TELEHEALTH & WIRELESS COMMUNICATIONS
Towards self-management
An EU-wide project to asses the impact of telehealth has facilitated self-management of patients across Milton Keynes. CommonWell project lead Sarah Hibble and advanced nurse practitioner for respiratory medicine at Milton Keynes Hospital NHS Foundation Trust, Mark Baverstock, spoke to NHE.
elehealth has long been cited as a cost- effective option to improve the lives of millions of people with chronic conditions, but recent reports from the Whole System Demonstrator seem to indicate that whilst equipment can signifi cantly reduce hospital admissions, the cost savings were not so clear.
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NHE examined the impact of the successful CommonWell project and what this could mean for the future of telehealth.
Project lead Sarah Hibble and advanced nurse practitioner Mark Baverstock explained how telehealth had improved their patients’ lives, with 79% of the users and 88% of the carers involved reported to have found major benefi ts from it.
would trigger a ‘red alert’, bringing the case to a clinician’s attention. They would then contact the patient to ascertain the circumstances of the reading and resolve any issues. Faulty or missed readings could be down to something as trivial as low batteries, but could indicate something more serious, such as a patient experiencing a fall.
The technology can indicate early signs of an infection or exacerbation of the patient’s condition, allowing patients to start treatment earlier and avoid admission to hospital.
“168 hospital admissions and 85 GP visits were avoided based on the use of telehealth.”
“They really liked it,” Hibble said, and Baverstock agreed: “All our patients think it’s fantastic!”
The CommonWell project took place across four cities in the EU, with the UK site designated as Milton Keynes. Set up by the community health service, the council and the trust, 100 patients with chronic obstructive pulmonary disease (COPD) were identifi ed for support with telehealth.
Once installed, the equipment allowed patients to take daily readings of blood pressure, oxygen saturation and so on, which were measured between parameters of risk set by the community matron team.
Red alert
Any readings outside of these parameters 36 | national health executive Jul/Aug 12
Although Hibble described the initial implementation as “quite overwhelming”, the project is
now securely embedded in the community health service, with matrons able to manage unplanned demand effectively.
The triage of alerts each morning means patients will not be phoning in “ad hoc” and the focus of care can shift from reactive treatment to prevention and preparation.
Baverstock said: “It helps the community matrons prioritise their workload; it helps them to use their time as effectively as possible. It can be done day-to-day as well so they can change their day’s schedule according to the alerts that have come through.”
Alleviating anxiety
Hibble admitted that the introduction of new technology and procedures would always be met with certain misgivings but that once patients got used to the equipment, they wanted to keep it.
“They were concerned in the beginning, because I think they thought they would just have this machine and no links with our matrons and nurses – but they soon came to realise that wasn’t going to be the case. If there was anything out of the ordinary, a clinician would respond.
“People found it useful and benefi cial; actually a lot of people who got the equipment in place didn’t want to give it back.”
A key part of the project was for the machine to pose a verbal question of whether the patient would like to be contacted by their clinician. This helped to reassure patients for whom anxiety is often a signifi cant aspect of their disease.
Below: The main cause of COPD is smoking, as illustrated in this photo produced as part of the ‘Every Breath You Take’ anti-smoking campaign for Fresh, the smoking cessation organisation for North East England. See
www.freshne.com
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