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Camden Telehealth

Camden Telehealth. Long Term Conditions and Cancer Programme. Jennie Symondson. Aims. Telehealth Evidence Case studies Camden Pilot. Telehealth. Telehealth is the monitoring of a patient’s vital signs and symptoms via technology in their home.

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Camden Telehealth

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  1. Camden Telehealth Long Term Conditions and Cancer Programme Jennie Symondson

  2. Aims • Telehealth • Evidence • Case studies • Camden Pilot

  3. Telehealth • Telehealth is the monitoring of a patient’s vital signs and symptoms via technology in their home. • Peripherals include, oximeter, BP, weighing scales, thermometer, glucometer • Patients take their readings and answer a series of health questions • Information is transmitted to a clinical triage centre (CNWL Milton Keynes) • Nurses will verify the results, complete a phone assessment and only refer to Camden clinicians if required

  4. Statistics • 15million people LTC in England (total population 53m) • Expected to rise to 18million by 2025 • 2010 est. the following • 70% of the total health & social care budget spent patients with LTC’s • 50% of all GP appointments • 65% of all out patient appointments • 70% of inpatient bed days Ref: DH 2012 Long Term Conditions Compendium of Information, 3rd ed. London:Available at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_134486.pdf

  5. Camden data Ref: http://www.camdenccg.nhs.uk/Downloads/ccg-public/about-us/board-meetings/Camden%20CCG%20Governing%20Body%20Agenda%20and%20Papers%20July%202013.pdf

  6. Telehealth evidence • The Whole System Demonstrator (WSD DH 2011) was the largest randomised control trial of telehealth & telecare in the world • 6191 patients • 238 GP practices • Newham, Kent & Cornwall • Heart failure, COPD, Diabetes Reference: https://www.gov.uk/government/news/whole-system-demonstrator-programme-headline-findings-december-2011

  7. WSD outcomes • 15% reduction in A&E • 20% reduction in emergency admissions • 14% reduction in elective admissions • 14% reduction in bed days • 45% reduction in mortality rates

  8. CHF evidence • Telemonitoring reduced all-cause mortality, hospitalisation, and increased adherence to treatment plans (Cochrane Nursing Care Field 2011, Nakamura et al 2014, Barrett 2012) • Remote medication titration is feasible & safe (Steckler et al 2011) • TH not only monitors but empowers & motivates individuals, giving them greater control over disease management (Barrett 2012)

  9. Camden case study • (JS of NW1) using telehealth since April 2011 • COPD, glaucoma, and experiencing hypertension • GP made referral to the district nurse team to monitor blood pressure once per week for 4 weeks. • CNWL resp nurse informed GP that JS has TH & printed off BP report • GP able to prescribe meds instantly

  10. Pilot scope • Commissioner led project • Small scale - 25 units from 14th July 2014-July 2015 • COPD & CHF • Integrated working- CCG, CNWL & LA

  11. Pilots aims • Pre-telehealth user survey • Patient/carer satisfaction: • Self-management skills, mental state, function & personal goal • Staff satisfaction

  12. Pilot aims Financial: Hospital admission, LOS, GP, A&E

  13. Pathway • Patient identified according this eligibility criteria • One or more Long Term Condition/s. • Known to CNWL Camden service (or eligible for) • Patient/carer is: • physically and cognitively able • Interested, motivated. • Capacity to understand TH not emergency service (mon-fri only)

  14. Pathway continued……. • Assessment, referral • Patient consent & leaflet • Set parameters for patient • Send letter to GP & LAS informing of TH • Patient data prev. year e.g. hospital admissions

  15. MK Triage • TECHNICAL TRIAGE- re-test, arrange repair • CLINICAL TRIAGE • Clinical assessment • Advice • Rescue pack (highlight ref form) • Update GP • Call ambulance • Refer to Cam before 1pm via Rapids • Reset parameters • Training • Discharge • Missing data, no data • Reading near to parameter limit • Outside of parameters

  16. Next steps • Evaluation • Set up hospital discharge pathway • Upscale to 100 units 2015/16 • Decide if GP surgery wants access to ICP • Launch event 30.07.14 St Pancras 2-5pm

  17. HF Case study • Heart failure, NHS North Yorkshire & York • http://www.youtube.com/watch?v=lWaa-o9rG5o

  18. Questions

  19. References Barrett A (2012) Benefits of Telemonitoring in the care of patients with heart failure. Nursing Standard Vol 27 no 4 DH (2012) Long Term Conditions Compendium of Information, 3rd ed. London: Available at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_134486.pdf DH (2011) Whole Systems Demonstrator. Available at: https://www.gov.uk/government/news/whole-system-demonstrator-programme-headline-findings-december-2011 Holly C (2011) Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Nursing Care Filed. International Journal of Evidence-Based Healthcare Vol 9 Nakamura N, Koga T, Iseki H (2014) A meta-analysis of remote patient monitoring for chronic heart failure patients. Journal of Telemedicine & Telecare Vol 20 p11-17 Steckler A E et al (2011) telephone Titration of Heart Failure Medications. Journal of Cardiovascular Nursing. Vol 26 No1 p29-36

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