Central Surrey Health NHS Trust have shown that using telemedicine as support for treating patients with Chronic Obstructive Pulmonary Disease (COPD) can bring benefits to both patients and nurses by allowing close, accurate and easy monitoring, potentially leading to earlier discharges.
Speaking at the Healthcare Computing conference in Harrogate, Julia Davey, community respiratory nurse specialist at the trust, said that Central Surrey had been able to make patient monitoring much easier by implementing AxSys Technology’s Excelicare platform.
Excelicare is a toolset-based application that provides clinicians with a modern, flexible, browser based workspace to review and interact with a patient’s clinical record. It supports clinicians by providing clinical alerts through embedded clinical algorithms and provides point-of-care documentation support.
Davey said: “Excelicare has enabled the remote monitoring and assessment of COPD patients and as a result has saved lives and cu hospital admissions by over 40%. We have witnessed a 26% reduction in bed days and patients have been encouraged to take an interest in their own day-to-day care.”
Central Surrey Health (CSH) is the first of a new kind of not-for-profit organisation that provides community nursing and therapy services to the people of central Surrey. It is co-owned and run by the nursing and therapy teams it employs. CSH says it combines the values and principles of the NHS with the ‘can do’ culture of a successfully run business.
In a bid to try and keep patients at home, CSH are using the Excelicare Direct component, an interactive telephone-based, patient self-monitoring module linked directly to the Excelicare platform electronic patient record.
An AxSys Technology spokesperson told EHIPC: “The use of Excelicare Direct empowers patients to become more actively involved in their own health and treatment, and provides them with 24-hour access to their healthcare provider via telephone. This in turn improves their compliance with treatment and allows closer and more accurate monitoring of patients within their home. By providing this monitoring via the telephone, minimal inconvenience, cost and time expenditure are incurred for both the patient and the healthcare provider, whilst improving the overall outcome of treatment.”
Davey told the audience that it was important that the system they used promoted best practice in intermediate care with standardised medical and social assessments and a patient-centred system suited to capture data from patients – many of whom are at the last stages of their lives and living depressed and cramped lifestyles – in the easiest possible way.
“Using the system, we can keep people at home for as long as possible. They can call the dedicated phoneline if they are feeling well and talk to a nurse, going through a detailed patient questionnaire. This keeps a ‘red count’ and if that goes too high then a COPD nurse is called straight away. If they do not feel up to a questionnaire, then they can ask to speak to a COPD nurse instead.”
Using Excelicare, the trust has also been able to keep the records on one system accessible to any authorised person under the Single Assessment Process procedure. For new members of staff, full guidance on the telemonitoring is available on the system.
Davey added: “Nothing will take the place of person-to-person care but it is very useful for nurses to be able to see who needs to be seen more quickly because they are really sick patients and who just needs frequent visits. It cuts down home-visits allowing more patients to be managed by the same number of healthcare staff. Care is delivered seamlessly by a chain of interconnected disciplines.”
The aim of the project was to help ensure that clinicians get the diagnosis right at the right time enabling patients to be treated from the comfort of their own homes and possibly be able to have a dignified death at home, with hospice places being few and far between.
Davey said: “Patient-centered telemedicine can improve healthcare delivery by supporting intermediate care and leading to cost savings while maintaining clinical effectiveness of intermediate care.”
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