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Unprecedented enthusiasm for telehealth in Notts

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Unprecedented enthusiasm for telehealth in Notts

Jayne Birch-Jones talks about the engagement process that put GPs centre stage and generated overwhelming pull for telehealth. As Jayne says when describing the impact of her model.... "No I'm not kidding, honestly its true!"

A nurse, turned health informatics professional turned Programme Manager, I work as the Assistive Technology Programme Manager for Productive Nottinghamshire.  We are a Health and Social Care Community Wide Programme which aims to make QIPP savings by working together across the whole County.  In April 2012 when we established our workstream, our only implementations of telehealth in Nottinghamshire had been a couple of pilots, which hadn’t really gone anywhere.

Choosing the right solution

In June 2012 we ran an accelerated design county-wide event (ADE) with support from the NHS Institute.  The event aimed to answer the question “How can Telehealthcare support your care delivery?”.  The event was based on the “scan, focus, act” model.  During the “scan” sessions, patients, clinical¸ social care, managerial and commissioning staff heard about different telehealth and telecare systems by attending several short “speed dating” presentations.

The “Focus” session saw attendees excitedly sharing their views of the presentations and deciding what was felt to be the most appropriate approach for Nottinghamshire.  During the final “Act” session, individuals made 60 day pledges in terms of how they would help to implement and drive actions to progress the agreed way forward for telehealthcare in Nottinghamshire.  These pledges enabled me to keep in regular contact with staff, who have been instrumental in helping to implement a simple telehealth solution across our County which saw its 1st patient enrolled within six months of this event.

GPs and nurses make clinically appropriate choice

To follow on from the event, we held a clinical workshop to assess the chosen telehealth system in more detail.  This created a lot of enthusiasm and GPs and nurses were keen to sign up.  We were conscious that there were other clinicians, unable to attend, so we undertook a two week email consultation exercise with all GP’s, providing them with summary information about the system, a list of frequently asked questions and responses and asked for expressions of interest.

Clinical leadership creates "pull"

The enthusiasm and interest of our GP’s and other Clinicians in telehealth has been unprecedented.  We have been overwhelmed by requests for demonstrations, which are translating into significant numbers of implementations.  Heart failure, COPD, appointment reminders, hypertension and diabetes to name but a few.  We started our Telehealth Programme in late August 2012 and by November we had our 1st patients signed up, using telehealth.  Within the first month, at least one hospital admission had been averted.

Independent telehealth user event

In January we had our first telehealth user event.   Six months down the line, we had 22 staff all in a room talking about telehealth, sharing their case studies and talking about how else they could use it to support clinical care and patient self-management. The conclusive headlines of the day included “Flexi Flo”, “Keep it simple – let’s do it!” “Adaptable to any patient pathways, no real barriers”

Clinicians make the choice and keep it simple

Why has our clinical engagement been so successful?  Well, that will be because this project has been truly clinically led:-

  • We have a Clinical Lead who is a GP and is a self confessed telehealth sceptic;
  • At our Community wide event, clinicians made the choice of which telehealth solution to use;
  • Following a telehealth clinical workshop, we offered to visit GP practice meetings to provide demo’s and give more information about the solution;
  • For those clinicians who could not attend the clinical workshop, we carried out an email consultation, concentrating on the benefits of using Flo for Practices in terms of productivity gains, increased self reported information, reduced home visits and clinic appointments without reducing patient contacts;
  • Clinicians choose what they want to use Flo for and identify the benefits and outcomes they want to achieve.

We have been overwhelmed with interest and the rest is history as they say!     Since August we have been invited to present at 31 different clinical meetings.  Our first cohort of heart failure patients began using Flo, just 4 weeks after a one hour meeting to demonstrate and discuss Flo!    By the end of March 2013, we will have 250 patients using Flo. This achievement is due to the fantastic engagement and support we have had from our clinicians who can see, because of its pragmatic, patient centric design, the benefits of using Flo and we are looking forward to developing more clinical protocols in line with the new Direct Enhanced Service and CQUIN requirements!

For more information about our clinical engagement approach, don’t hesitate to get in touch,

Jayne.Birch-Jones@mansfieldandashfieldccg.nhs.uk

Feb 18th, Jayne Birch-Jones