In many ways, the Great Plains Health Regional Medical Center in North Platte, Nebraska, appears an unremarkable local hospital. However, a pioneering approach that has been trialled there and is now a fully fledged program, offers an insight into the future of healthcare in the UK.
This rural hospital in the midwest of the United States is using a new way of managing the care of patients with long-term or chronic conditions once they leave the hospital.
Using the eCareCoordinator, new technology from Philips that works as a clinical dashboard for ambulatory health, medical teams can now remotely monitor discharged patients. The system logs large quantities of data throughout the day, then makes it accessible on tablets and PCs for clinicians to analyse and act upon.
Julie Johng, a nurse for 40 years who works at Great Plains, believes this marks a significant step forward.
“Patients across the world are now living longer with very serious health conditions,” she says. “It means we have to monitor them more closely. We need a way of having more coordinated care that is less disjointed. This data system gives us a continuous picture of a patient’s health.”
Although the technology has taken many years to develop, how it works is relatively simple, Mrs Johng explains.
Patients are given easy-to-use devices that instantly measure vital signs such as blood pressure, heart rate, lung capacity and weight, depending on their condition, which can often be of a chronic cardiac or respiratory nature. Every day, the data is immediately transmitted automatically to their tablet or similar device and sent to their medical care providers through the eCareCompanion application. The statistics are archived and the patient also answers some health assessment questions.
“They might be asked how they’re feeling on a scale of 1-10 or if their cough is better or worse than the day before,” says Mrs Johng.
Speeding up key decisions
This information builds up a detailed picture of the patient’s health, allowing the medical team to check on them remotely at any moment.
Dr Carla-Krystin Andrade, director of product management for the Philips HealthSuite Digital Platform, says this new approach can greatly help clinicians.
“In the past, doctors and nurses would have to flip through lots of charts to find the data they wanted which could be quite unwieldy and not always easy to analyse quickly,” she says. “But with eCareCoordinator, clinicians can obtain an overview of all their patients and their risk levels from the ‘triage dashboard’. Then they can drill down to find out more about a specific patient and decide what to do next.”
This prevents a situation in which patients become “lost” in the system after leaving hospital, before becoming ill again and needing to be re-admitted.
At Great Plains, eCareCoordinator was originally trialled for a 30-day period on 30 patients.
The “vitals” and survey responses are amalgamated, creating a risk score of how likely the patient is to need urgent intervention. The system prioritises the patients for intervention by the medical team.
A live two-way video function on eCareCompanion also allows clinicians to see their patient as they are consulted. “Even if the stats present the patient in a certain light, there’s also a need to assess them on their affect, reactions to the care plan and their physical environment,” Dr Andrade says. “This video function gives clinicians more confidence about their decision when combined with the empirical data.”
Doctors can see the results of their care plan for the patients and make adjustments, while the monitoring also helps patients learn about their conditions.
“We have a large focus on educating those who have chronic diseases, which can be problematic if they suffer with several chronic conditions.,” Mrs Johng says. “And while time may be limited while patients are in hospital or at their physician’s office to help educate them about their health conditions, in our program we are able to sit down with them in their homes and spend the time they need to really understand their health conditions and how they take better care of themselves.”
Giving patients more control
Dr Andrade agrees. “Healthcare organisations are shifting very rapidly to home-based care,” she says.
“This also changes the patient’s role. We are empowering them and they are becoming more active in their care. This reflects a trend of earlier identification and response to a downturn in their health indicated by the data that’s been gathered. Intervention will occur before it becomes serious.”
The advantage to both individuals and healthcare systems could be huge, as highlighted in a recent study by NHS Liverpool Clinical Commissioning Group and Philips.
In the study, 1,808 patients with long-term health conditions such as diabetes, heart failure and chronic obstructive pulmonary disease (COPD) were monitored remotely. Emergency admissions and secondary care costs fell, while 90 per cent of patients felt more in control and better able to handle their illness.
“This type of care provides a safety buffer around the patient,” says Dr Andrade. “They are supported remotely by health professionals who have all the data about their condition at their fingertips.”
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