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Flo wins top "Digital" accolade at NHS Sustainability Awards 2017

posted 30 Jun 2017, 07:43 by Hollie O'Connell







‘Flo’ in West Lancashire’s Heart Failure Service named No1 for NHS digital sustainability 

"
West Lancashire Clinical Commissioning Group (WLCCG) implemented an effective Tele Health text messaging system – ‘Flo’ in West Lancashire’s Heart Failure Service.  Flo (which was named after Florence Nightingale) sends patients reminders and health advice tailored to the patient’s needs. 

The technology allows Clinicians (Doctors or other health professionals such as Nurses or Community Matrons) to design specific protocols (define messages, set up parameters and alerts, etc.) on Flo for their patients.  Flo enables Clinicians to capture real time information about their patients at any time via a simple messaging interface.  The solution prompts the patients to submit readings such as their oxygen, pulse, blood pressure and weight readings.  Depending on the readings, prompt advise & guidance is given to the patients; Clinical alerts (if any) are sent to the Clinicians.

Since the implementation of Flo within the Heart Failure Service, the selected cohort of patients, identified suitable for this technology, were able to self-manage their conditions more effectively.  It decreased unnecessary Clinician-patient contact and released capacity within the system for more appropriate appointments and referrals.  

Recent feedback captured from patients using Flo, following it’s implementation, have shown:
  • Significant reduction in the number of face-to-face Clinician-Patient contact, thereby reducing hospital admissions/unnecessary visits
  • Empowered patients to manage their health conditions better
  • Freed up Clinician’s time to see other patients who need urgent care
  • Delivered positive patient experience due to a sense of personal support and flexibility offered by the unique Tele Health solution
  • Patients felt more confident co-managing their condition  
"

Scotland; 'Mission Slimpossible', ‘Walk 500 Miles Step Count Challenge’ & fab new video from NHS Lothian

posted 30 Jun 2017, 05:05 by Hollie O'Connell   [ updated 30 Jun 2017, 07:00 by Philip O'Connell ]





It's another busy month for Simple Telehealth Community members and whilst we're not able to share everything that members achieve each month, heres a couple of new items from Scotland worth checking out this month.

A great new patient video animation showing how Flo works and the type of conditions being supported by good old Flo in Lothian !  

And...   'Mission Slimpossible' and ‘Walk 500 Miles Step Count Challenge’ from NHS Western Isles, describing how clinicians are using Flo to help their patients to lose weight and keep fit with innovative programmes.





#Scotland #NHS Lothian #NHS Western Isles

RCGP Technology Enabled Care eLearning course stars Flo

posted 14 Jun 2017, 08:15 by Philip O'Connell

Hannah Mountford 
Assistant to the Director of Services and Community SSHC 


15 June 2017 


RCGP "Telehealth, Telemedicine and Telecare: an Introduction to 'TECS'"


Technology continues to develop at a rapid pace, often improving our lives and becoming integral to how we conduct our day to day and professional lives.  A prime example of this is the development of the smartphone; given that we have embraced technology so fully in today’s world, it is vital that our healthcare services do so to maximise opportunities that it offers and bring healthcare into the world of how many patients operate their lives.

This is where Technology Enabled Care Services (TECS), such as Flo come in using accessible and convenient methods in motivating patients to increase their engagement in their own self-care by providing that extra support that really gives patients the confidence to engage in the self-management of their health.  Indeed, Flo’s efficacy hinges on the fact that she utilises one of the most accessible and familiar forms of modern technology: text messaging.

To get the most from TECS such as Flo, it is vital that healthcare staff are well informed, and have the knowledge that allows them to use TECS to bring true benefit to the lives of their patients.  The Royal College of General Practitioners now offers a free online course to introduce the core concepts, applications and advantages of TECS to healthcare workers.


How to access the RCGP eLearning Course
To access the eLearning course, you can either use your existing RCGP login details, or if you are not registered you can sign up for a free account. Sign up open to all, so non-clinical members of staff are also able to improve their knowledge and understanding of TECS.


