Telehealth: a new paradigm in patient-focused care?

Practice

Joan Pons Laplana, RGN, Telehealth FLO Clinical Lead NHS Arden & Greater East Midlands Commissioning Support Unit.

Proud Nurse, NHS Change Day Hubbie and Care Maker

Florence telehealth

Technology will play a key role in a ‘healthy state’ NHS, both for patients and the public, and for the system.   We are living on a 21st century society where communication is fast and accessible; however, our NHS still using technology from 25 years ago.

As John Lennon said “Call me a dreamer but I am not the only one”.  NHS England clearly commits to this in its Five Year Forward View [1].   This sets out a clear direction for the NHS, showing why change is needed, and emphasises that patients need to gain far greater control of their own health.  The NHS is making the commitment to do more to support people to manage their own health, staying healthy, making informed choices of treatment, managing conditions and avoiding complications.

I am a firm believer in this vision.  Person-centred care is my passion.  Making a difference is what motivates me to get up every morning and go to work with a smile.  I am on a mission to turn the healthcare system upside down and empower frontline staff and patients to lead together in achieving better health outcomes.

New technology

The past decade has seen rapid development and adoption of technologies that change the way we live.  The NHS needs to start using these new technologies and embrace the new opportunities that they bring for our health and care system: improving the accuracy and usefulness of information we can gather on our health; changing how and where care is delivered; and offering new ways to prevent, predict, detect and treat illness. 

Telehealth is the way forward and is emerging as a critical component of the healthcare crisis solution. Telehealth can change the current paradigm of care and allow both improved access and improved health outcomes in cost effective ways whilst increasing access to healthcare, reducing healthcare costs and improving support for patients and families.  What’s not to like it?   It’s a win win!!

Empowering patients is my passion and when my CCG advertise for a Telehealth Flo Clinical lead I jumped out to the occasion [2]. Since my appointment in July last year,  I have been travelling all over North Derbyshire to meet practices, attend local health meetings and public and patient engagement events to show how Flo can both empower patients and save nurses and GPs’ valuable time.

Flo is currently being used all over the country, enhancing the care of 30,000 patients in over 70 health and social care organisations. Its use:

  • saves precious clinical time
  • saves NHS money
  • improves clinical decision making and intervention
  • reduces appointments

Most importantly, makes it possible for patients to take greater control and ownership of their condition, improving their quality of life.

The roll out in North Derbyshire is still in its infancy, but already we have over 200 GP patients registered (from 21 GP practices with another 21 practices planning pilots in coming weeks) and a similar number of  patients registered from the DCHS Community Diabetes Specialist Nurse (DSN) Team. Its impact and promise has been recognised through being shortlisted for the ‘innovative use of technology/social media’ at the  Patient Experience Network national awards .

Benefits of Flo

The benefits for me are obvious. Flo is a very simple mobile phone technology which uses a texting service to help patients self-manage any conditions or health issues they have. Gradually, people understand and manage their condition more confidently or improve their health issue or lifestyle habits. The benefit to their local GP practice is that by managing their condition better they don’t need to consult their doctor or nurse so often which saves the NHS time and money.

Flo is designed to work around the patient. All a patient needs to use Flo is a basic mobile phone. They can text their readings in when it’s convenient and receive advice almost immediately.

Flo was designed by professionals within the NHS to provide clinically approved remote support and guidance to patients inbetween clinician contacts. Flo is free for patients (while they are in the UK) and has a range of functionality which can help them. The system requires limited monitoring by clinicians as messages are designed to be automated and clinicians can be alerted when a patient’s readings cross a pre-determined threshold.

One of the things I love more of being a Nurse is the contact with the patients and when I started my new job I was worried that I would lose this contact and wouldn’t be able to make much difference, but thankfully I was wrong. Now I can have a bigger impact. It has given me a chance to carry on making improvements to how care is delivered on a larger scale.

Part of my role is to analyse the impact that Flo is having. I do this in part by colecting patient stories.  Seeing how Flo is transforming lives it’s a really euphoric feeling.

Flo has transformed Brenda Greaves life; it allowed her to take control:

"Flo has helped to tighten the control I have on my diabetes and check my blood levels more regularly. I am thrilled that I have been able to stop injecting insulin. It took me 2-3 weeks of regular monitoring using Flo before I was told that I could stop taking insulin because I had control over my blood glucose levels.” 

Lois Henson uses Flo to remind her to take her Parkinson's disease medication every two hours:

"It’s been great. Both my husband and I can switch-off a bit more because Flo is now taking charge of the reminders. When James and I found out that a simple text message service could possibly help us to manage things with a little less effort we were all for trying it straight away.  Something so simple has made the world of difference to us both. It’s a godsend.” 

Chris Pettett, a grandfather to seven, ranging in age from 18 months to 17 years, uses Flo to help him manage his diabetes. For him, Flo means:

"I’m being monitored on a regular basis instead of going to the doctor for a check up on a less frequent basis.”

Conclusion

I believe there are three key elements that make Flo a successful tool:

  • It’s simple for patients and clinical staff to set up
  • it is flexible in that it can easily be adapted to meet the specific needs of each individual patient
  • it gives patients an active role in managing their condition

Joan concludes:

I love what I do, and that is priceless. I’m on a mission to turn the NHS upside down and empower patients and frontline staff to the way.