The Mocketts Wood Telehealth project was set up as a Managed Service Agreement with Telehealth Solutions (Telehealth Solutions Ltd) in order to fund a small scale pilot project in the Thanet area of Kent centred on the Mocketts Wood practice in St Peters, Broadstairs, working with Dr Venkat Reddy and his practice team.
The Aims of the project included:
- To look at the effect on patients, carers and the practice of using Telehealth to monitor vital health signs
- To monitor if the use of home monitoring encouraged a greater degree of self-management and better understanding of their conditions within the selected group of patients
- To assess whether such a form of intervention can help to reduce GP practice activity and prevent avoidable hospital admissions.
Details of the daily readings and actions taken were collected from mid-July 2014 through to the end of March 2015 for the selected group of patients.
Alongside this Telehealth Solutions also produced a monthly project report, which was shared with the monitoring group set up as part of the project governance.
There were a total of 1,167 case results generated throughout the 8.5 months of the trial.
a. Hospital Admissions Avoided
One of the most striking results shown is the number of hospital admissions avoided as a result of the daily monitoring of patient vital signs.
The project highlighted 27 cases of hospital admissions avoided.
b. Indicative Savings
If we therefore take the 27 hospital admissions above which we believe to have been avoided as a result of this pilot project and multiply this by the average cost per admission of £2,203 we have an indicative saving of £59,481.
The cost of Telehealth Solutions providing the managed service support was given as £100 per month for the 10 participating patients, or £1,000 per month. The project was in place for 8 and a half months giving a total cost of £8,500.
c. Alert Handling
Alerts were produced in line with clinical protocols agreed with the practice, when readings and question responses fell outside the agreed patient tolerances set for each individual.
The project sought to add to the evidence base associated with the use of Telehealth or in home monitoring.
We have looked at the lessons learned during the course of the trial from 3 angles:
- Patient perspective
- Carer perspective
- Clinical perspective – in this case from the perspective of the GP and the practice team
The trial was very successful. It highlighted a number of significant results from the use of Telehealth monitoring in a GP setting, albeit from a very small sample of patients.
Many favourable benefits were reported, particularly in terms of the reduction in unplanned hospital admissions for this group of patients and the high levels of satisfaction reported with a remotely managed monitoring service, from the perspective of patients, carers and clinicians alike, as evidenced by some of the feedback and quotes included in section 4 and also in Appendix 4.
The benefits associated with the trial can be summarised thus:
- Reduced avoidable hospital admissions (and the costs associated with these)
- Promoted behavioural change in self-management
- Improved understanding of conditions
- Improved quality of life for patients
- Reduced anxiety and improved security for patients and carers - knowing that monitoring is taking place on regular basis
- Development of good rapport between practice and patients
- Satisfied patients, carers and clinicians
The trial demonstrated how Telehealth, or in home monitoring, can be used as part of a more proactive primary care service, as a tool which assists and enables the practice team to work more effectively with their clientele. It showed the tailorability of the managed service solution and its flexibility to fit in with the individual needs of the local practice population.
The use of Telehealth at Mocketts Wood has provided support in respect of the following:
- Allowing early intervention and prompt response to patient concerns
- Helping to avoid unnecessary hospital admissions and GP appointments and visits
- Allowing appropriate follow up and case management
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