Paul Marriott MA FCMI TECH Eng IME Telehealth Project Manager NHS South of Tyne and Wear

www.3millionlives.co.uk

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Paul Marriott MA FCMI TECH Eng IME

Telehealth Project ManagerNHS South of Tyne and Wear


My Background

• 1977 Started career as an Engineer in Heavy Industry in the North East and progressed as a Divisional Manager in Staffordshire and then the Greater Manchester region.

• 1995 moved into Local Government as a Senior Manager implemented Telecare, Telehealth, and Ran Sheltered Housing and the 24hr Community Alarms Services.

• July 2011 formed own Telehealth Telecare Management Consultancy.

• In August 2011 was contracted to lead the South of Tyne and Wear NHS Telehealth Project.


The Workshop

M-Care as a Scalable Patient Self Care Solution

The Department of Health is rolling out the ‘3 Million Lives Initiative’ which will see a rapid expansion in the use of Telehealth and Telecare Services over the next five years.

The Workshop is to look at M-Care and hear how as an example it is being adopted in Multiple Pathways in the South of Tyne and Wear NHS


The Definition of M-Care

M-Care is Mobile health /care monitoring where an individual can have their health and/or wellbeing monitored at or away from home via mobile technologies such as 3G, SMS, Mobile Apps and the now imminent 4G technologies.


M–Care The Demographics

The original Telecare/health idea came about because of the growing prevalence of telephone lines across the UK. Beginning with1G telephone lines then moving to 2G Broadband Enabled lines, and then onto 3G Mobile and now 4G Technologies are in the wings

1G and 2G Technologies were the automatic choice as ownership of a landline increased rapidly during the second half of the 20th Century but has subsequently declined as many people and entire households have chosen to use mobile telephones for all their communication needs

In 2010, there were more households in the UK with a mobile phone and no landline than households with a landline but no mobile phone

The percentage of people with a mobile phone continues to increase with the fastest growth now for people aged 65 and over


The usability of mobile phone handsets has been one of the most significant obstacles to increased ownership and use amongst the oldest people in society

There are now many designs of mobile phone that could be used for mobile alarm applications by older or disadvantaged groups

Smaller size Large digitsFast-dial keysLarge and high-contrast displaysVoice activation

Evolving 3G Telephony


Limitations of Current 1st & 2nd Generation Technologies in Health and Care Provision

Telecare services provide reassurance and assistance for vulnerable people and their families, especially for people who live alone

However, they are limited in their scope because they operate exclusively in the home and its immediate vicinity

A basic problem is some people can become concerned about going outside having experienced illness or post accident such as a fall. They may be inclined to stay at home rather than re mobilising which could help improve their health and quality of life

Also:

What about Patients who have long term conditions who are also long term well and wish to work, and not having to be at home completing daily health checks?


Examples of M-Care Devices

NHS Florence SMS System bespoke algorithms promotes Self Care whilst critical breaches or alerts goes to supervising clinician

Rapidly Deployable 3&4G Blue tooth Tablet based system with bespoke algorithms breaches or alerts goes to supervising clinician

Care/Nursing Home Multi User Telehealth bespoke algorithms breaches or alerts go to supervising clinician or Clinical Contact Centre

Health/Care Hub devices are beginning to emerge that can interface comprehensive Health and Care Packages working with both Telehealth and Telecare peripheral devices along with Mobile Phones and Mobile Apps. 4G will only accelerate this interface and development.


Current 3G and Expected 4G Coverage in the UK


How the South of Tyne & Wear NHS and the 3 SOTW Local Authorities are Currently Approaching M-Care


South of Tyne & Wear

Northumberland

Durham

South of Tyne & Wear has:

Population of around 644,000

3 - Foundation Trusts

3 - PCT’s / CCG

3 - Metropolitan CouncilsSunderland, Gateshead and South Tyneside

3 – Telecare/Telehealth Control Rooms


South of Tyne and Wear Project Approach• The Project is to run until 31st March 2013 • Overall Control of the Project Rests with a Telehealth Project Board Chaired by a Clinical Director

• Pathway Officers Appointed/Seconded in each of the 3 Sub Regions to develop Clinical Pathways with Lead Clinicians

• Pump Priming Funding Available in Each Sub Region Until March 2013

•The University of Hull (Post Graduate Medical School) have been engage to add academic rigour to the reported outcomes

• No Single Equipment Procurement Exercise

WHY?


