Rachel Binks

Nurse Consultant – Digital & Acute Care

Airedale NHS Foundation Trust

Telehealth,

e health,

digital health…..

Telecare

Telemonitoring

Teleconsultation

Tele care

Tele monitoring

tele medicine

tele coaching

Tele coaching

tele medicine

Tele medicine

a system designed by default

some people seem to do

quite well without

waiting for healthcare

support……

Telehealth Hub

• 24/7 working

• Experienced nurses

• 2nd tier - physician

• Shared Electronic

health records

• Resilient infrastructure

• Opened September 2011 – now

supports >3000 people

• www.immedicare.co.uk

The Aim of the Service

• Provide, safe, effective high standards of care

• To support residents to stay at home

• Support residents/nurses/carers in the planning, and

delivery of care

• Escalate to community teams out of hours

providing remote consultant opinion to the

English prison service

supporting elderly patients with long term

conditions in their own homes, nursing and

residential care homes via Telehealth HUB

developing the support of rural communities with

community based remote outpatient

consultations and remote out patient care for

patients in residential and care homes

Bringing healthcare home

Providing Telemedicine To:

•3000 Patients

•200 Care homes in:

Airedale, Wharfedale, Craven,

Bradford

Calderdale & Huddersfield

Cumbria

East Lancashire

Dartford & Gravesham

Coventry

•70 Patients with long term diseases in own home

Nothing is ever new…

• Custodial health care

8 year programme

Live in 20 prisons

Significant change in patient flow

735 consultations past 12 months

Teleconsultation at Airedale

Applications

Case studies

• Chronic chest disease

patient at their own home

– “frequent flyer”

• Care home resident – fall

• COPD patient – acutely ill

Case Studies

• Stroke

• CPR

• Head injury

• Unwitnessed fall nose & lip laceration

• Unwitnessed fall (shoulder injury)

Technical infrastructure?

Information Governance?

Clinical Governance?

Medico-Legal?

SystmOne, EMIS?

Prescribing? Consent?

SystmOne – Shared Record

• Shared record between the hub, and other services

involved in the residents care

• Consent obtained from resident/best interest

decision form

• Consultation flagged to GP, and other services

When Admission to Hospital is Required

• Streamlined process

• Avoiding A&E where ever possible

• Supporting the resident, and their carer until the

ambulance arrives, via the video link

Care homes – summary results (2011-2012)

(n=17)

Care Homes (continued 2013-2014)

-53%

-59%

-35%

Call outcomes

Call outcomes

Results: 24 hr teleconsults to 26 patients

with COPD (at home) – 1 year pre/post

Video system displays via home TV

Patients measure their Oxygen / Peak

Flow

Typically have “rescue” meds at home

-45%

Call numbers 2012 „v‟ 2013

Nurse led triage is the norm

Feedback

“Definitely has reduced

admission rates. Telemedicine

is an asset to the home with

benefits Out Of Hours and

weekends”

“Telemedicine became our lifeline – what a

wonderful piece of equipment!

“At the press of a button we could have face-to-face contact with a

medical team, which is so important for both a patient and carer, and

that helped to keep Geoff’s spirits high…”

“The Doctor was fantastic when one of our

dementia patients fell and hurt herself. I would

have called an ambulance and she would have

endured an A&E visit which would have terrified

her. Your consultant saved her from this and

reassured me that the cut was superficial and she

was fine...”

“The Telehealth Hub came into its own last winter when snow and ice

brought traffic to a halt. My Husband’s condition deteriorated suddenly,

and having visual, instant contact with the team was very reassuring. A

wonderful service.”

GP Triage Calls

• Clinical assessment by Hub nurse

• Onward refer if required to HCP for home visit

• Request prescription

• GP surgery informed by NHS secure mail

Remember - we are transforming healthcare

for our children…. So “design for tomorrow,

not today”

What Are We Waiting For?

“Jeremy Hunt @Jeremy_Hunt 3h Just been 2 Airedale hosp & seen

some of best tech anywhere in NHS including digital patient records

shared with GPs - and gr8 patient care”

Questions?