Kent TeleHealth Evaluative Development Pilot

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Kent TeleHealth Evaluative Development Pilot

• Matt Rye
• Evaluation Supervisor

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What is Telehealth?
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It is a Chronic Disease Management Tool
Self Managing Chronic Obstructive Pulmonary
Disorder (COPD), Type 2 Diabetes, Heart Failure
(HF) Vital signs measured Blood pressure,
Blood oxygen, Blood sugar, Weight, Peak flow and
temperature.

• Using
• User friendly interfaces.
• Simple telephone connection to the provider via
  the web.
• Customisable, personalised scheduler, reminder
  and alarm.
• Reporting tools include tracking and alerts.
• Disease management questions and answers.
• Send advice messages to the client.

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GP Model
6 month period pre vs post intervention.
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Shepway
A reduction in GP/patient consultations by 40
was observed post TeleHealth installation. This
is specifically in face to face consultations.
A reduction in GP/patient telephone activity of
45 was observed post TeleHealth installation.
In monitoring these 28 service users, 22
changes to medication resulted from TeleHealth
readings. 10 exacerbations were managed in the
service users home. Readings led to 2 additional
investigations being carried out. Bed days
dropped from 220 in the preceding 3 months to 30
in the following 3 months. This is an 85
reduction.
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Extended Shepway results
870 emergency bed days were used in the 12 months
prior to being accepted onto the caseload.
. Subsequently that usage dropped to 85 bed days
post matron involvement. To put this into
context, our records indicate we have managed in
excess of 50 exacerbations which arguably could
have resulted in a hospital admission hospital.
As a result using the cost of an average bed day
of 200 taken from NHS reference costs Prior
to Matron involvement - 174,000 Post Matron
involvement - 17,000 Saving of 157,000
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Case Study

• Female aged 84
• 6 admissions in the previous year
• PMH I.H.D., A.F., T.R., Type 2 Diabetes, R Heart
  Failure, awaiting pacing.
• TeleHealth used to identify that as little as
  1.5kgs of fluid overload as a significant
  threshold for patient to throw off arrythmias.
• Monitoring her weight, BP and renal function we
  have successfully titrated diuretics several
  times to avoid potential admissions.
• TeleHealth data used to identify sensitivity to
  betablockers after titration of Bisoprolol 2.5mgs
  to 3.75mgs. Pulse rate dropped to 41.

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Case Study

• Male aged 49
• 5 admissions in the previous year
• PMH I.H.D., C.V.A., Hyperlipidaemia, M.I.x2,
  Angina, Uncontrolled Hypertension, Parkinsons,
  Depression.
• Within 2 weeks of going onto the TeleHealth kit
  his systolic have fallen from 190mmhg to 140mmhg
  and diastolic from 120mmhg to 80-90 without any
  titration of his antihypertensives.
• His Consultant Stroke Physician feels that this
  is attributed the TeleHealth monitoring leading
  to a reduction in his anxiety.
• 1 admission as a result of a fall though
  TeleHealth readings used to gain prompt
  discharge.