A pilot of cardiac telemedicine services in Cumbria and Lancashire has concluded that if introduced nationally the technology could save 100s of lives, lead to 45,000 fewer hospital admissions and save the NHS around £46m.
In a pilot lasting 18 months, NHS North West, in collaboration with the NHS Lancashire and South Cumbria Cardiac Network trialed advanced cardiac telemedicine devices at 15 GP surgeries and two walk-in-centres. The devices and monitoring services were provided by Broomwell Healthwatch.
Broomwell’s hand-held 12-lead ECG machine is used by a nurse, clinician or paramedic in the same way as a conventional machine. When the ECG is complete, it is transmitted by fixed line telephone in just 45 seconds to Broomwell’s monitoring centre, where it is displayed on screen for interpretation by experienced clinicians.
Based on the high-quality ECG trace, Broomwell staff give an immediate verbal interpretation by phone so that action can be taken quickly, if needed. A full written ECG report is also sent to the GP surgery by email or fax for inclusion in the patient record.
Steve Ward, senior medical adviser for the pilot, told E-Health Insider: “We had the opportunity to look at new innovations around healthcare and we felt cardiac monitoring was a good place to start. Using these new devices health workers have seen the advantages of new technology first-hand.
“Now, a patient can have an ECG taken immediately with the device and not have to wait long for results to see if any further action is necessary. The reading just goes through the phone line to a dedicated centre and in literally minutes the GP has a diagnosis for the patient. It means no more of the old slow process.”
Data from the pilot showed 82% of patients receiving ECG’s did not need to go to hospital following the test – giving the patients rapid reassurance, and reducing their stress and anxiety.
The results of the pilot showed that access to ECG tests through this technology could potentially save hundreds of lives each year by early detection of heart problems.
Such early detection is proven to be a factor in helping to avoid irreversible heart damage. A further benefit is that patients can be accurately diagnosed within local healthcare settings instead of having to travel to a hospital for testing.
Sally Chisolm, a programme director on the pilot told EHI: “Based on the results of our pilot, we have come up with financial estimates. The 15 GP practices and two walk-in-centres showed a saving of around £150,000, so on a national scale, even with the cost of the equipment brought, this could equate to up to £46m.
“Furthermore, the pilot has demonstrated the potential to save 90,000 accident and emergency visits, 45,000 hospital admissions and hundreds of lives each year in England.”
The strategic health authority are releasing the report today to send out to commissioners and urge them to invest in this type of technology, including GP surgery’s Practice Based Commissioning teams
The research was funded by the Department of Health, and the heart tzar (national director for heart disease), Roger Boyle, said: “When you need an ECG to diagnose a problem with the heart rhythm or the cause of a pain in the chest, you need it there and then. You also need somebody to interpret it accurately. But in rural areas like parts of Cumbria and Lancashire, access to expert interpretation is not always immediately available.
“This pilot has helped to demonstrate not only the benefits to patients – accessing care in the local community and preventing unnecessary trips to hospital – but also the potential financial benefits to the NHS. Cardiac telemedicine is an excellent way to ensure that expert advice is available in a matter of minutes, not only to the patient but also to the healthcare professionals involved with the care."
Some parts of the region have already started investing in this technology and Ward says this is just the start.
“Following this publication, we plan to maintain this service. This is just the start of the journey and the aim of it all is to ensure that everyone knows that it is a win-win-win situation. The patients will win, the GPs will win and the healthcare environment will win.”
The device from Broomwell Healthwatch was also piloted at the high-security Her Majesty’s Prison Wakefield for 12 months to see if outsourced cardiac monitoring would help to improve public safety by avoiding off-site hospital admissions.
The technology costs around £300 per unit, compared with £100 for a single A&E visit, and Broomwell Healthwatch believes the savings to the NHS from using telemedicine ECG’s on a wider scale would be around £250M per year.
Further research is now underway to look at other benefits from telecare including using mobile phones, instead of landlines, allowing patients to do their own ECG’s using hand-held devices and giving patients a wristband-watch device for tele-monitoring.
The full report is available from the website of the NHS Lancashire and South Cumbria Cardiac Network.