How is the course structured?
The course begins by taking you through a pre-course assessment with 8 multiple choice questions, providing a baseline for what you may, or may not already know about TECS.  Having completed this, you will then work your way through 3 learning sessions:
  • Telehealth, telemedicine and telecare: an introduction to "TECS" 
  • Technology enabled care in practice: ideas and examples 
  • Technology enabled care in practice: developing and evaluating
 
Each of these sections is made up of interactive slides that along the way will ask you to consider your existing knowledge of TECS as well as what you have learned during the session.  For example, the first session, Telehealth, telemedicine and telecare: an introduction to "TECS" asks you to write about any example telehealth you may have already come across already, a prime example being Flo. Having done so you are able to submit your answer, and additional information specific to the question is provided.  These tasks are present in all three learning sessions, and are useful to both consolidate knowledge and prompt more consideration of the application of TECS.  Additionally, at the end of the learning session, there is the option to download any answers you may have submitted so that you can review them at a later date.

Having completed the learning sessions, there is a post-course assessment and once complete you will be able to download a certificate stating that you have completed the online course. 


What is the course like?
The course itself is very informative; it provides a great overview for any who are new to the idea of TECS, or can act as a useful refresher for those who already have some knowledge of the subject.  The learning sessions also feature a number of short videos about the application of TECS; how they are implemented, how they work and the experiences that patients have of using them, the focus of many of the videos being Flo’s application.


The questions asked during the learning sessions are particularly useful, as the suggestions given afterwards are likely to prompt more in depth thought on the subject.  The post-course assessment is also helpful in this way, as once submitted the answers are expanded on, which further consolidates your knowledge. 

The length of this course is suggested to be around 90 minutes; while this may be accurate for those with prior knowledge of TECS, perhaps slightly more time may be needed by those unfamiliar with them to really get the most from the course.

This RCGP eLearning course showcases the implementation of the NHS's Flo as the subject example, something that we here at Simple Shared Healthcare are proud of.  The eLearning course also features an excerpt from the Health Foundation’s award winning short film about the impact that Flo has on patient’s lives, “The Power of People”.  You can watch the full film here.

This recognition by the RCGP by using Flo as the exemplar example of TECS delivery in their pioneering eLearning package is another milestone for Flo distinguishing the scale at which Flo is used and the impacts delivered across the United Kingdom.


                                                                                                                                                                           

Annie scoops 2017 FedHealthIT Innovation Award in DC

posted 9 Jun 2017, 06:17 by Philip O'Connell   [ updated 9 Jun 2017, 06:23 ]




We're delighted to share that after competing with the best US innovations from the Veterans Affairs, Military Health, Health and Human Services, and Centres for Medicare & Medicaid Services, Annie, Flo's US #FloMania cousin has been recognised by FedHealthIT as one of the "top 25 Federal Health programmes"

This ground breaking work by the US Veterans Health Administration was nominated by, and chosen as a top programme by their peers.   The top 25 awardees "stood out from the rest based on their willingness to take on achievable risk, and more importantly, to deliver real results in support of their mission."

Congratulations to @neilcevans and all our colleagues at the VHA!



Digital Sustainability at Spring 17 International Conferences

posted 6 Jun 2017, 02:49 by Hollie O'Connell   [ updated 8 Jun 2017, 00:39 ]



07 June 2017 



Regularly shared at regional and national events; Members’ independent, ‘sustainability’ and clinical case studies describing application of the NHS's unique Simple Telehealth methodology and Florence to achieve significant and measurable results, often attracts recognition from respected international healthcare institutions. 


This spring, two of our Leading* Member organisations who’d already taken to the stage at international events in Orlando and New Zealand sharing their experience with Simple Telehealth and Flo, were again sharing their knowhow and experiences at the BMJ & IHI’s ‘International Forum on Quality and Safety in Healthcare’ in London and the World Congress on Integrated Care’s ‘International Conference on Integrated Care’ in Dublin.

With lively interest in both talks, organisers arranged substantial auditoriums to accommodate registered interest from delegates.

 




International Conference on Integrated Care


We were honoured that the outcomes from NHS Western Isle’s redesigned hypertension pathway were selected as an oral presentation at The International Foundation of Integrated Care (IFIC) in partnership with the Health Service Executive (HSE) 17th International conference on Integrated Care “Building a platform for integrated care: delivering change that matters to people” in Dublin, Ireland 8 to 10 May 2017 in association with 5th World Congress on Integrated Care (WCIC5). 

The conference brought together researchers, clinicians and managers from around the world who are engaged in the design and delivery of integrated health and social care, sharing their experience and latest evidence.

