Cross-Cutting Telehealth Programme

Paul Marriott TECS Lead Consultant NHS England Strategic Clinical Networks.

TECS Clinical Advocate to NHS England &

AHSN NENC Telehealth Programme Lead NENC

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AHSN Programme of Cross-Cutting Themes

• Respiratory \ COPD• Fractures• Mental Health• AF• Medicines Optimization• Elderly Care

We are seeking to use new and existing technology to innovate, pioneer and ultimately share with the health economy what we learn in using Technology Enabled Care Services (TESC) in the pinch points within these and many other clinical pathways across the North East and North Cumbria.

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Paul Marriott TECS Lead

Liz AllanPathway and Communications

Rachael ForbisterSunderland CCG Pathway

Development

Jackie SmartFlorence Application

The Resource and Team

Tripartite Programme and Partnership

North England TECS Capability

Cross-Cutting Telehealth Programme

What is Technology Enabled Care Services TECS?

• Telehealth is the delivery of healthcare at a distance using electronic means of communication usually from service user to clinician e.g. a service user measuring their vital signs at home and this data being transmitted via a Telehealth monitor to a clinician

• Telecare is the continuous, automatic and remote monitoring of real-time emergencies and lifestyle changes over time in order to manage the risks associated with independent living

• Telemedicine is the delivery of healthcare at a distance using electronic means of communication – usually from one clinician to another e.g. a non-specialist GP undertaking an ECG on a patient suspected of heart disease and the transfer of that data electronically to a specialist clinician for discussion/comment.

• E-Health is health services, information and education delivered or enhanced through the internet and related technologies. E-Health encompasses Telecare, Telehealth and Telemedicine

• M-Health is Mobile health monitoring where a patient can be monitored away from home via mobile technologies 3G SMS and 4G and Apps

Whole System Demonstrator 1st & 2nd Generation Telehealth

2nd Generation Telehealth Added Cloud Services

Telehealth Clinician Led Not Procurement Led

“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 GPSCCG Urgent Care Clinical Lead

Optimum Health

Robust Health

Good Health

Average Health

Signs of Illness

Chronic Illness

Irreversible Illness

Premature Death

Wh

ole

Lif

e P

ersp

ect

ive

Conception

Death

The Multi Matrix Telehealth Model Seeks to Cross the Whole Life Perspective by Proportionally Matching Telehealth Systems with the Patients Needs, Lifestyles and the Clinicians Medicine.

NHS Florence SMS Simple Telehealth System

SMS

Prompts and adviceGP Practices

Specialist Clinicians

Community and SpecialistNursing

Public HealthAnd the 3rd Sector

Local Authority Control Room and Adult Social Care

NHS Florence Simple and Instinctive NHS Florence Simple and Instinctive For Patients Who Can Not Use SMS There is a WHZAN Solution

Annual Average Cost Per Patient by Generation of Equipment

EquipmentType

1st Year Capital

Purchase Cost

Annual Leasing Cost

Annual Maintenance

CostTotal

1st GenerationPurchased System

£2000 £1000 £3000

2nd Generation Leased System

£1150 £1150

3rd & 4th Generation Rapid Deployment Leased System

£365 £365

SMS Florence SystemNHS Owned

£45 £29 £74

Example of Current Telehealth Pathway Costs

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Pregnancy Induced Hypertension £1.20 First Week Subsequent Weeks £0.96p P/P

Gestational Diabetes £4.72 P/P

Condition Clinical Lead

Heart Failure, Angina etc. FT, GP COPD and Respiratory etc. FT, GP Hypertension GP Diabetes FT, GP Gestational Diabetes FT Pre Pregnancy HbA1c Family Planning FT Parkinson’s FT Rapid Discharge FT Deprivation Medicine and Social Prescribing GP and 3rd Sector Acquired Head Injury and Stroke FT, GP Primary Care Step Up Step Down GP Care and Nursing Home GP Weight Management FT, GP, LA & PH Smoking Cessation LA & PH Remote Wound Dressing Monitoring FT Community Matron Case Load FT Alcohol Induced Morbidity FT

FT = Foundation Trust GP = General Practitioner LA & PH = Local Authority & Public Health

Some of the Current Pathways within the North East Programme (there are now over 150)

Some the Recent highlights: Over 150 live pathways developed spanning from Breast Feeding and Gestational Diabetes to COPD, HF and End of Life. Pregnancy Services commenced at City Hospital Sunderland and the pathway is now live in 5 FT’s in the NE with 8 further FT’s scheduled to adopt the pathway and system across the UK in Summer 2015. A recent CQC Report at City Hospital Sunderland published 25th January 2015 stated that the “Telehealth Services were adjudged as Outstanding.” “The use of the Tele-health system in maternity services enabled women to monitor blood glucose levels and blood pressure in their own homes avoiding unnecessary visits to hospital.”

CQC City Hospital Sunderland January 2015 There has also been a cost saving in clinical practice identified with Pregnancy Services of around £200 per patient per week. Patient satisfaction survey shows between 98% and 100% approval.

Potential Test Bed Status

Bringing the Partnership Together of Multiple Organizations Across the North

And

Combining the TECS I.P. of County Durham and Darlington NHS Foundation Trust with its INR and Nutrition Programmes with that of the NHS England and AHSN NENC Telehealth Programme we have a huge head start.

1st GenerationTelehealth

2nd Generation Cloud BasedTelehealth

3rd GenerationMobile

Telehealth

4th Generation Linked to NHS

Spine

5th Generation Wearable

Technology

And Beyond

A Final Thought About Ascent of TECS in NE&NC

Contact Details

Paul Marriott TECS Lead Consultant NHS England Strategic Clinical Networks. TECS Clinical Advocate to NHS England &AHSN NENC Telehealth Programme Lead

NHS England Northern SenateWaterfront 4, Goldcrest WayNewcastle upon Tyne, NE15 8NY

Mob: 07779816519paul.marriott@nhs.netmarriott.p1@sky.comwww.england.nhs.uk

AHSN North East North CumbriaBiomedical Research BuildingCampus for Ageing and VitalityNuns’ Moor RoadNewcastle upon TyneNE4 5PLwww.ahsn-nenc.org.uk

Workshop Activity

• Can you think of your area of work and specialism and write down the “Pinch Points” or areas you think could benefit from the use of TECS (Telehealth)?

• Can we now use the remaining time to discuss your thoughts?