care anywhere

Ann WagnerDirector of Strategy & Business Development

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SCENARIO FOR A FRAIL ELDERLY PATIENT TODAY

EDNA IS 79 YEARS OLD, HAS CHRONIC CHEST DISEASE AND LIVES ALONE AT HOME

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EDNA IS ALONE AND DOES NOT KNOW WHO TO CONTACT, SHE CALLS 111

AN AMBULANCE IS DESPATCHED AND TAKES EDNA TO THE EMERGENCY DEPARTMENT

THE EMERGENCY DEPARTMENT DOES NOT HAVE ACCESS TO EDNA’S PRIMARY CARE RECORD. EDNA IS STABILISED AND TRANSFERRED FOR INPATIENT CARE

DURING EDNA’S INPATIENT STAY HER SOCIAL CARE PACKAGE IS PLACED ON HOLD. THIS SUBSEQUENTLY RESULTS IN HER DELAYED DISCHARGE

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EDNA’S CONDITION DETERIORATES

EDNA

AIREDALE PARTNERS

FOLLOWING HER DISCHARGE EDNA IS CONFUSED ABOUT HER MEDICATION AND HER FOLLOW UP CARE PLAN

ANNUAL PATIENT JOURNEY COST: £40,500ANNUAL PATIENT JOURNEY COST: £40,500

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SCENARIO FOR A FRAIL ELDERLY PATIENT TOMORROW

EDNA IS 79 YEARS OLD, HAS CHRONIC CHEST DISEASE AND LIVES ALONE AT HOME

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EDNA IS ENROLLED ONTO THE NEW MODEL BY HER GP

EDNA IS SUPPORTED BY AN INTEGRATED, MULTI-PROFESSIONAL TEAM

EDNA RECEIVES SUPPORT IN SELF MANAGEMENT, INCLUDING PULMONARY PHYSIOTHERAPY

EDNA MONITORS HER OWN CONDITION USING GUIDANCE BUILT INTO HER ELECTRONIC WORK SPACE WHICH SHE ACCESSES FROM HOME

EDNA USES HER WORK SPACE TO COMMUNICATE WITH OTHERS IN A SIMILAR POSITION AS WELL AS HEALTH AND CARE PROFESSIONALS

IN THE EVENT OF A DISEASE FLARE, EDNA USES TELECONSULTATION TO SEE AND SPEAK WITH HEALTHCARE PROFESSIONALS AND SAFELY DEAL WITH THE ISSUE IN THE COMFORT OF HER OWN HOME

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RULES DRIVEN ANALYTICS IDENTIFY EDNA AS SOMEONE WHO SHOULD BE SERVED BY THE NEW MODEL

EDNA

SUPPORTED SELF CARE

PATIENTS IN CONTROL

REDUCTION IN UNPLANNED HOSPITAL ADMISSIONS

PRIMARY CARE CONTACTS MINIMISED

BETTER REOURCE UTILISATION & VALUE FOR MONEY

AIREDALE PARTNERS

ANNUAL PATIENT JOURNEY COST: £26,100

introducing Airedale

our focus

right care

telehealth, e health,digital health…..

Telecare

Telecoaching

Telemonitoring

Teleconsultation

teleconsultation journey Prison health care

8 year programmeLive in 15 prisonsUp to 50% change in patient flow>1600 consultations past 2 yrs

Stroke patients

Care at home

Nursing and Residential care homes

Supporting end of life patients

24/7 Telehealth Hub

Telehealth Hub

24/7 seven day working Experienced acute nurses 2nd tier - physician Shared electronic record Resilient infrastructure Technical partnership Opened September 2011 – now

supports >3238 people (April 2014)

EU 3 star status

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400

500

600

700Acute Admissions 1Year Prior toDeployment ofTelemedicine

Acute Admissions 1Year PostDeployment ofTelemedicine

care homes results

-35%

care homes (continued)

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400

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800

1000A&E Attendances 1Year Prior toDeployment ofTelemedicine

A&E Attendances 1Year PostDeployment ofTelemedicine

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2000

4000

6000

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10000Acute Beds Days 1Year Prior toDeployment ofTelemedicine

Acute Beds Days 1Year Post toDeployment ofTelemedicine

-53%

-59%

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%

nurse led triage is the norm

results: primary care

applications

case studies

Trapped wind Sleep walker Falls CPR Allergic reaction Medication Good death

feedback

Patients/Carers“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.”

“I only have one word to describe [the] Telehealth [Hub] – excellent.”

“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…”

Care homes“A very good service. It made me feel confident within my job so I could do the best I can for our residents. This service takes the pressure off us as we have access quickly to a health professional…”

“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...”

“Definitely has reduced admission rates. Telemedicine is an asset to the home with benefits Out Of Hours and weekends”

what are the challenges? technical (care homes) tariff scheduling collaborative working

(community teams, GPs) culture change…STILL

(evidence?) the importance of scale noise – right noise

our future vision

our next steps Scale up our teleconsultation work

Transform workforce

Adopt new models of care

Close gap between primary & secondary care

Greater cross org working

Integrated, supported self care becomes the norm

Maximise benefits from technology

Understand resulting financial flows

so what are we waiting for?

“Just been to Airedale hosp & seen some of best tech anywhere in NHS including digital patient records shared with GPs – and gr8 patient care”

any questions?