Improving outcomes andefficiencies of managing patients        in the community               Adrian Flowerday            ...
Enabling Technologies supporting                          Community care   • Telehealth – Managing patients             – ...
Issues Surrounding Home based Care Delivery • New Providers    – Vertical and Horizontal Integration, Private providers   ...
An independent BBC video
What did Stan tell us• Patient experience   – He’s doing it from his lounge in his usual chair   – He has become an expert...
doc@HOME® Infrastructure Overview                                                                                         ...
Features:    • Simple to use – fit for    purpose for demographic    • Handheld cradle based –    used anywhere, no wires ...
CAREPORTAL® – Assisted Living                                                                  •    CAREPORTAL® a multi-me...
Clinicians View28/11/2011   Copyright © Docobo Limited   Not to be reproduced without permission   9
Example stored ECG (lead 1)
HVI and Rhythm Analysis
Efficiency savings 1                                                   Prior to doc@HOME                    With doc@HOME ...
South East Essex   • 999 calls – the average number of 999 calls made per month by the     patients whist using the Telehe...
New Directions... Consumer power   • Current doc@HOME service is mainstreamed in many organisations, with     over 85% of ...
Its more than Health.......             Older/vulnerable people                                              Complex LTC  ...
Independence Infrastructure Overview     BeTogether™                                      Assistance                      ...
ComCare – Management of Community Care       Copyright © Docobo Limited   Not to be reproduced without permission
Wound Management                              Can record multiple wound locations                              Each woun...
Productivity ImprovementsMore than 60,000 hours ofsavings                                                  Target Saving =...
Efficiency SavingsA days nursing activity at one locationafter optimisation…..62 hours of travel reduced to 27 hours3708 k...
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Improving Outcomes And Efficiencies Of Managing Patients In The Community - Adrian Flowerday

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  • Improving Outcomes And Efficiencies Of Managing Patients In The Community - Adrian Flowerday

    1. 1. Improving outcomes andefficiencies of managing patients in the community Adrian Flowerday Managing Director
    2. 2. Enabling Technologies supporting Community care • Telehealth – Managing patients – Self care – Risk Stratification – Professional care • Care delivery logistics – Managing Staff – Staff self management – Performance management • Assisted Living – Managing the elderly and vulnerable – Social isolation, fragmented families, digital divide – Son/Daughter responsibilities – Access to support and wider world28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 2
    3. 3. Issues Surrounding Home based Care Delivery • New Providers – Vertical and Horizontal Integration, Private providers – New ways of working need to be introduced now – Virtual Wards and Virtual Rounds • Home based healthcare – Typical district nurses, health visitors and therapists – PLUS complex nursing care (Hospital at home – reduce LoS and outpatient visits) – PLUS LTC and elderly management (avoidance, empowerment, self management) – Increasing Social Care issues – Multi-Disciplinary team working • In Ireland – Approx 10,000 complex and symptomatic LTC patients (CHF, COPD) – High demand on services and hospital beds – Approx 80,000 Diabetics Copyright Docobo Limited Not to be reproduced without permission
    4. 4. An independent BBC video
    5. 5. What did Stan tell us• Patient experience – He’s doing it from his lounge in his usual chair – He has become an expert patient; knowing when vital signs are high – He is confident and able to live in his own home with his wife – He’s no longer grumpy! – His wife’s quality of life has improved• Productivity / Efficiency / Burden reduction – The nurse has reduced the number of visits per week by 4 enabling her to visit other needy patients – Stan is empowered – no longer anxious – reduced calls on Health Service• Climate / Environmental – Reduction in unnecessary home / clinic visit
    6. 6. doc@HOME® Infrastructure Overview • Clinical decision 3rd Party support •Case Co-ordinators Analytics •Trending Browser doc@HOME® •Clinical Teams Web Services 3rd Party Web •Clinical Teams eHealth •Call Centres Application vendors Clinical Scheduling Database Engine •Tailored to Prompts and needs of patient. questions etc •Self Management •Medication Service Provisioning management GPRS, 3G docoboWEB™ Broadband GPRS, 3G Email / SMS Broadband with URL GPRS, POTS CarePortal® HealthHUB® Tablet Apps •IT Literate•Elderly •Mild LTC’s•Poorly Case Management Patient & Care Giver Wellness Diabetes II•Symptomatic Asthma 28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 6
