Download Telehealth Project Manager NHS South of Tyne and Wear

www.3millionlives.co.uk
Paul Marriott MA FCMI TECH Eng IME
Telehealth Project Manager
NHS South of Tyne and Wear
1
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My Background
• 1977 Started career as an Engineer in Heavy Industry in the North
East and progressed as a Divisional Manager in Staffordshire and
then the Greater Manchester region.
• 1995 moved into Local Government as a Senior Manager
implemented Telecare, Telehealth, and Ran Sheltered Housing and
the 24hr Community Alarms Services.
• July 2011 formed own Telehealth Telecare Management
Consultancy.
• In August 2011 was contracted to lead the South of Tyne and Wear
NHS Telehealth Project.
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The Workshop
M-Care as a Scalable Patient Self Care Solution
The Department of Health is rolling out the ‘3 Million Lives Initiative’
which will see a rapid expansion in the use of Telehealth and
Telecare Services over the next five years.
The Workshop is to look at M-Care and hear how as an example it is
being adopted in Multiple Pathways in the South of Tyne and Wear
NHS
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The Definition of M-Care
M-Care is Mobile health /care monitoring where an individual can
have their health and/or wellbeing monitored at or away from home
via mobile technologies such as 3G, SMS, Mobile Apps and the now
imminent 4G technologies.
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M–Care The Demographics
The original Telecare/health idea came about because of the growing
prevalence of telephone lines across the UK. Beginning with1G telephone
lines then moving to 2G Broadband Enabled lines, and then onto 3G Mobile
and now 4G Technologies are in the wings
1G and 2G Technologies were the automatic choice as ownership of a
landline increased rapidly during the second half of the 20th Century but has
subsequently declined as many people and entire households have chosen
to use mobile telephones for all their communication needs
In 2010, there were more households in the UK with a mobile phone and no
landline than households with a landline but no mobile phone
The percentage of people with a mobile phone continues to increase with
the fastest growth now for people aged 65 and over
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Evolving 3G Telephony
The usability of mobile phone handsets
has been one of the most significant
obstacles to increased ownership and use
amongst the oldest people in society
There are now many designs of mobile
phone that could be used for mobile alarm
applications by older or disadvantaged
groups
Smaller size
Large digits
Fast-dial keys
Large and high-contrast displays
Voice activation
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Limitations of Current 1st & 2nd Generation
Technologies in Health and Care Provision
Telecare services provide reassurance and assistance for vulnerable people
and their families, especially for people who live alone
However, they are limited in their scope because they operate exclusively in
the home and its immediate vicinity
A basic problem is some people can become concerned about going
outside having experienced illness or post accident such as a fall. They
may be inclined to stay at home rather than re mobilising which could help
improve their health and quality of life
Also:
What about Patients who have long term conditions who are also long term
well and wish to work, and not having to be at home completing daily health
checks?
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Examples of M-Care Devices
Care/Nursing Home Multi User
Telehealth bespoke algorithms
breaches or alerts go to supervising
clinician or Clinical Contact Centre
NHS Florence SMS System
bespoke algorithms promotes
Self Care whilst critical
breaches or alerts goes to
supervising clinician
Rapidly Deployable
3&4G Blue tooth Tablet
based system with
bespoke algorithms
breaches or alerts goes
to supervising clinician
Health/Care Hub devices are
beginning to emerge that can
interface comprehensive Health
and Care Packages working with
both Telehealth and Telecare
peripheral devices along with
Mobile Phones and Mobile Apps.
4G will only accelerate this
interface and development.
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Current 3G and Expected 4G Coverage in the UK
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How the South of Tyne & Wear NHS and the 3 SOTW Local
Authorities are Currently Approaching M-Care
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South of Tyne & Wear has:
Population of around 644,000
3 - Foundation Trusts
Northumberland
3 - PCT’s / CCG
3 - Metropolitan Councils
Sunderland, Gateshead and South Tyneside
South of Tyne & Wear
3 – Telecare/Telehealth Control Rooms
Durham
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South of Tyne and Wear Project Approach
• The Project is to run until 31st March 2013
• Overall Control of the Project Rests with a Telehealth Project Board Chaired
by a Clinical Director
• Pathway Officers Appointed/Seconded in each of the 3 Sub Regions to
develop Clinical Pathways with Lead Clinicians
• Pump Priming Funding Available in Each Sub Region Until March 2013
•The University of Hull (Post Graduate Medical School) have been engage to
add academic rigour to the reported outcomes
• No Single Equipment Procurement Exercise
WHY?
