Wireless Telemedicine in Primary Care

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Wireless Telemedicine in Primary Care

• Karen Greenwood
• Ian Bett
• Greater Manchester Cheshire Cardiac Network

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Background

• Greater Manchester has the worst CHD mortality
  rate in England the current position (2001-3) is
  a mortality rate of 135.9 per 100,000 against
  104.1 for England as a whole
• There is a lack of direct access for GPs to
  reported diagnostic services which may result in
  delays in treatment and / or referral
• This project is the result of a successful bid to
  the Greater Manchester Strategic Health Authority
  (SHA) Invest to Save Capital Budget
• 100k has been secured each year for 3 years -
  capital monies only

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Aims and Objectives

• Aim
• The aim of the project is to define the benefits
  (or not) of the use of wireless telemedicine in
  primary care for diagnostic purposes for both
  healthcare professionals and patients and to
  identify potential savings
• Objectives
• Improve access to diagnostics for primary
  healthcare professionals
• Reduce referrals to secondary care
• Reduce admissions to secondary care
• Reduce unnecessary attendances at AE departments
• Reduce number of re-attendances at GP surgeries
• Increase expertise of primary care staff
• Evaluate technology

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Process

• Identification of participating PCTs in phase 1
• South Manchester
• North Manchester
• Central Manchester
• Stockport
• Bury
• Liaise with Greater Manchester Collaborative
  Procurement Hub
• Identification of potential service providers
• PCTs agreed on diagnostic services required
  ECG and / or arrhythmia recognition
• 2 service providers chosen by PCTs and Cardiac
  Network
• Welch Allyn
• Broomwell Healthwatch
• PCTs identified participating General Practices
• 52 practices in total
• Contracts signed
• Equipment ordered and delivered

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High level model of care
Patient seen at GP practice
GP/practice nurse takes reading using equipment
GP/practice nurse telephones call centre
sending readings down telephone line
Clinical specialist at call centre receives
readings and interprets over the phone
Diagnosis and recommendations made over the
phone
Results and recommendations of test sent to
GP/nurse via fax and or email
GP/nurse acts on recommendations made
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Clinical Governance

• Risk Management
• - quality control
• - training
• - quarterly update meetings
• Ongoing support
• Project evaluation benefits realised??

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Evaluation

• Evaluation forms completed by clinicians and
  returned on a monthly basis
• Activity figures returned on a monthly basis from
  Service Providers
• Both pieces of information to provide continuous
  monthly analysis
• Quarterly update meetings with Service Providers,
  Users and Cardiac Network

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Evaluation
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Future Plans

• Monthly analysis and quarterly meetings
• Evaluation of phase 1
• - benefits realised?
• - savings made?
• Phase 2 roll out to other PCTs and interested
  / appropriate organisations

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• Thank you
• www.gmccardiacnetwork.nhs.uk