    7. 7. Features: • Simple to use – fit for purpose for demographic • Handheld cradle based – used anywhere, no wires • Timeslot questions – when the patient is ready • Built-in LEAD I ECG and BioZ – Rythym, AF, HRV and respiration • Class IIa Medical Device – data collected can be used for diagnosis • Anytime and friends questions – capture events and impress friends • Unique 4 week display - empowered28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 7
    8. 8. CAREPORTAL® – Assisted Living • CAREPORTAL® a multi-media Android based, simple to use, platform with colour touchscreen, camera, WIFI, Broadband ,3G and phoneline connectivity. • Designed to be able to give an older or less technically capable user access to social networks and services • User group involvement – they specified the look and feel, and they love the result • The purchaser will typically be child, relative or partner who wants to opens access to a virtual world • Sold through mobile retail outlets and other community organisationsCAREPORTAL® is a Class IIa Medical Device Platform Copyright © Docobo Limited Not to be reproduced without permission
    9. 9. Clinicians View28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 9
    10. 10. Example stored ECG (lead 1)
    11. 11. HVI and Rhythm Analysis
    12. 12. Efficiency savings 1 Prior to doc@HOME With doc@HOME Jan 2006 – Oct 2006 Nov 2006 – Mar 2007 Emergency Admissions 23 2 A&E Attendances 12 0 Hospital Admissions 16 2 Unscheduled Out of calls 55 3 Estimated costs >£54,000 <£6,00028/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 12
    13. 13. South East Essex • 999 calls – the average number of 999 calls made per month by the patients whist using the Telehealth service reduced by 72%. • GP visits – the average number of visits made by the patients per month to their GP whilst using the Telehealth service reduced by 56%. • A&E visits – the average number of visits made per month to A&E by the patients whilst using Telehealth reduced by 75%, meaning a saving of £1091 for 53 patients per month, equating to a total saving of £13092 per annum for 53 patients. • If Telehealth was implemented for 1000 patients the equivalent savings on A&E admissions would equate to approx £247k per annum. • Hospital admissions – the average number of hospital admission per month for the patients reduced by 83% indicating a cost saving of £44892 for this group of patients using Telehealth per month. This equates to a saving per annum of £847k. • If Telehealth supported 1000 COPD patients this could equate to a potential cost savings in A&E attendances and hospital admissions of £10.4m per annum.28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 13
    14. 14. New Directions... Consumer power • Current doc@HOME service is mainstreamed in many organisations, with over 85% of customers ordering additional product. • But, established Healthcare providers (NHS) limit potential and supply – Funding incentives not aligned – Clinicians are gatekeepers – Keep the Status quo • Consumer becoming more informed – Aware of what can be done – Aware of failings of current provision (Care Homes , care of elderly in hospital) – Want a “Cohesive, Co-ordinated Care Service” for mum, for them – Its more then just healthcare28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 14
    15. 15. Its more than Health....... Older/vulnerable people Complex LTC (poorly and symptomatic - Independence COPD and CHF etc) - Social Isolation - Fragmented Families Medium LTC - Digital Divide (Less symptomatic ) - Support for Daily living activities - “Soft Assistance” Mild LTC (Type2 Diabetes, Asthma, Hypertension28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 15
    16. 16. Independence Infrastructure Overview BeTogether™ Assistance Services Family Web Delivered Telehealth access concierge@HOME™ Meals Other Community groups: Services • Diary • Photos • 3rd sector • Local volunteer Web Other Peer to • Private providers Browser Health IT Peer Systems groups doc@HOME® Social 3rd Party Contact Community ServicesBeTogether™ Assist Web Browser Community Clinical access Teams eNABLE™ Service Provisioning Email / SMS with URL GPRS, 3G CarePortal® GPRS, 3G Broadband Broadband Tablet Apps docoboWEB™ Location Environmental Services Controls Interface 28/11/2011 Copyright © Docobo Limited Not to be reproduced without permission 16
    17. 17. ComCare – Management of Community Care Copyright © Docobo Limited Not to be reproduced without permission
    18. 18. Wound Management  Can record multiple wound locations  Each wound retains its own history and progress  Graphical representation of the wound healing progress against the system specified healing parameters (best practice)  History of wound products used during the healing process  Defines the regions of the wound and calculates the area of the wound regions to create the healing graphCopyright © Docobo Limited Not to be reproduced without permission
    19. 19. Productivity ImprovementsMore than 60,000 hours ofsavings Target Saving = 5,100,000 klms Copyright © Docobo Limited Not to be reproduced without permission
    20. 20. Efficiency SavingsA days nursing activity at one locationafter optimisation…..62 hours of travel reduced to 27 hours3708 kms reduced to 1620 kms A typical nursing round after re sequencing….. Saving = 1 hr 42 mins and 53 km Copyright © Docobo Limited Not to be reproduced without permission
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