Trust, tech, and teamwork: how Essex’s health and care professionals are using technology-enabled remote monitoring to protect health and prevent hospital admissions.
Delivered in partnership with the AHSN Network.
Thousands of residents in Mid and South Essex (MSE) are being supported at home and protected against the development of serious health infections by staff using technology-enabled remote monitoring.
This work is saving and improving the lives of people from the comfort of home, including 227 care homes in MSE, and reducing the incidence and potentially devastating impact of conditions like sepsis and urinary tract infections (UTIs) through early detection and prompt management.
People
Serving a population of 1.2 million, MSE Integrated Care System (ICS) is working to provide person-centred care through a blend of digital and face-to-face support and scaling up its use of technology-enabled remote monitoring.
Trust and training, along with relationships that transcend traditional sector boundaries, means professionals including care home staff, GPs and ambulance staff offer technology-enabled support to all of MSE’s 7,000 care home residents.
Process
A 2018/19 pilot of technology-enabled remote monitoring for residents in eight care homes, aiming to reduce health deterioration and the harm of infections like sepsis, accelerated during the pandemic to support residents in 227 homes.
Speaking about the impact of technology-enabled remote monitoring during the Covid-19 pandemic, Dr Raymond Arhin, a GP partner at Aveley Medical Centre, said:
We’ve seen a dramatic improvement in the way we offer care to our care home patients. By updating the digital tool with patient observations such as blood pressure, oxygen saturations and temperature, care home staff are able to work interactively with us, providing us with objective evidence about what is happening to the residents for us to then give the necessary advice.
Established clinical governance processes underpin all MSE activity and helped the team to rapidly deploy training to care home staff, ensuring confidence with compliance alongside effective observation technique. Virtual and face-to-face staff training, supported by best practice models, remains a key element of the team’s work to develop and scale technology-enabled services
Culture
Aiming to ensure digital inclusivity for everyone, the MSE team is working together with partners to build confidence in technology-enabled remote monitoring among both residents and staff.
This includes new work with Healthwatch to understand attitudes to digital health benefits, barriers, and appetite for use within the local population. The team also loan tablets and larger capacity SIM cards to virtual ward patients, whether home is a care home or different type of home, to ensure they can receive remote consultations and remote monitoring support.
They are also working with pharmacists to leverage the potential of technology-enabled remote monitoring to support early interventions, like medication reviews, and with the ambulance service to embed confidence in remote monitoring readings and the resulting actions recommended by care home staff.
The ambulance trust also now holds a list of the care homes using technology-enabled remote monitoring, supporting their control centre team to request details of recorded observations.
Rachel Hunt, East of England Ambulance Service Clinical Lead said:
The technology has helped early identification of sepsis markers and other conditions like Covid 19, allowing an ambulance or help to be sought sooner and ensuring these patients don’t become so critically unwell. There’s learning about the latest technology in use in Mid and South Essex and within each ICS to take back to ambulance staff, many of whom are new, as it’s common for an ambulance to travel from one ICS area to another.
Tools and Technology
Care home staff support residents by using blood pressure monitors, pulse oximeters and thermometers to take regular vital sign readings.
They use Whzan remote monitoring technology to input the readings digitally, supporting them to quickly understand a resident’s health through an automatically calculated NEWS2 score. Staff also use the Istumble app to assess the potential risk of a resident falling.
This information is securely uploaded to the MSE team’s digital dashboard, while a separate dashboard provides them with aggregated data on impact and outcomes to inform planning and commissioning, including length-of-stay and non-elective admissions by condition including sepsis, UTIs and falls.
The team is working within a strong information governance framework to enable the secure flow of this information from care homes to GP practices, with more than 60 per cent of practices now connected, and aims to then develop access for community teams, Integrated Care 24 and NHS 111.
They continue to scale and expand technology-enabled services to help MSE residents at home including via virtual and physical hospital pathways, with an initial focus on virtual wards for frailty and respiratory conditions.
Michelle said:
We’re piloting Whzan as part of NeuroResponse rehabilitation, led by clinical entrepreneur Bernadette Porter. We’re also looking at the Isle of Wight’s model to support patients who are due to attend hospital for an operation, in ensuring their appointment is not cancelled on the day. Another pilot with Essex Partnership University NHS Foundation Trust aims to support patients with severe mental illness to receive their annual health checks, with the utilisation of Whzan and additional glucometers.
Benefits and impact
Among residents aged over 65 in care homes using technology-enabled remote monitoring, comparing June 20 to June 21 to the previous 13-month period and adjusted to take into account the impact of Covid, the MSE team recorded:
- 24% reduction in non-elective hospital admissions (compared to 13 per cent reduction in homes not using technology-enabled remote monitoring), equating to approximately 307 admissions avoided or 24 fewer admissions per month.
- A reduction in length of stay from 6.8 to 5.6 days a fall of 18% compared to 12 per cent overall reduction.
- 899 bed days saved - or around 69 per month including a significant reduction in sepsis bed days.
Find out more
You can read the full case study on our Innovation Collaborative workspace at FutureNHS.
Join the National Innovation Collaborative
The Innovation Collaborative is open to all NHS, social care and local authority staff with an interest in remote monitoring, providing access to peer-to-peer support, guidance and tools designed to help you implement a remote monitoring service.
Existing members can access the Innovation Collaborative Digital Health workspace on the FutureNHS platform. Alternatively, to join or ask any questions email innovation.collaborative-manager@future.nhs.uk.