paul-marriott-presentation
TRANSCRIPT
Innovative Telehealth Programme Across NHS
Northern Senate
Paul Marriott TECS Lead Consultant NHS England Strategic Clinical Networks.
AHSN NENC Telehealth Programme Lead
What We Aimed to Achieve at the Outset
• Test our Multi-Matrix Model of Telehealth as a Means of Expanding the use of Telehealth within the Whole Life Spectrum of Health Care
• Evaluate the Patient Outcomes and Health Economics of the Multi-Matrix Model of Telehealth in Pregnancy Services Across Multi Partner Foundation Trusts in Conjunction with Kim Hinshaw and clinical colleagues.
• Develop the Potentials for the Model to expand Telehealth into a wide number of Clinical Pathways gaining traction and acceptance with clinicians across the North of the Country.
• Demonstrate the potential for the model to be expanded across the UK in the delivery of the NHS Quality, Innovation, Productivity and Prevention (QIPP) Agenda.
Optimum Health
Good Health
Average Health
Signs of Illness
Chronic Illness
Irreversible Illness
Death
Wh
ole
Lif
e P
ers
pe
cti
ve
Conception
Death
The Multi Matrix Model Seeks to Cross “The Whole Life Perspective”
Telehealth Clinician Led Not Procurement Led in it’s Design
“Practitioners are bloody minded and practice their own medicine
following their beliefs and clinical training. If something does not fit
with their medicine then they will simply not follow it.”
Dr Hussien El Shakankery GP
SCCG Urgent Care Clinical Lead
Engage the Clinicians in the Multi Matrix Model
The customer needs or wants are listed on the left
Needs/wants are ranked numerically in order of importance to customer
How these needs/wants can be delivered are listed
Scores are totalled, Needs plus how and a ranked Set of needs and how to fulfil them emerges
Using the Quality Tool Quality Function Deployment (QFD) the Needs and
Wants of Clinicians and Patients are Matched with Functions
Annual Average Cost Per Patient by Generation of Equipment
Equipment
Type
1st Year
Capital
Purchase
Cost
Annual
Leasing
Cost
Annual
Maintenance
Cost
Total
1st Generation
Purchased System
£2000 £1000 £3000
2nd Generation
Leased System
£1150 £1150
3rd & 4th Generation
Rapid Deployment
Leased System
£365 £365
SMS Florence
System
NHS Owned
£45 £29 £74
NHS QIPP Requires Low Unit Costs as a Benchmark
NHS Florence SMS Simple Telehealth System
SMS
Prompts and
advice GP Practices
Specialist Clinicians
Community and
Specialist
Nursing
Public Health
And the 3rd Sector
Local Authority Control Room and Adult Social Care
NHS Florence Simple and Instinctive NHS Florence Simple and Instinctive For Patients Who Cannot Use SMS There is a WHZAN Solution
Mobile Cardio Monitoring
Integrating Telecare
Control Rooms with
Telehealth Platforms
Multiple Technologies, Multiple Pathways, Multiple Patients and Clinicians
Remote Wound
Monitoring
Condition Clinical Lead
Heart Failure, Angina etc. FT, GP
COPD and Respiratory etc. FT, GP
Hypertension GP
Diabetes FT, GP
Gestational Diabetes FT
Type 1 Kids T1KZ FT, GP and 3rd Sector
Parkinson’s FT
Rapid Discharge FT
Carers Pathway GP, LA & PH and 3rd Sector
Acquired Head Injury and Stroke FT, GP
Primary Care Step Up Step Down GP
Care and Nursing Home GP, LA
Weight Management FT, GP, LA & PH
Smoking Cessation LA & PH
Remote Wound Dressing Monitoring FT
Community Matron Case Load FT
Alcohol Induced Morbidity FT, GP
FT = Foundation Trust GP = General Practitioner LA & PH = Local Authority & Public Health
Some of the Current Pathways within the North East and Cumbria Programme
(there were 143 at the end of March 2015 and there are now over 180)
Expand and Widen the Number of Telehealth Pathways and Clinicians
The Innovative Telehealth Programme has 9 Regional Florence Telehealth
Licenses in Operation!
Evaluate Health Economics and Patient Outcomes
Kim Hinshaw has presented earlier our Evaluation of Telehealth Monitoring in
Pregnancy Using a Multi Matrix, Multi Partner Model.
COPD Patient “I am much better now as I am using
02 readings to prompt using oxygen I feel my
condition is more controlled now.”
COPD Patient “I like the reminder text as I would forget. Prompts me to think about doing my
breathing exercises when readings are low. I like the
freedom of doing the reading more often.”
Heart Patient “Its easy to use and my son helps with the readings. Its
great we can now go to family members for
example at Christmas and continue to do readings.”
Young Diabetic “I Don’t have to come in every
week now which is much better I have a busy life
and that helps as I have a another child which I needed to get looked
after. Costs me £8 on bus to attend each
appointment at clinic.”
Middle Aged Diabetic “Really happy with the
service. It’s a combination of exercise programme
and monitoring my health my control is far better
now”
Community Nursing Patients
Feed Back
Finally In Summary What Have We Delivered During This Project
• 143 Clinical Pathways delivered by March 2015 and over 180 delivered to date
• Working in 6 Foundation Trusts
• 25 Hospital Departments
• 12 Community Clinical Teams
• 6 CCG’s
• 128 GP Practises
• 4 Local Authorities
• Two 3rd Sector Organisations and Type 1 Kids (T1KZ) Rapidly Expanding Regionally
• 4 Community Health Groups
• 7 Nursing Care Homes
• Over 700 Clinicians involved
• US Department of Veterans Affairs Adopted our IP
• Pregnancy Services Telehealth Pathway adopted in 5 FT’s with a further 6 nationally
wishing to also implement.
• Health Economic Evaluation completed in Pregnancy Services with potential savings
being evidenced across the NHS and whole health economy (High Level Figures
published by Kim Hinshaw 11th Sep 2015 and a Future Open BMJ Paper Likely)
1st
Generation
Telehealth
2nd
Generation
Cloud Based
Telehealth
3rd Generation
Mobile
Telehealth
4th
Generation
Linked to
NHS Spine
5th
Generation
Wearable or
Ingestable
Technology
And Beyond
A Final Thought the About Ascent of Innovative Telehealth in NE&NC
Contact Details
Paul Marriott
TECS Lead Consultant NHS England Strategic Clinical Networks.
AHSN NENC Telehealth Programme Lead
NHS England Northern Senate
Waterfront 4, Goldcrest Way
Newcastle upon Tyne, NE15 8NY
Mob: 07779816519
www.england.nhs.uk
AHSN North East North Cumbria
Biomedical Research Building
Campus for Ageing and Vitality
Nuns’ Moor Road
Newcastle upon Tyne
NE4 5PL
www.ahsn-nenc.org.uk