- The document discusses the use of telehealth in Southampton to monitor and treat patients with long term conditions like COPD, cardiac issues, diabetes, and more. - Over 100 Docobo HealthHUB devices are used to remotely monitor patients' vital signs and symptoms. This has led to 242 avoided hospital admissions and improved outcomes for patients and the healthcare system. - Barriers to expanding telehealth include finances, information governance challenges across organizations, and cultural resistance from staff. However, plans are in place to further integrate telehealth into clinical pathways and purchase more devices.

1. Telehealth in Southampton Mr C Webb

2. Brief CV Mental health nurse and CPN (1976 – 1989) Mental health service manager - community and in-patients (1989 – 2002) Social services (2002) PCT long term conditions and equipment manager (2002 – 2011) COPD, cardiac, diabetes, continence, stoma Equipment, wheelchairs Telehealth & telecare

3. Location

4. Southampton information 240,000 population (12% over 65) Centres of deprivation (91 st out of 354, 4 th most deprived in SE England) 37 GP practices Large acute teaching hospital 86,000 people with a LTC Includes COPD/asthma, CVD & hypertension, diabetes, epilepsy & all severe mental illness 28,000 on hypertension registers Unconfirmed 4000 people with COPD

5. Solent NHS Trust £177 million 4,200 staff 2 cities – Southampton & Portsmouth, and elements of the South of Hampshire £25,000 core telehealth budget (Southampton only) Manage all telecare work for Southampton City Council and partially in Portsmouth

6. Drivers for change Personal interest EU project application Budgetary pressures on staff and resources Increasing frailty & LTCs increased numbers and diagnostics in the population Shortening of acute admissions and desire for more community care

7. Uses Anything that needs monitoring! COPD ✔ (full usage) Cardiac ✔ (heart failure) Continence ✔ (monitoring between clinics) Asthma ✔ (paediatric) Podiatry ✔ (wounds between visits) Leg ulcers ✔ (size of wounds) Diabetes Pain Terminal care

8. Telehealth in the Solent’s Community COPD Team The main project aims were: To increase the use of telehealth within the Community Chronic Obstructive Pulmonary Disease (COPD) Team, To explore how the team could work differently to provide an effective service for an increasing number of patients with this condition. To measure the efficacy, benefits and cost effectiveness of the technology in supporting patients with COPD. To examine the impact of telehealth on patient experience and quality of life To review whether the technology improves the ability of the patient to self manage Over 100 Docobo HealthHUBS are in use Additional aims

9. Avoided admissions : 242 to the acute sector (Oct 09 to May 11). Improved data collection and data content : A richness of data A greater understanding of a patient’s condition Earlier intervention in exacerbation An enhanced service without increasing the number of clinical staff. An improved seamless pathway with allied community staff and general practice, to provide a more sustainable service Improved patient experience of the service Increased quality of life for both themselves and their carers, feeling more supported and connected to the team Improved knowledge: supporting the patient to learn more about their condition Outcomes

10. Benefits 1 Patients / clients /carers Contentment Knowledge and awareness Reduction in inappropriate admissions and GP attendances Reduction in dependency and institutionalisation Staff Improved information Improved work planning Reduced travel Appropriate visits / clinics Improved satisfaction

11. Benefits 2 - overall Reduction in admissions to hospital Reduced costs More patients managed, same staff complement Reduced travel costs Cheaper alternative & earlier treatments (at home) ‘ Green issues addressed’ Patients able to ‘do’ more for themselves Peer support Socialise Potential to work longer or again

12. Barriers to change Finance For equipment From savings elsewhere Information governance Sharing across organisations and even internally Culture Traditional working and clinical pathways Staff Mistrust of ‘NHS IT’ Fear for jobs

13. Planning for development Examine existing clinical & care pathways to consider where innovative technology (telehealth and telecare) can be used. Re-align working practice to use telehealth & telecare. Work with commissioners to re-align finance alongside the new clinical and care pathways. All staff to be trained in the uses of telehealth and all new referrals to be assessed for telehealth via an ‘exclusion policy’. A range of telehealth and telecare to cover as many patient groups as possible, (simple and complex) Link with Single point of access and virtual ward case management Purchase (100) additional units for the next expansion

14. Future aspirations Telehealth & telecare systems link across NHS, housing and social care Central monitoring Case management via central information centre Assessors, therapists work directed via information and technology