Led by Iain Trayner, TECS Project Manager the abstract ‘NHS Western Isles - Involving our Patients: Faster Access to Treatment for Hypertension in Primary Care’ describes the case for change and subsequent wide-ranging impact delivered by integrating Flo into the pathway for patients with suspected hypertension identified in primary care.  Iain’s presentation stimulated healthy discussion amongst the audience with overall recognition of the impact that self-management supported by Flo had been made and of the potential for the delivery of scalable benefits.  NHS Western Isle’s new pathway is now complete in 7 days from identification of raised blood pressure to treatment initiation and maximises opportunities for home monitoring to improve both patient safety and engagement; patient and clinician experience has been overwhelmingly positive.  The outcomes demonstrated included:

Patient: 
 
  • A safe, supported alternative to ABPM providing patient choice in treatment planning 
  • Faster diagnosis or exclusion of hypertension reduced patient uncertainty 
 
  • Confidence and ability to self-manage improved 
  • Engagement in condition and/or symptoms improved 
 
  • Improved patient acceptance of new or increased medication 
 
  • Reduction in patient travel 


Clinician: 
  • Improved patient safety during diagnostic process 
  • Immediate initiation, faster access to diagnostic data to initiate treatment 
 
  • Real time access data to expedite and evidence treatment decisions. 
 
  • AF screening increased via monitors provided by the practice 
 
  • Supports development of a nurse-led service 
 

System: 
 
  • Reduced handoffs improved patient flow 
 
  • Reduction in patient contacts 
 
  • More cost effective pathway 
 
  • Reduction in administrative processes improves productivity 

  • Opportunity to support the delivery of person centered care when treatment planning 
 

Outcomes from the initial cohort confirmed that the redesigned pathway provides sustainable and scalable learning for further adoption across primary care adding significant benefits to traditional ABPM or non-supported home monitoring practice.  With a small proportion of the clinical time released reallocated to diagnostic result analysis, it was further recognised that the application could be extended to support diagnosis or monitoring of other conditions where patients can be supported to submit readings or symptoms from home. 
 This was the first model within Scotland reviewing hypertension diagnosis pathways with Flo forming the basis for NHS Lanarkshire’s large-scale implementation

NHS Western Isles are now collaborating with Scottish Centre for Telehealth and Telecare and NHS24 on a national pathway based on this methodology, which has, been adopted as part of a national evaluation model. The abstract will soon be published in the International Foundation of Integrated Care Journal.


Presentation slides from the conference are available to download here or download Iain’s presentation only 
For more information please contact Iain.Trayner@nhs.net 





International Forum on Quality and Safety in Healthcare


Originating out of a submission from Sian Clarke of Nottinghamshire’s Assistive Technology Team, the talk tackled the elusive topic of sustainability in a presentation titled “Whole system approach: A cost effective way to allow patients to self-manage”.

The talk discussed the journey of Nottinghamshire from the all too familiar low point of “historical failure of initiatives to deliver the digital utopia portrayed by some suppliers” through to their wide ranging, evaluated and evidence based implementation of Florence and subsequent inclusion in Nottinghamshire's STP.






The Scotsman - NHS Lanarkshire reach CBT milestone with Flo

posted 8 May 2017, 00:48 by Philip O'Connell





We are proud to share that NHS Lanarkshire have been featured in an article by ‘The Scotsman’ Scotland’s national newspaper, for their continuous success using Florence.

The article highlights how NHS Lanarkshire have supported and helped a milestone 1,000 patients who suffer with depression and anxiety, by enhancing their Cognitive Behavioural Therapy programme ‘Beating the Blues’ with Flo. The animation ‘Fraser’ is also featured due to its help towards growing and spreading awareness of how Telehealth is allowing patients to be more confident and independent in their own healthcare.


#Lanarkshire #CBT #eCBT #Scotland

Sharing Success - NHS's Simple Telehealth National Conference 2017

posted 7 Feb 2017, 00:30 by Philip O'Connell   [ updated 30 Mar 2017, 01:59 by Hollie O'Connell ]



The "Making Change Happen with Simple Telehealth and Florence" conference was held on 25th January 2017 at the North Stafford Hotel, Stoke-on-Trent and saw a day of collaboration and enthusiastic sharing of real world applications of the unique Simple Telehealth methodology.   The 100+ delegates from England, Scotland, Wales and Australia enjoyed a packed schedule of independent evidence backed case studies and evaluation delivered by 32 speakers in three streams, on topics ranging across Primary, Community and Secondary Care, Mental Health and Education.


