Remote monitoring facilitates the management of inflammatory bowel disease

In February 2012, Luton and Dunstable University Hospital in Hertfordshire became the first hospital in the UK to commence a remote management programme for stable inflammatory bowel disease (IBD) patients. The project, titled IBD-SSHAMP (Supported, Self Help And Management Programme), was funded by an Innovation Award presented by the East of England Primary Care Trust (PCT) Innovation Team.

Situation

The Trust needed to identify and implement an appropriate digital solution to enable them to transfer patients from routine face-to-face clinic visits into an efficient remote monitoring service.

The system would need to enable early detection of issues and permit pre-emptive management to prevent disease flare-ups requiring hospitalisation.

Aspiration

To implement a system that enables patients to monitor their own symptoms, decide when they need to go to the hospital, and seek information and advice about self-management.

Solution and impact

A patient management portal called Patients Know Best (PKB) was implemented in 2012.

This released 1,100 appointment slots from a patient group of approximately 600 per year.

In the first 3 years, there were 43 flares, most of which were resolved through self-guided management using mesalazines. Sixteen patients required steroid prescriptions, but there were no hospital admissions.

Impact

By 2018, 1,000 patients (which accounts for one third of the total cohort) moved to a PKB remote pathway where they initiated the follow-up as needed.

Patients were empowered with self-management, remote monitoring capabilities and virtual consultations.

This has resulted in the hospital being able to review patients within 48 hours if they are experiencing a flare, as opposed to having to generate an appointment.

Functionality

• PKB is a web-based patient management portal
• Patients are set up with an account to log into the website

Capabilities

• Personalised care plans are created for patients with symptom tracking to monitor their condition. These care plans can also be accessed by the patient’s GP
• Can be used by patients to undertake routine monitoring (for example, blood pressure, weight), symptomatic assessments, and to obtain test results. The IBD team is notified by an alert if a patient’s symptom indices deteriorate markedly
• Patients and the IBD team can communicate easily for professional support and review
• All patients have access to their hospital healthcare records through the PKB portal

Scope

PKB is a portal between patients at home and clinical teams. Available on web, mobile and in the NHS App.

Key learning points

As the number of patients messaging through PKB increased, there was a corresponding reduction in the phone calls coming through the IBD hotline.

The Trust felt that receiving and responding to questions through PKB messaging tended to be more time efficient than dealing with queries over the phone, saving the staff time.

Key figures/quotes

“There’s a direct link to the hospital. Anyone with a high symptomatic score is added to a workload sheet so that when the nurses log in to their system, they can see a list of patients that need to be contacted for additional support. Using an internet-based electronic management system enables the patient to manage their inflammatory bowel disease condition better themselves from the comfort of their own home.”
Dr Matthew Johnson, lead gastroenterology consultant, Luton and Dunstable University Hospital

“I found it very useful. It’s convenient for both parties to communicate. However silly the question is, I get an answer back usually within 48 hours.”
David, a patient of Luton and Dunstable University Hospital’s IBD service

Find out more

Read more about how remote monitoring facilitates the management of IBD

Read about patient initiated follow up in an IBD service

Watch a video on how Luton and Dunstable Hospital used the IBD Patient Portal

Read staff and patient testimonials on PKB

Key contact

Matthew Johnson, consultant gastroenterologist, Luton and Dunstable Hospital University Hospital NHS Foundation Trust

Matthew.Johnson@ldh.nhs.uk

Supplier: Patients Know Best

communications@patientsknowbest.com