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Simple Telehealth

5. Reflect on how well prepared you are to start using Flo telehealth for your patients

 

5. Reflect on how well prepared you are to start using Flo telehealth for your patients

Learning and service outcomes – you will be able to:

  1. Identify and address gaps in understanding and preparedness/motivation as an individual practitioner and practice team.
  2. Recognise the importance of motivation to trigger and sustain behavioural change in patients – as relayed by telehealth delivery.

Train the team: invite your CCG’s clinical telehealth facilitator to run a learning session for your team. They will help you to finalise your practice action plan, learn how to sign up patients for your selected clinical protocols, enrol your clinicians onto the system, answer your queries. They can signpost you to another practice where Flo telehealth is already underway and patients are obviously benefiting.

Various research and evaluation studies generally indicate that integrating telehealth and telecare into any team working requires good leadership, targeted upgrading of working practices, skills and development, and data management.10-15

Selecting patients: each patient must fit the selection criteria for the protocol. They must have access to a mobile phone, give you their current phone number and be capable of operating texts (or their carer be willing to do so on their behalf). They will need appropriate cognitive ability to understand any jointly agreed management plan; take readings (e.g. BP) and text in the result. They must not require daily triage in relation to their health condition for your GP setting (telehealth is still possible if patient is overseen by a community nursing team who have the capacity to monitor telehealth data on an at least daily basis and respond with home visits if patient is critically unwell). They must be aware of the frequency of the text messaging that is part of the protocol and agree to this.

Equipment: if any further equipment is needed it must be readily available, validated and reliable; and the patient should be confident about using it – see Flo resource pack for clinicians, pages 8 and 51 (click here).

Patient motivation: the patient must be willing to engage with Flo telehealth for the length of time for the selected protocol (e.g. one week if initial high blood pressure, but up to 2 months for poorly controlled hypertension). If you are using Flo to improve the patient’s adherence to medication or improved lifestyle habits they must be ready to change or at the pre-contemplation stage (see Figure 1).16 Behaviour change is not a linear movement through these stages of change. It can be progressive, regressive, spiralling or static; people may skip one or more stages or stick in one for a long time.

It is essential to choose an appropriate time to motivate a person to change, such as from risky habits to a healthy lifestyle. Hopefully, individuals pass through the stage of contemplation and onto the stage of taking action for themselves. You should set realistic targets for that change that are achievable so as not to demotivate the person or allow them an escape route ("I knew I couldn't do it."). It can be difficult to assess what stage someone is in - especially if you are pressed for time. You can make assumptions and mistakenly rate someone as being ready to change, so the more you can involve the other person in rating where they are themselves, the better. Flo will help to sustain change by persistent reminders and confidence boosting information messages. Their increased understanding of their condition will sustain their willingness to adhere to the agreed dual management plan.

Promote the opportunity to be signed up to Flo telehealth by displaying posters in the waiting room. A patient success story will engage other patients’ interest- maybe via your Patient Participation Group or practice newsletter.

Dual management plans: look at the dual management plans we offer for you and other clinicians to agree with your patients in the Flo resource pack for hypertension (pages 41-46). Select the one to adopt or adapt as your own practice dual management plan for protocols 2, 3 and 10. If you are focusing on asthma (page 47) adopt or adapt the dual management plan on offer for protocol 4 or protocol 5. (hyperlink 1) These will be owned by your practice, so the contents must be revised to fit with your own practice clinical management protocols.

CPD F1

Figure 1 Cycle of Change

Question1So has your practice team agreed to adopt and adapt the dual management plans on offer? Are you each able to motivate patients to adhere to their agreed plans and move them round the cycle of change by motivating them to attain improved health outcomes? Can you see how Flo can help you do this?

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