Inspiring Innovation in Digital Health Realising the Potential - - PowerPoint PPT Presentation
Inspiring Innovation in Digital Health Realising the Potential Lessons Learned Kevin McSorley Executive Director Fold TeleCare The tantalising possibility .. for public policy to meet more peoples desire to remain
Inspiring Innovation in Digital Health
“Realising the Potential – Lessons Learned”
Kevin McSorley Executive Director Fold TeleCare
The tantalising possibility ……
….. for public policy to meet more people’s desire to remain independent for longer, while at the same time saving money
Audit Commission 2004
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Telecare Service Model
Living (ADL)
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Lesson: Leaders & Partners……
The Northern Ireland Challenge
60% of all GP visits 72% acute bed days 69% of health & social care spend 2/3s of over 75s
Population 1.8M Health Budget Declining Demand and cost
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Lesson: Leaders & Partners
Minister for Health, Michael McGimpsey, said: "This is a wonderful achievement for the health service in Northern Ireland. The pressures
demographic trends such as an ageing population, mean that the health service is going to have to find new ways to ensure that we continue to provide a high quality service.”
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Telehealth Service Model Managed Service Overview
Core Values
Centred
approach
service levels
Lessons: Political Support – Defining Success
today marked the roll-out of a ground-breaking hi-tech scheme which will enable more patients to monitor their health in their own homes.
to 3,500 patients across Northern Ireland per annum for a period of six years. “The Telemonitoring NI service will allow thousands to monitor their vital signs without having to leave their own homes… …is an excellent example of how the Health Service can innovate using modern technology to deliver a better service for our patients."
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Patient Pathway
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Each Healthcare Trust has specific Patient selection processes and associated goals Risk Stratification Tools can be used to identify suitable patients The selection process includes a preliminary patient assessment
Step 1 – Patient Identification and Referral
Clinical care pathways enable clinicians to identify the right cohort of patients suitable for the Remote Monitoring service
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HSC Clinicians access an on-line web portal to create a referral and create a patients care plan The TF3 Clinical Triage Team receives and validates the referral Referral requests triggers patient appointments, obtaining consent, installation, training, …
Step 2 – Patient Enrolment on the service
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Patients are enrolled on to the service and start to monitor their vital signs at home Readings are taken with the various peripherals and transmitted to the monitoring centre Qualitative patient feedback be captured via condition specific health interviews/ questionnaires
Step 3: Patient Self Management Support
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There are two types of patient monitoring provided Track and Trend - Data recorded by service but clinical monitoring is by patients own care team Triage Service - The Patient is monitored and triaged by the TF3 Clinical Triage Team
Step 4 : Patient Monitoring Services
www.telemonitoringni.info If a patient’s data record outside the parameters set in the care plan, a nurse will contact the patient to check on their health and decide whether there is a need for intervention or escalation There are three types of Escalations : Local Response – the Clinical Triage Nurse escalates to the Local Care Team Out of Hours Service – over the weekend the Clinical Triage Nurse escalates to the Out of Hours Service Emergency Response –Clinical Triage Nurse escalates directly to Emergency Services
Step 5 : Escalation of Issues
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The patient portal allows patients to review their progress. They can look at trends, comparisons and get health tips Patients can receive reminders and messages as well as information on events related to their condition Patients gain a greater understanding over time of their condition through the patient portal and become empowered to manage their condition proactively
Step 6: Self Management and Education
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At referral all patients have a planned review date set based on the reason for referral and the condition(s) Clinicians review and decide whether to extend or discharge patients On discharge, the patient is assessed as to whether the clinical goals for the referral were achieved
Step 7: Patient Review, Discharge and Outcomes
Lesson: Learning & Building on Success
Thursday, 17 October 2013
Jon Darpón Sierra, Basque Minister for Health visits Telemonitoring NI Eddie Ritson, Programme Director of the CCHSC, said: “Telemonitoring is an excellent example of how modern technology can help deliver a better service for the patient, allowing them to take control and manage their condition with confidence. It also allows more efficient use of the healthcare professional’s time and skills. The service has an ambitious programme for development and next year plans to accelerate the uptake of telehealth into broader clinical conditions and expand into telecare.
Lesson: Political & Clinical Support for Success
30th January 2015 Health Minister, Jim Wells, and the Chief Medical Officer, Dr Michael McBride,
The Minister said: I was particularly interested to hear the perspectives of service users about how they have benefited from the service. Telemonitoring NI is a great example
delivery of Transforming Your Care (TYC) and fits with direction of Making Life Better framework for public health with the focus being on the needs of the individual, empowering and educating them so that they can take control of their
making a positive impact on the lives
Lesson: Political Support for Building on Success
Health Minister Hamilton Visits Telemonitoring NI Centre at Fold
Mr Hamilton said, “The opportunity to speak to staff here at the centre has given me a much clearer insight into how the service operates and interacts with clients
provides gives patients and their carers reassurance, as well as more confidence in managing their conditions. There can be no question that in the context of our ageing population, we need to be maximising the potential of solutions such as telemonitoring, telecare and other assistive technologies which can support independent living. To be fully effective in this, we need to work in partnership with
councils and the community and voluntary sectors.”
4th March 2016
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Lesson: Political Support is Key
New Secretary of State Visits Fold Housing Association on NI induction tour 22nd August 2016
Lesson: Political Support for Building on Success
02 November 2016
During a tour Minister O’Neill commented: “Looking ahead, technology will be a critical enabler in delivering the change set out in ‘Delivering Together’, my ten-year vision for the HSC. Having seen for myself how the service operates, I can understand how the continuous, personalised care which it provides helps to keep patients more engaged and focused on their wellbeing.” By fully embracing the potential of technology, I believe that we can shape a more effective and sustainable health and care system for the future.” O’Neill visits Telemonitoring NI Centre
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Referral Activity – from OSC
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Referral Activity – FY Yearly Comparison
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Activity : Patients Actively Monitored
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Monitored Patient Days
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Length of monitoring 2014/2017
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Triage Activity 2014/2017
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Expected Outcomes – trend over time
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Regional Outcomes
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Outcomes – COPD
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Outcomes – Diabetes
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Outcomes – Heart Failure & Stroke
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Lesson: Engaging Patients
Results from a 100 Patient Survey (2014)
www.telemonitoringni.info Key Lesson: Defining Success September 13 2017 - Donna Cusano Telecare Aware
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The HSC Public Health Agency for Northern Ireland and Queen’s University Belfast have released an evaluation of the six-year (2011 – 2017) Remote Telemonitoring Service for Northern Ireland (RTNI). The Northern Ireland findings were at best equivocal. While the qualitative data gathered from patient, carer, and clinician focus groups and interviews were positive in terms of engagement and on reassurance–to be able to carry on with their lives as usual–the quantitative data did not confirm gains in effective care. Although there were a number of testimonials from the participants in the patient focus groups regarding reduced hospitalisations and a reduced need to attend outpatient clinics, this did not carry through to the data obtained in the effectiveness aspect of the current evaluation. In general terms, the number of hospitalisations, length of hospital stay and outpatient clinic attendance (and therefore overall cost of healthcare provision) did not differ between the quasi-control ‘never installed’ group and any of the groups who received some amount of telemonitoring.
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Key Lesson 1: Choose Your Leaders……
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KeyLesson 2: Shared Vision/Defined Success E Health – is Education, Empowerment Building Trust & Confidence – Politicians & Expert Panels/Advisors – Front-line Health & Care Professionals – Patients, Clients, Carers
Key Lesson 3 : Keep Stepping……
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And Finally: Remember to say…