asingle presentation

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Remote Monitoring for People with Long Term Conditions Angela Single

An Overview…. : 

An Overview…. ‘Chronic medical conditions – such as asthma. diabetes, heart disease and hypertension are lifelong and often progressive. As the population in England ages growing numbers of patients will need help in managing complex, multiple conditions over sustained periods. Quite part from the burden of ill health, treating these conditions is likely to cost the NHS in England far more than elective surgical procedures.’ Managing Chronic Disease: Kings Fund Jan 2004

Newham……. : 

Newham……. Diverse and multi cultural community, population approx 254,000. Using national estimates of 30%, the number of people who have a long term condition will be approx 72,000. Population increasing faster than rest of London (15% since 1981) and rest of the country, set to grow considerably before 2016. 2001 census identified it has the greatest diversity of ethnic groups in the country (62% of residents come from an ethnic minority). High rates of CHD, COPD, respiratory disease, in some cases, highest in the country within elderly population. High death rates from chronic liver disease and infectious disease. Access to healthcare is late in the disease progression. The proportion of residents who report health problems is increasing steadily each year. [1] Newham Annual Public Health Report 2004. Newham PCT

NEWHAM’S DEMOGRAPHIC/SOCIO-ECONOMIC CHARACTERISTICS: 

NEWHAM’S DEMOGRAPHIC/SOCIO-ECONOMIC CHARACTERISTICS Newham PCT

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A Relatively Small Number of PatientsAccount for a Large Share CostsHospitalized Patients and % of Total Patient Days Percent of Total Percent of Total Hospitalized Patients Total Patient days Hospitalized Patients Total Patient Days All London Newham PCT 74% 86%

What is it like to have a LTC?: 

What is it like to have a LTC? When you leave the clinic, you still have a long term condition. When the visiting nurses leaves your home, you still have a long term condition. In the middle of the night you fight the pain alone. At the weekend, you manage alone without help. Living with a long condition is a great deal more than medical or professional assistance….’ Supporting People with Long Term Conditions …DoH Jan 05

Aims of the project…: 

Aims of the project… Help individuals: self manage increase treatment/medication compliance increase knowledge of their condition feel supported ’24/7’ Identify earlier than currently possible when patients condition deteriorate Increase access to information readily available to healthcare professionals Reduce the risk of patients on the project becoming ‘Intensive Service Users’

Project set up: : 

Project set up: Project steering board 1 year research project - 35 systems funded 1wte Nurse Case Manager Nurse based in alarm centre (Newham Network) Joint project with Council's Telecare project Referrals from: Consultants GP’s District Nurses Intermediate Care Socail work team HV’s for the elderly Community Matrons Assessed using SAP

Patient Selection Criteria: 

Patient Selection Criteria Patient over 65 yrs Patient must speak one of the following languages English Punjabi Bengali Urdu Newham postcode 2 or more emergency admissions over the last 13 months Diagnosis of heart failure, COPD in combination with other chronic diseases such as diabetes and arthritis, etc. Living in their own home with land line telephone Patients with early stage dementia are eligible but not those with severe cognitive impairment No history of alcohol or drug abuse or severe mental illness

Telecare System : 

Telecare System

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Assessment Unit Assessment Unit + wireless devices Assessment Unit + wireless devices + videophone

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Outcomes: It was found that be using this system the Nurse was able to: identify deviations from expected outcomes for each individual patient provide advice tailored to individual patient need investigate seriousness of symptoms alert primary care team when required

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This system also: Reduced uncertainty for patients and the care team about the seriousness of symptoms Improved patient confidence Improved communication between the patient and primary care team Improved the ability of the primary care team to accurately diagnose and treat patients at home

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Reduction in hospital use Modified patient disease management behaviour Improved interaction with health and social care providers Increased frequency of access to care  Improved medication and treatment compliance Enabled early intervention in and prevention of acute exacerbation of chronic disease Overall Outcomes…

Proactive Home Monitoring : 

Proactive Home Monitoring These services help bridge the gaps and maintain continuity of care by providing access to care, enhancing patient self- management skills and facilitating early system recognition and intervention. …...…Home Health Technology Report 2004

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Angela@ajsingle.co.uk