Delivering

Technology-Enabled

Health and Care Services

Katy Lethbridge

UK Sales & Client Services Manager

TELEHEALTH SPECIALIST

Technical innovation

and development

led by clinical

need and expertise

REMOTE CARE SPECIALIST

In-depth clinical and

operational expertise

in telecare, OOH and

SPOA services

INTEGRATED CARE SPECIALIST

Comprehensive, flexible telehealth & telecare

services

Scalable clinical triage & case-management with

approved protocols

ISO 9001. ISO 13485 Design and Delivery of

Medical Devices

TSA Platinum Member & Integrated Code of Practice

CQC Registered

Delivering Technology-Enabled

Health and Care Services

Meeting the Challenges

Demand Perceptions Engagement

Service Transformation Evaluation

Cost Scalability Integration

DEMAND

The Health & Social Care Challenge

Cost - £70bn per annum

COPD is the fifth leading

cause of death in the UK, and

fourth worldwide

COPD is the second largest

cause of emergency

hospital admissions in the

UK

COPD accounts for more than 1 million bed days

each year in hospitals the UK

The direct cost of COPD to the UK

healthcare system has been estimated to be between £810- £930 million a year. More

than half of these costs relate to the provision

of care in hospital.

Heart failure accounts for 1

million in-patient bed

days

This is set to rise by 23% in

the next 25 years

15.4 million people in England

suffer from at least one Long Term Condition, that’s almost one

in threei

Around 900,000 people in the UK

have heart failure, and just

as many may be undiagnosed

PERCEPTIONS

Negative perceptions

WSD Lack of relevance to today’s technologies & systems

Simple intervention v programme of service improvement

Unrealistically high costs – no disinvestment

Inability to assess self-care behaviour

Fears Job losses

Interference with care relationship

Increased isolation

Technophobia

Technology Traditional technology provision

Proprietary systems

Deployment issues

Data overload i

ENGAGEMENT

Key Engagements

Commissioners

Commissioners & collaborators

committed

Key influencers engaged

Requirements

agreed

Clinicians

Clinical leads identified

Local clinical teams actively

involved

Key clinical areas and local

pathways agreed

Programme Leads

Collaborative programme

managementdeveloped

Local implementation

trajectories agreed

Evaluation and review

embedded

Frontline Staff

Staff consulted & frontline

requirements understood

Barriers and fears addressed

Referral culture embedded

i

SERVICE

Telecare Service

Telecare is a pro-active service which:

• Assists people to live longer in their own home

• Maintains or increases independence

• Improves safeguarding for vulnerable people

• Provides reassurance and support to family, friends

and carers

• Reduces Ambulance Service call outs

• Reduces cost of care packages

• Reduces admissions to hospital

• Reduces admissions to residential care

TelehealthService

Patient engagement

Clinical engagement

Monitoring & clinical triage

Clinical case management

Project Management

Configuration & Optimisation

Technical Triage & Support

Telehealth - a pro-active service which:

• Enables early detection of symptoms

• Allows early intervention

• Avoids unnecessary hospital admissions

• Avoids unnecessary GP appointments & visits

• Ensures follow up and case management

• Allows a larger number of patients to be managed by one nurse

• Releases provider teams to focus on those with greatest need

i

SERVICE

TRANSFORMATION

Service transformationCase study – Ayrshire & Arran Telehealth

Collaborative partnerships

• Project facilitates closer working relationship between NHS Ayrshire and Arran and Local Authority staff in the joint management of COPD

• Streamlined care pathway, increased awareness, reduced duplication of assessments

End-to-end service

• Early discharge programme using HomePod involving local hospitals, GPs, Practice Nurses and Community Nursing Teams

• Pulmonary rehabilitation - classes in own home with a personalised programme on HP

Dedicated programme development

• Developed dedicated protocols and pathways with clinicians for early discharge and rehab

Programme support

• Proactive commitment to programme from all stakeholders

On-going evaluation and analysis

• Reductions: 26% GP appts, 70% emergency admissions, 86% on-call contacts

• -> projected savings over 5yrs of 40% v ‘usual care’

Service transformationCase study – Surrey Telehealth Programme

Collaborative partnerships

• Surrey County Council, the 6 CCGs, Local Providers and private partners

• Largest telehealth programme in UK - ~1,700 connections

End-to-end managed service

• Delivered by Medvivo - HomePod with configured protocols; relevant peripherals; installation, training and technical support; project management; remote monitoring; clinical triage: proactive case-management by specialist nurses

6 month programme development

• Stakeholder engagement / pathway development

Programme support

• Dedicated programme management from Commissioner and Medvivo

On-going evaluation and review

• Flexibility, sustainability, ongoing value

Service transformationCase study – Hampshire Telecare Programme

Change-led collaborative partnership – ‘Argenti’

• Hampshire CC commissioned a consortium of leaders in their fields

End-to-end service

• Service design, engagement and culture change - PA Consulting Group

• Telecare packages and solutions - Tunstall, CareCalls, Oysta

• Assessment, installation and maintenance - Magna Careline

• Monitoring services - Medvivo

Prioritised programme development

• Achievable business case

• Focus on winning hearts and minds of care teams and practitioners

Programme support

• Excellent support from Adult Services management

Agreed outcomes and ongoing evaluation

• Clear outcomes identified for every user -> referrals up by 8 times

• Flexibility to incorporate new solutions as requiredi

EVALUATION

Trends showing significant reductions in:

- unplanned admissions

- length of stay

- GP appointments

Evaluated Case Study

Data for pre 6 months and post 6, 12 & 18 months

Portsdown Conclusions

Benefits:18 months data for 21 patients who had at least one unplanned hospital

admission in the year prior to participating in telehealth

– 52% reduction in unplanned admissions to hospitals

– 65% reduction in length of stay in hospital

– 36% reduction in A & E attendance

– 25% reduction in GP visits

12 months data for 52 patients who visited their GP at least 5 times in the

year prior to participating in telehealth.

– Patients who had at least 5 visits to the GP over the year prior to

telehealth showed a 45% reduction in GP visits

– 95% of patients found the service welcoming, successful and

compelling i

COST

Portsdown - Efficiencies & Effectiveness

NHS Service

Used

Approx

Service Cost per activity

Reduction

In Usage

Cost

Reduction per patient per year

Baseline

Assumptions per patient per year

Unplanned

admissions

£2,500 52% £1,250 1 baseline

hospital

admission

Visit to GP £50 45% £110 5 baseline GP

visits

Visits by

community

matrons

£80 50% £480 12 baseline

matron visits

Attendance at

A&E

£80 36% £30 1 baseline A&E

attendance

i

SCALABILITY

A specialist telehealth nurse in a centralised monitoring centre can manage a caseload of around 300 i

INTEGRATION

Integration

Co

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olla

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tion

•Join

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SERVICE USER

Behavioural change in self-management

Development of a good rapport with the patients

Improved trends in long-term conditions

Improved QoL of Patients

Reduced hospital admissions

Satisfied patients

“ I feel more at ease knowing there is someone checking up on me.”

“Telehealth nurses have helped me to cope with my anxieties.”

“I feel I know more about my condition than

before.”

Questions? And Thank You!

Katy Lethbridge

UK Sales & Client Services Manager

07887 414 011

katy.lethbridge@medvivo.com

www.medvivo.com

@medvivonews