The LiveWell programme has reduced emergency admissions of its participants by more than 20%, according to the clinical lead
One of Europe’s biggest biggest telehealth schemes is being scaled up by Liverpool NHS organisations with a careful, ongoing analysis of who are likely to be the most consistent, long term users of the technology.
Maurice Smith, a GP and clinical lead for the LiveWell programme, told last week’s EHI Live NHS IT conference that this is encouraging the city’s ambitions to be ranked as one of the top ten most advanced tech enabled health and social care local economies in Europe by 2020.
“We want to be proactive and make the best use of digital technology we can,” he said. “That’s because we see technology as being key to shifting healthcare out of hospitals and A&E to lower cost care settings as much as possible.”
To do so, the city’s NHS leadership is committed to providing support for more self-care and better support for people with long term conditions who would like to avoid endless GP and outpatient visits.
Telehealth is a key part of the programme being delivered by the city’s main clinical commissioning group, Liverpool CCG, which delivers healthcare to just under half a million residents with an £860 million budget.
Target patients
“We have a target of getting the patients who will most benefit onto telehealth,” Smith said, and that is being gradually met by intensive work with local surgeries to identify the best candidates for the support option.
After three years of early work, 3,200 patients are now on board, with about 50 more being recruited per week.
“What we’ve found is that it’s not the technology of telehealth that’s the issue, but the human factor,” he said.
“You need to do the work to see who will most readily accept it, and it’s not necessarily who you’d think of first thing; I have met very enthusiastic 90 year-old users. You can’t go into a big telehealth roll out with any one-size-fits-all approach, that’s for sure.”
His team’s initial research showed was that it is also only a subset of NHS users who will likely be that interested, mainly around those with long term health challenges. As a result, patients with heart failure, diabetes and chronic obstructive pulmonary disease are the ones that the team most reaches out to.
It also found that GPs will resist recruitment efforts if they perceive that adding telehealth will add to their work burden, he added.
Lifestyle improvements
Although the project is far from complete, some early benefits have been identified, with results verified by extensive data analysis by the programme’s technology partner, Philips Healthcare.
Specifically, 70% of participants said they have modified their lifestyles to be more healthy, there has been a 54% drop in face to face interactions with clinicians, and 91% claimed to feel “more in control” of their conditions, Smith reported.
So far, the most significant statistic for the city as whole is that there has been a 10% drop in emergency admissions for patients on the scheme identified as being of above average risk of such crises, he concluded.
Image: Liverpool skyline, public domain from Wikimedia