SOTW Telehealth Clinician Led Not Procurement Led

“Practitioners are bloody minded and practice their own medicine following their beliefs and clinical training. If something does not fit with their medicine then they will simply not follow it.”

Dr Hussien El Shakankery GP

SCCG Urgent Care Clinical Lead


So We Match Clinicians Medicine with Pathways, and Then and Only Then, The Equipment

Structure of the Telehealth Pilot Team


Within the South of Tyne & Wear NHS We are Currently Working on the Following M Health ApplicationsCondition Clinical Lead

Heart Failure, Angina etc. FT, GPCOPD and Respiratory etc. FT, GPHypertension GPDiabetes FT, GPGestational Diabetes FTPre Pregnancy HbA1c Family Planning FTParkinson’s FTRapid Discharge FTDeprivation Medicine and Social Prescribing GP and 3rd SectorAcquired Head Injury and Stroke FT, GPPrimary Care Step Up Step Down GPCare and Nursing Home GPWeight Management FT, GP, LA & PHSmoking Cessation LA & PHRemote Wound Dressing Monitoring FTCommunity Matron Case Load FTAlcohol Induced Morbidity FT

FT = Foundation Trust GP = General Practitioner LA & PH = Local Authority & Public Health

The SOTW Telehealth The SOTW Telehealth Model Uses any Configuration Model Uses any Configuration

1st Generation Vital Signs (Home Based)

3rd & 4th Generation Vital Signs / Patient Self Care(Home Based and Mobile Rapid Deployment)

3rd & 4th Generation Vital Signs and Patient Self Care (Home Based and Mobile)

GP Practices

Specialist Clinicians

Community and SpecialistNursing

Monitoring Centre or 111

Care/Nursing Home Multi User Telehealth

Wound Sense


Goodlin, S. J. J Am Coll Cardiol 2009;54:386-396

Schematic Depiction of Comprehensive Heart Failure Care

Long /Short or Intermittent Duration Application of Simple Self Care Telehealth (TH) Florence System

Rapid Deployable Short Duration 3/4G Telehealth with Primary or Secondary Care Support

Palliative or Long Term Telehealth Home Install with Community Support / Palliative Also Care & Nursing Home Application

Patient Offered Inclusion on Simple Self Care (TH) as soon as First Symptoms of LTC Appear


SOTW Telehealth Equipment Provision Annual Average Cost Per Patient by Generation of Equipment

EquipmentEquipmentTypeType

11stst Year Year Capital Capital

Purchase Purchase CostCost

Annual Annual Leasing Leasing

CostCost

Annual Annual MaintenanceMaintenance

CostCostTotalTotal

1st GenerationPurchased System

£2000 £1000 £3000

2nd Generation Leased System

£1150 £1150

3rd & 4th Generation Rapid Deployment Leased System

£365 £365

3rd Generation M Care SOTW Florence SystemNHS Owned

£45 £29 £74


M-Care In Public Health Working with the Local Authority Telecare Control Rooms

M-Care NHS SOTW Florence System

South Tyneside Council’s Jontek 3G Control Centre

Smoking CessationWeight ManagementExercise Depravation Medicine


As an Example Deprivation Medicine Pathway

GP

Recovering Substance User

3rd Sector Patient Buddy

M-Care NHS SOTW Florence System

South Tyneside Council’s Jontek 3G Control Centre


Paul Marriott Telehealth Project Manager NHS SOTW

[email protected]

0191 5297044

Paul Marriott MA FCMI TECH Eng IME Telehealth Project Manager NHS South of Tyne and Wear

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