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NHS England - Transformation Directorate

Remote ECG monitoring to support mental health patients in the North East and Yorkshire

What was the aim?

Delivering a new remote monitoring device to support mental health patients from the side effects of certain medications.

Part of a wider digital programme to transform cardiology outpatient services across the region, the project uses new mobile heart monitoring technology to track the impact of antipsychotic drugs on a patient’s cardiac health in their own home

Using a portable electrocardiogram (ECG) device that is no bigger than a credit card, community health professionals are able to take fast, accurate readings of a patient’s heartbeat without requiring them to visit their GP surgery or local hospital. The process is also significantly quicker than a conventional ECG and can be done by a community health professional during a routine visit, making it more convenient for the patient while also saving clinical time.

The project aims to:

  • support continuity of care by ensuring new and existing patients can receive their ECG monitoring remotely during the COVID-19 pandemic
  • deliver a faster, more efficient way of performing essential monitoring, saving clinical time and making the process quicker for the patient
  • enhance the patient’s experience by allowing monitoring to take place in the individual’s own home and performed in a more discrete and dignified way

What was the solution?

Using a portable ECG mobile device manufactured by AliveCor KardiaMobile. The light-weight device is easy to use and in most cases the ECG can be performed during a routine home visit by a community health professional.

The technology makes the ECG process faster and more efficient as:

  • ECG results are securely shared via Bluetooth straight to the professional’s smartphone or tablet
  • analysis from the ECG is then shared with the patient’s clinical team, flagging up any abnormalities or red flags
  • based on these results, changes to the patient’s treatment are discussed between their GP, psychiatry and cardiology team
  • GP and psychiatry team then work together to put any new treatment plans into action and continue the heart monitoring process

What was the impact?

Over 741 ECGs were conducted between October 2020 to June 2021, with:

  • 140 additional devices commissioned for use
  • 217 hours saved so far
  • 17.5 minutes saved per ECG
  • the trust to save approximately £327,607 per year, allowing savings to go back into mental health care

Key actions and insights

The technology is unlocking significant benefits for both patients and clinical teams, with early feedback showing unanimous support for the new way of working. Here are 3 reflections:

“It is so easy! It’s much less intrusive. I don’t have to remove my clothing and I’m amazed how small the device is.” - Patient

“It is amazing. It’s much less distressful and the ECG was obtained so quickly.” - Patient

“The new equipment is brilliant and so easy to use ...if you take the device off me I will cry!” - Feedback from a community nurse involved in the initial phase of the project

How is the technology working in practice?

We asked a selection of health professionals working with portable ECGs to describe the real-world impact of their technology on their patients and their own working practices. Here are their personal experiences.

“It cuts in half the time it takes to 15 minutes or less”

Everlyn Rodriguez, a community mental health nurse, talks about her experience of using the technology, describing how it is empowering and supporting community nurses while dramatically reducing the amount of time taken to perform the procedure.

“A less intrusive way of doing an important physical health check”

Dr Santosh Kumar, consultant forensic psychiatrist, describes the significance of this solution as a way of supporting patients with complex needs. He also outlines some of the practical benefits, from improving dignity of care to increasing the frequency and ease with which ECGs can be done.

“I’m carrying it around with my mobile phone”

Consultant psychiatrist, Dr Swapan Kole, explains how the highly portable and easy-to-use nature of the technology is already making it a popular and effective solution for staff, which is helping to support high uptake among patients and should deliver significant cost savings for the service.

Key lessons and next steps

Looking ahead, how might this project help to shape the future direction of health services in the region? We asked members of the project team to outline the key lessons that are shaping their priorities for the future.

Breaking down artificial barriers to change

It’s often the case that necessity precipitates important changes, and in our case the pandemic forced us to adapt our ways of working in order to reduce footfall of patients into hospitals and GP surgeries.

The urgency of the situation enabled the team to fast-track processes that would otherwise have delayed implementation. It’s a lesson learnt for future transformation projects.

Having the support of a multidisciplinary team of advocates

Mental healthcare is a wide-ranging field involving professionals working across various settings, so an essential part of the engagement was ensuring a strong group of advocates from across the workforce who could help to share and spread technical innovation.

Since a lot of our training had to be done virtually, this multidisciplinary support was even more important to help embed the use of the technology and manage any concerns or challenges that emerged during implementation. The results have received very positive feedback from all staff using the equipment.

Supporting higher ambitions for technology in mental health

In many ways, mental health has been catching up with other disciplines in terms of how it uses technology to improve care. The success of this project can be a gateway for further innovation within this locality and across the system.

Find out more

You can read the full case study on the work across the region 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