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SOTW Telehealth Clinician Led
Not Procurement Led
“Practitioners are bloody minded and practice their own medicine
following their beliefs and clinical training. If something does not fit
with their medicine then they will simply not follow it.”
Dr Hussien El Shakankery GP
SCCG Urgent Care Clinical Lead
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So We Match Clinicians
Medicine with Pathways, and
Then and Only Then, The
Equipment
Structure of the Telehealth Pilot Team
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Within the South of Tyne & Wear NHS We are
Currently Working on the Following M Health
Applications
Condition
Clinical Lead
Heart Failure, Angina etc.
COPD and Respiratory etc.
Hypertension
Diabetes
Gestational Diabetes
Pre Pregnancy HbA1c Family Planning
Parkinson’s
Rapid Discharge
Deprivation Medicine and Social Prescribing
Acquired Head Injury and Stroke
Primary Care Step Up Step Down
Care and Nursing Home
Weight Management
Smoking Cessation
Remote Wound Dressing Monitoring
Community Matron Case Load
Alcohol Induced Morbidity
FT, GP
FT, GP
GP
FT, GP
FT
FT
FT
FT
GP and 3rd Sector
FT, GP
GP
GP
FT, GP, LA & PH
LA & PH
FT
FT
FT
FT = Foundation Trust
GP = General Practitioner LA & PH = Local Authority & Public Health
The SOTW Telehealth
Model Uses any Configuration
3rd & 4th Generation Vital
Signs and Patient Self Care
(Home Based and Mobile)
GP Practices
Wound Sense
Specialist Clinicians
Monitoring Centre
or 111
Community and Specialist
Nursing
1st Generation Vital Signs
(Home Based)
3rd & 4th Generation Vital Signs /
Patient Self Care
(Home Based and Mobile Rapid
Deployment)
Care/Nursing Home
Multi User Telehealth
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Schematic Depiction of Comprehensive Heart Failure Care
Long /Short or
Intermittent Duration
Application of Simple
Self Care Telehealth (TH)
Florence System
Rapid Deployable
Short Duration 3/4G
Telehealth with
Primary or Secondary
Care Support
Patient Offered
Inclusion on
Simple Self Care
(TH) as soon as
First Symptoms of
LTC Appear
Goodlin, S. J. J Am Coll Cardiol 2009;54:386-396
Palliative or Long
Term Telehealth
Home Install with
Community
Support / Palliative
Also Care &
Nursing Home
Application
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SOTW Telehealth Equipment Provision Annual Average Cost
Per Patient by Generation of Equipment
Equipment
Type
1st Generation
Purchased System
1st Year
Capital
Purchase
Cost
Annual
Leasing
Cost
£2000
Annual
Maintenance
Cost
Total
£1000
£3000
2nd Generation
Leased System
£1150
£1150
3rd & 4th Generation
Rapid Deployment
Leased System
£365
£365
3rd Generation
M Care SOTW
Florence System
NHS Owned
£45
£29
£74
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Annual Cost of Telehealth Equipment by Type
Purchase and Annual Cost £
3000
1st Generation Purchased System
2500
2000
2nd Generation Leased System
1500
1000
2nd Generation Rapid Deployable 3G
Leased System
500
0
Generation of System
3rd Generation M Care SOTW
Florence System NHS Owned
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M-Care In Public Health Working with the Local
Authority Telecare Control Rooms
M-Care NHS SOTW
Florence System
Smoking Cessation
Weight Management
Exercise
Depravation Medicine
South Tyneside Council’s
Jontek 3G Control Centre
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As an Example Deprivation Medicine Pathway
South Tyneside Council’s Jontek 3G Control
Centre
GP
Recovering Substance
User
3rd Sector Patient
Buddy
M-Care NHS SOTW
Florence System
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Paul Marriott
Telehealth Project Manager NHS SOTW
[email protected]
0191 5297044