December 6, 2023

The Frimley Well being and Care Built-in Care System (ICS) has rolled out a proactive method to distant monitoring that’s serving to to scale back hospital admissions.

The ICS, which covers East Berkshire, Surrey Heath, Farnham and North East Hampshire, has rolled out the answer to 4,000 sufferers with high-risk situations akin to diabetes, coronary heart failure and persistent obstructive pulmonary illness, in addition to 800 care house residents.

The method is a part of Frimley’s digital transformation programme, Linked Care, and was run in two phases. The primary stage noticed it carried out inside care houses in March 2022, with the sufferers with complicated wants following in December 2022.

Since implementation, Frimley Well being and Care has seen hospital admissions diminished by 40% for high-need sufferers and 34% for care house residents. Whereas A&E attendance has dropped by 31% for high-need sufferers and 40% for care house residents. As well as, GP contact was diminished by 19% for the high-need sufferers and 20% for care house residents, whereas each teams diminished the quantity of medicines prescribed by 11%.

Anna Fishta, affiliate director shared care information and distant monitoring at Frimley ICS, stated: “Outcomes like these, such because the discount in hospital admissions and A&E visits, are encouraging, and why we’re all so passionate concerning the challenge.

“Distant monitoring is a part of our overarching dedication to working in another way, extra successfully and effectively. Sufferers are robotically recognized and contacted for the distant monitoring service when wanted, utilizing our inhabitants well being answer, which is quicker than the standard referral course of. Due to that, care groups are in a position to assist their sufferers on the earliest doable alternative.”

Sufferers are recognized utilizing Graphnet Health’s inhabitants well being answer, CareCentric. This makes use of data-driven insights to assist suppliers establish those that are most in want of extra assist.

As soon as accepted onto the programme sufferers are supplied with distant monitoring know-how by Docobo, together with the DOC@HOME app. This app permits customers to speak with healthcare professionals shortly and simply, in addition to submit well being readings and different important data.

Shared care file integration

Moreover, the DOC@HOME distant monitoring answer integrates with Frimley’s shared care file – which is powered by Graphnet. This allows well being and care groups to entry affected person data from acute trusts, major and group suppliers, scientific monitoring hubs and out-of-hours GP companies. Ought to a affected person current in an pressing care scenario, workers have all the data wanted to make sure they obtain applicable and well timed care.

Fishta added: “Suggestions has been constructive to date, with sufferers feeling extra answerable for their very own well being and higher supported.”

She continued: “On the scientific facet, we’ve had docs telling us that the method is stopping their high-risk sufferers from falling into disaster. These testimonials are what it’s all about. The know-how is a way to an finish, it’s the folks and serving to them reside higher high quality, extra impartial lives that’s on the coronary heart of what we’re doing.”

There are actually greater than 5,000 sufferers onboarded onto the distant monitoring programme, with plans to roll out the method to the rest of the Frimley ICS area over the following six months.

The primary rankings awarded to each built-in care system for the ‘digital maturity’ of its NHS suppliers positioned Frimley Well being and Care very extremely.