"The conference was an overwhelmingly positive success!"



Plenary speakers included;

- Dr. Ruth Chambers OBE, NHS Stoke-on-Trent Clinical Chair & WMAHSN LTC Network Clinical Lead
- Dr Dawn Moody, Associate National Clinical Director for Older People & Integrated Person-Centred Care, NHS England
- Dr. Michael Dixon, General Practitioner, Chair of the College of Medicine and National Clinical Champion for Social Prescription, NHS England
- Dr. Elizabeth Boath, PhD, NTF, SFHEA, Associate Professor in Health, Staffordshire University 
- Caroline Poole, Service Development & Sustainability􏰃 Pennine Care NHS Foundation Trust 
- Brendon Wickham, South East Melbourne Primary Health Network
- Melissa Le Mesurier, South East Melbourne Primary Health Network
- Iain Trayner, TECS Lead NHS Western Isles
- Morag Hearty, Project Manager Lanarkshire Smart Care & United 4 Health

  


In a non-commercial environment, the conference was designed to facilitate transparent peer to peer sharing of real world experiences of the NHS's Simple Telehealth methodology, the atmosphere was energised with delegates taking in new ideas and ways of working and networking with others in similar clinical interest areas.   


"I came back buzzing with new ideas, it was a great conference in Stoke"


Full details of all of the conference content, slides and posters can be found in the members section by clicking here.
(shared materials are not for commercial use)



Diabetes - Journal of Nursing and Healthcare research article; Enhancing Adherence to Treatments

posted 3 Feb 2017, 06:35 by Philip O'Connell



We are excited to announce the publication of “Use of an Innovative Technology Enabled Care Service (Tecs) “Florence” to Empower Patients and Enhance Adherence to Treatments in Diabetes” in the Journal of Nursing and Healthcare, written by Parijat De, Susan Irwin, Jagjit Kaur and our own Karen Moore

This research article encapsulates how Flo is helping Sandwell and West Birmingham Hospitals in relation to blood pressure readings and medication in diabetic patients. The main objectives were to improve adherence of patients through regular encouragement and text reminders, thus engaging patients in their own health care, improving clinical productivity and demonstrating the cost effectiveness of using Tecs.


#Diabetes, Acute, Secondary Care

Flo exemplars included in Scottish Government's TEC National Action Plan

posted 21 Oct 2016, 03:44 by Philip O'Connell   [ updated 21 Oct 2016, 06:00 ]



We're delighted that the Scottish Government's National Action Plan for Technology Enabled Care, "Supporting & Empowering Scotland's Citizens" includes evidence based exemplars of sustainable and scaleable use of Flo in Lanarkshire and Lothian.  

The report highlights programmes of work led by Morag Hearty and Edinburgh University, focussing on hypertension and 'MasterMind' (computerised CBT), both of which show significant clinical results with Flo.  (See Scottish Network Event and new film launched)


"
Home & Mobile Health Monitoring

Lanarkshire’s Rapid Improvement Study: Hypertension Monitoring in General Practice demonstrated that within 3 months 115 patients self monitored their Blood Pressure with result of saving 415 practice nurse / GP
appointments. They concluded that for this population of patients in Lanarkshire;
    • Home & mobile health monitoring (HMHM) of blood pressure improves efficiency
    • HMHM of blood pressure for about two to three weeks avoids an average of four to five GP or Practice Nurse appointments. This saves clinic time for clinicians, reduces telephone contact time (using texts instead) and prevents patients having to travel to the surgery for routine monitoring.
    • HMHM of blood pressure supports clinical decision-making
    • GPs/Practice Nurses report that HMHM of blood pressure enables faster decision-making and provides optimum readings. This resolves issues around „white coat syndrome‟ (it did so for one third of this cohort) and allows a diagnosis of hypertension to be either confirmed or ruled out.
    • People mostly find it easy to monitor their own blood pressure and report results by text
    • People found the BP monitor and Flo text messaging system easy to use, felt it helped them monitor their BP, and would use it again in future, if they needed to.
A larger scale version of this, using the FLO telehealth system, is currently being rolled out across Lothian as part of the development of home and mobile health monitoring in Scotland, with full evaluation by the Edinburgh University (with funding from the Chief Scientist Office). As of 2016, there are over 100 GP practices engaged in HMHM initiatives and numbers continue to expand.
"


