The Bristol-based practice has successfully integrated telehealth into its CHF service, to provide more preventative support within the community setting, help avoid hospital admissions and reduce some of the burden on secondary care providers whilst providing a cost-effective model of care for the management of the condition.
GPs at the Orchard Medical Centre have liberated valuable additional resource and have reported reduced hospital admissions for some of the CHF patients since deploying the telehealth solutions.
In the case of one patient who had severe heart failure and a history of poor medication compliance, the telehealth monitor enabled GPs to view the direct link between poor medication compliance, weight gain and low oxygen saturation. This was remedied with the aid of telehealth as the patient could see for herself the importance of taking her medication. Telehealth also resulted in a dramatic improvement in another patient with severe heart failure who has not had to use out-of-hours health services in the 18 months since using the monitoring equipment, where previously she had been in and out of hospital four times in a nine-month period.
Clearly from this example telehealth has the potential to reduce costs, which is even more compelling when CHF is becoming an increasing burden in an ageing population, and the annual cost to the NHS is £600m. According to the British Heart Foundation, inpatient care accounts for 60% of heart failure care; with average admissions approaching two weeks, and so keeping patients out of hospital and supporting them within the home environment through telehealth has the potential to deliver significant resource and budgetary savings.
Telehealth has proven valuable in identifying trends such as change in body weight at an early stage to enable early intervention, and also in providing support to patients who find it difficult to visit the surgery. Patients have found the solutions easy to use, resulting in increased medication compliance and a resulting improvement in quality of life.
According to Dr Richard Berkley, clinical lead on the telehealth project: "Telehealth keeps people where they want to be, and that's at home with their family. Patient acceptance of telehealth is high; daily monitoring has enabled more accurate titration of patient medication, and also gives patients valuable reassurance, keeping them calm and reducing the risks of exacerbation and of hospital admission.
"Clinical contact with the district nursing team has actually increased as a result with patients taking greater interest and increased responsibility for their condition. The reassurance of self-monitoring has also helped to boost medication compliance, which in turn is thought to have helped to avoid unplanned emergency admissions and has helped to keep patients safe and well within the home environment."
The GP practice deployed RTX telehealth solution from leading provider Tunstall Healthcare to carry out remote health monitoring; this is where the telehealth solution prompts patients, in this case with CHF, to take their vital signs and to answer health-related questions at a pre-set time each day. By using the telehealth it has lessoned the need for patients to visit the GP practice or hospital and also to better understand their own healthcare, improving their condition and lifestyle.
Tunstall's RTX telehealth monitors are used with medical devices including weighing scales, blood pressure monitors, peak flow meters and ECG monitors that connect via serial port, infrared or Bluetooth to collect and transmit the patients vital signs and related health information. The District Nurses at the practice then securely access the data to make informed and timely decisions about patient health and well-being, working closely with the doctors.
The positive results reported by The Orchard Medical Centre reflect the growing acceptance of telehealth as a means of enabling trusts to support a greater number of patients, improving outcomes and making the best use of available resources.
The telehealth project was a joint venture between NHS South Gloucestershire and South Gloucestershire Council community care & housing department, and was funded by a technology grant from the council together with three years project support from Takeda UK Ltd. As a result of the success of the project, the Orchard Medical Centre is looking to expand the use of telehealth within Gloucestershire, through closer involvement and collaboration with other local GP practices.
The full case study on The Orchard Medical Centre is available at www.tunstallhealth.com.
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- Tunstall's Profile
Tunstall Healthcare Group is the market leading provider of telehealthcare solutions, with over 2.5 million users globally. Tunstall's solutions support older people and those with long-term needs, to live independently, by effectively managing their health and well-being. Tunstall provides technology, expertise and advice to millions of people enabling them to lead independent more fulfilling lives. For more information on how telehealthcare can improve quality of life, visit www.tunstallhealth.com.