TO A COMMUNITY ALARM SYSTEM.  WHEN AN ALARM IS TRIGGERED IT SENDS A WARNING TO A CONTROL CENTRE THAT CAN BE RESPONDED TO WITHIN A DEFINED TIMESCALE.  AN ALARM CAN BE TRIGGERED ON A DETECTED EVENT SUCH AS A FALL, OR IF AN UNUSUAL PATTERN OF ACTIVITY HAS NOT BEEN FOLLOWED SUCH AS A FRIDGE DOOR NOT BEING OPENED WITHIN A 24 HOUR PERIOD.

AVAILABLE EQUIPMENT

AA A SMALL HAND HELD TELEHEALTH MONITOR DESIGNED FOR EASE OF USE BY PATIENTS AND CARERS OF ALL AGES, IN ANY LOCATION AND AT ANY TIME.

OVERVIEW  Purpose designed for home use by patients of all ages with Long Term Conditions, the Docobo HealthHub is an innovative European solution to the growing burden placed on health providers for managing patients at home and in the community. Similar to a PDA and using the principle of “store and forward”, vital signs measurements and changes in symptoms, side effects, life style and quality of life are securely recorded and transferred to the centre of care