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CASE STUDY

Successful remote monitoring programme benefits Heart Failure patients in St Helens

Patients suffering with Congestive Heart Failure (CHF) in the St Helens and Knowsley area are benefitting from a remote monitoring solution that is being used in the area to monitor their health and ultimately to reduce admissions to hospital. Patients are reporting benefits from the solution, including a reduction in anxiety, and making life easier for them. This is a multi-disciplinary project with St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens CCG, Mersey Care NHS Foundation Trust and Docobo.

What happened with the remote monitoring project?

The remote monitoring of Heart Failure project started in September 2021 after St Helens CCG identified a need to remotely monitor more complex patients with long term conditions. The team wanted to use remote monitoring to better manage patients’ outcomes, to enable patients to stay in their homes rather than constantly come in for appointments, to make evidence-based decisions on medications by tracking and ultimately to reduce the load on local hospitals St Helens and Knowsley Teaching Hospitals NHS Trust. These benefits have been realised as part of the project.

St Helens CCG, part of the Cheshire and Merseyside family, worked with Docobo to provide the technology and Mersey Care clinician’s Hub to provide the monitoring service – in order to monitor Heart Failure patients in the area. The solution enables nurses to alter medications remotely, monitor blood results and help patients to manage their chronic disease pathway better.

How does remote monitoring work at St Helens?

Once a patient has been identified for the service, they are given a range of devices to enable them to monitor their signs and symptoms from home i.e. a thermometer and blood pressure monitor.

Remote monitoring uses the DOC@HOME platform to do the following.

• Heart failure patients record their vital signs and symptoms onto the device including blood pressure, blood glucose levels, oxygen, pulse
• They are asked a few specific ‘question sets’
• All information entered is automatically transferred to the clinical Hub provided by Mersey Care – with their team of expert trained nurses on hand.
• Any anomalies in the readings will automatically alert the nurses at the Mersey Care telehealth monitoring hub
• Nurses at Mersey Care Hub triage the alert and will respond within 2 hours

Benefits of remote patient monitoring

The solution has been rolled out to patients across the St Helens area and has received great feedback from clinicians and patients alike.

Trish Wainwright, Community Heart Failure Nurse, St Helens says: ‘I feel there’s been real benefits in adopting this telehealth monitoring for patients. These patients have long term chronic conditions, and they need surveillance in order to manage these better and more thoroughly. Using remote monitoring technology from Docobo, we can then increase medications in and evidence-based way, which helps patients to manage their chronic disease pathway much better, avoid hospital admissions and get these patients as well as we can do.’

Excellent feedback from pilot evaluation

Trish continues: ‘Docobo is providing patients with more knowledge and more education around their own disease. We have found that since using the system patients ‘trigger’ more appropriately – so they know when they are decompensating, and we can manage those things quicker and nip things in the bud more efficiently.’
Peter, a patient with chronic heart failure in conjunction with a number of other diseases, is being monitored by the Docobo solution. Before using remote monitoring used to go into clinics regularly. Since using the solution, he’s reported positive benefits. Peter says: ‘I’ve found Docobo to be very helpful – I no longer have to go in and report my condition. When I recently suffered a flutter on my heart, I put that information into Docobo and whilst out in car – they phoned me up to find out what it was and if there had been any other side effects. I would strongly recommend Docobo – it gives you peace of mind. It’s made my life a lot easier and left me feeling a be a bit more confident – if I need help, it’s literally round the corner.’

Trish continues: ‘The introduction of this technology was really good for Peter – and he’s seen it as a real positive. His previous observations were never recorded – so now we are able to access the dashboard and we can look at the trends. In heart failure that’s really important – it’s not about the one off observations – it’s about the trends and the response to alterations in medication. This is giving him confidence because he knows that somebody’s watching that and we can then liaise with our clinicians and either upscale that monitoring or decrease that monitoring accordingly.’

Dr Greg Irving is Research Lead for St Helens CCG and one of the GP governing body members, who says: ‘Using the Docobo service allows us to ensure that those patients with heart failure who have complex needs and a very unpredictable disease trajectory receive well-coordinated care in a timely fashion and we know they were being monitored safely. There’s been good satisfaction from a clinical point of view – speaking as a GP we’ve found that it’s not really increased the GP workload, which is important at this current time. If anything, it’s offered something in addition to the usual care that patients receive. We have run a number of evaluations using Docobo locally, and the individual patient feedback was overwhelmingly positive.’

Peter Almond, Cheshire and Merseyside Remote Monitoring Programme Manager at Mersey Care NHS Foundation Trust says: ‘We’re really pleased to be providing the monitoring service for the people of St Helens and happy to see the great feedback from patients and clinicians.’

Futures

Dr Greg Irving continues: ‘One of the big strategic priorities for the future is developing the NHS @HOME services which focusses on the delivery of telemonitoring services at home for patients with chronic diseases. In St Helens we’re using the service for heart failure and COPD but there’s huge potential for using the service for other areas such as hypertension and type 2 diabetes and mental health.’

‘I feel there's been real benefits in adopting this telehealth monitoring for patients. Using remote monitoring technology from Docobo, we can then increase medications in an evidence-based way, which helps patients to manage their chronic disease pathway much better, avoid hospital admissions and get these patients as well as we can do."

Trish WainwrightCommunity Heart Failure Nurse, St Helens