Transcript Kent TeleHealth Evaluative Development Pilot

Kent TeleHealth
Evaluative
Development Pilot
Matt Rye
Evaluation
Supervisor
What is Telehealth?
V500
Camera
Thermometer
ECG
Blood pressure
30
9
Pulse O22
Digital Scale
Blood sugar
Stethoscope
It is a Chronic Disease Management Tool
Self – Managing
Chronic Obstructive Pulmonary Disorder (COPD), Type 2 Diabetes, Heart
Failure (HF)
Vital signs measured
Blood pressure, Blood oxygen, Blood sugar, Weight, Peak flow and
temperature.
Using:
User friendly interfaces.
 Simple telephone connection to the provider via the web.
 Customisable, personalised scheduler, reminder and alarm.
 Reporting tools include tracking and alerts.
 Disease management questions and answers.
 Send advice messages to the client.
Benefits
Service Centred
Patient Centred
Additional diagnoses
Improved quality of life
Fewer exacerbations
Early interventions
Improved case/load management
Reduction in ad hoc acute care
Reduced anxiety/increased confidence
Reactive Care
Pro- Active Care
Key: Patient Benefit ClinicianBenefit
GP Model
GP
practice
Test group 1
8 patients
Test group 2
7 patients
Totals
GP site 1
7patients
GP site 2
8 patients
Totals
Combined
Totals
Without
TH
1686
956
2642
1872
2442
4314
6956
With TH
1623
792
2415
1119
2506
3625
6040
Saving
63
164
227
753
+64
689
916
Secondary Care
Without
TH
17193
8652
25845
20737
22966
43703
69548
With TH
3435
1216
4651
6111
4251
10362
15013
Saving
13758
7436
21194
14626
18715
33341
54535
£ Total
21421
£ Total
34030
55451
6 month period pre vs post intervention.
Shepway
A reduction in GP/patient consultations by 40% was
observed post TeleHealth installation. This is specifically
in face to face consultations.
A reduction in GP/patient telephone activity of 45% was
observed post TeleHealth installation.
In monitoring these 28 service users, 22 changes to
medication resulted from TeleHealth readings.
10 exacerbations were managed in the service users
home.
Readings led to 2 additional investigations being carried
out.
Bed days dropped from 220 in the preceding 3 months
to 30 in the following 3 months. This is an 85%
reduction.
Extended Shepway
results
870 emergency bed days were used in the 12 months prior to
being accepted onto the caseload.
.
Subsequently that usage dropped to 85 bed days post matron
involvement.
To put this into context, our records indicate we have
managed in excess of 50 exacerbations which arguably could
have resulted in a hospital admission hospital.
As a result using the cost of an average bed day of £200
taken from NHS reference costs;
Prior to Matron involvement - £174,000
Post Matron involvement - £17,000
Saving of £157,000
Case Study
Female aged 84
6 admissions in the previous year
PMH: I.H.D., A.F., T.R., Type 2 Diabetes, R Heart Failure,
awaiting pacing.
TeleHealth used to identify that as little as 1.5kgs
of fluid overload as a significant threshold for
patient to throw off arrythmias.
Monitoring her weight, BP and renal function we
have successfully titrated diuretics several times
to avoid potential admissions.
TeleHealth data used to identify sensitivity to betablockers
after titration of Bisoprolol 2.5mgs to 3.75mgs. Pulse rate
dropped to 41.
Case Study
Male aged 49
5 admissions in the previous year
PMH: I.H.D., C.V.A., Hyperlipidaemia, M.I.x2, Angina,
Uncontrolled Hypertension, Parkinsons, Depression.
Within 2 weeks of going onto the TeleHealth kit his
systolic have fallen from 190mmhg to 140mmhg and
diastolic from 120mmhg to 80-90 without any titration
of his antihypertensives.
His Consultant Stroke Physician feels that this is
attributed the TeleHealth monitoring leading to a
reduction in his anxiety.
1 admission as a result of a fall though TeleHealth readings
used to gain prompt discharge.