#hypertension #CBT #cCBT #Scotland

Simple.uk.net - Evidence published by Lords Select Committee

posted 19 Oct 2016, 04:45 by Philip O'Connell   [ updated 19 Oct 2016, 04:58 ]


We're delighted at Simple Shared Healthcare to announce that our evidence to the House of Lords Select Committee on the Long Term Sustainability of the NHS has been published on www.parliament.uk.  The submitted evidence overwhelmingly reflects the views of our Community of Practice members.



"

Simple Shared Healthcare Limited – Written evidence (NHS0104)

 I write on behalf of Simple Shared Healthcare Limited, a not-for-profit social enterprise, limited by guarantee and committed to improving the quality of self-care.

  1. Our interest cuts across the committee's  areas of interest as follows;
    1. Resourcing issues - productivity and demand management.
    2. Models of service delivery and integration
    3. Prevention and public engagement - motivating people to take greater responsibility for their own health - Keeping people healthier for longer.
    4. Digitisation.
       
  2. The business case for each service commissioned by the NHS to achieve clinical and preventative outcomes assumes a particular level of patient engagement and adherence with their own healthcare.
    1. The typical level of patient engagement and adherence presents the opportunity for significant room for improvement across all conditions, pathways and treatments. 
    2. Through increasing the level of engagement and adherence to the best practice health care currently delivered by the NHS, better clinical outcomes can be achieved faster and more cost effectively than is otherwise the case.
    3. Such improvements can be achieved using evidence based techniques without re-engineering clinical pathways, changing clinical practice, or introduction of costly and/or unproven technology.
    4. The current evidence base built using the NHS owned methodology ‘Simple Telehealth’ www.simple.uk.net uses psychological methods and zero footprint technology (uses the patients own mobile phone) to help patients.  It motivates, engages, educates and increases adherence to their shared healthcare plans.
       
  3. The application of this methodology enjoys support within the clinical community and is used in some primary, secondary, community and mental healthcare settings in England, Scotland and Wales.  The NHS ‘Simple Telehealth’ methodology has been assessed and adopted by the United States Federal Government’s Veterans Health Administration for national rollout and there is keen interest from other countries.  The clinical community have also formed a Community of Practice through which they build a knowledge base and freely share their practice, achievements and evidence with others.
     
  4. Practical use of the methodology through the ‘Florence’ system in England has been cited by the CQC as outstanding in a number of primary and secondary care inspections and improvements in engagement and adherence bring about productivity, efficiency and prescribing improvements  
     
  5. The evidence of clinical outcome improvement and high patient satisfaction through the impact of improved engagement and adherence is widespread ranging across all ages,  geographic regions and demographics.  A number of case studies and links to medical journal articles can be seen at http://www.simple.uk.net/home/casestudies and http://www.simple.uk.net/home/articles

     
  6. However the current fashion for the adoption of the latest technology and apps for self-care needs to be treated with caution in terms of attaining clinical outcomes and improving productivity for the NHS.  The NHS has wasted many millions of pounds investing in technology for self care that has no basis in evidence and scant clinical support. In some cases today, managers are still persuaded by professional sales techniques citing overstated benefits to invest in equipment and apps for which there is no or little evidence or even evidence to the contrary or has been proven to be ineffective previously in other areas. http://www.simple.uk.net/home/blog/blogcontent/duediligenceforcommissioners / http://www.bmj.com/content/347/bmj.f6070
     
  7. The long term sustainability of the NHS is critically dependent upon the level of Self Management Support provided to improve the engagement and adherence of patients.  This impacts directly on the quality and efficacy of healthcare, productivity, cost of care episodes, avoidance and delaying of health complications  and significantly the  sustained and lasting impacts of patient behaviour change.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964251/
     
  8. Should the Self Management Support results achieved to-date of improved engagement and adherence with over 40,000 patients via use of the NHS’s Simple Telehealth methodology be replicated at scale, but only achieving a fraction of the improvements evidenced, the impact on the sustainability of the NHS would be substantial and achieved at an insignificant cost.

 

 
23 September 2016
 
"
http://www.parliament.uk/nhs-sustainability

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