Clinical Evidence
Effective outcomes as evidenced by 20 peer-reviewed journal articles and over 100 independent clinical studies
Flo is proven to help clinicians work smarter and have more fulfilling patient encounters
You can rely on Florence to deliver safe and effective outcomes as evidenced by 20 peer-reviewed journal articles and over 100 independent clinical studies. From the very beginning of Florence, patient safety and clinical efficacy has been our top priority.
By working with academic institutions and clinical researchers, we have robust clinical evidence not only from the UK but also from successful trails and implementations in the United States (for the Veterans Administration) and in Australia.

Journals & Guidance – Florence
PLOS Medicine, 2020, doi.org/10.1371/journal.pmed.1003124, Vicky Hammersley, Richard Parker, Mary Paterson, Janet Hanley, Hilary Pinnock, Paul Padfield, Andrew Stoddart, Hyeon Gyeong Park, Aziz Sheikh, Brian McKinstryTelemonitoring at scale for hypertension in primary care: An implementation study
Publication/Reference | Title |
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Journal of the American Medical Informatics Association, 2020, ocaa122, https://doi.org/10.1093/jamia/ocaa122, Jason J Saleem, Jacob M Read, Boyd M Loehr, Kathleen L Frisbee, Nancy R Wilck, John J Murphy, Brian M Vetter, Jennifer Herout | Veterans’ Response to an Automated Text Messaging Protocol During the COVID-19 Pandemic |
British Journal of Clinical Psychology 2020, https://doi.org/10.1111/bjc.12244 Sam Malins, Sanchia Biswas, Shireen Patel, Jo Levene, Nima Moghaddam, Richard Morriss | Preventing relapse with personalized smart‐messaging after cognitive behavioural therapy: A proof‐of‐concept evaluation |
Journal of Psycho-Oncology 2019, https://doi.org/10.1002/pon.5256 Chloe Wells, Sam Malins, Simon Clarke, Iwona Skorodzien, Sanchia Biswas, Tim Sweeney, Nima Moghaddam, Jo Levene | Using smart‐messaging to enhance mindfulness‐based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation |
British Journal of General Practice 2019; 69 (suppl 1): bjgp19X703529. Brian McKinstry, Vicky Hammersley, Richard Parker, Hilary Pinnock, Paul Padfield, Janet Hanley, Andrew Stoddart and Adam Steventon | Evaluating a large-scale roll out of blood pressure telemonitoring using routinely acquired data |
US National Library of Medicine National Institutes of Health 2019 Aug; 36(Suppl 5): S54–S57, PMCID: PMC6719802, Connie Jaenicke, FNP-BC, BMTCN, corresponding author Dan Greenwood, MS, RD, LD, CNSC, Kathleen Nelson, MS, CNS, ONS, Mark Klein, MD, Bev Foss, RN, Lara Carson, RN, BAN, Kim Smith, MS, PA-C, and Evan Mariash, MD | Use of Mobile Messaging System for Self-Management of Chemotherapy Symptoms in Patients with Advanced Cancer |
Primary Health Care 2018 Chambers R, McKinney R, Schmid M et al (2018) Digital by choice: becoming part of a digitally ready general practice team. Primary Health Care. doi: 10.7748/phc.2018.e1502 | Digital by choice: becoming part of a digitally ready general practice team |
Journal of Nursing & Healthcare, 2016 Vol. 1 Issue 2; Parijat De , Susan Irwin, Jagjit Kaur, Karen Moore | Use of an Innovative Technology Enabled Care Service (Tecs) “Florence” To Empower Patients and Enhance Adherence to Treatments in Diabetes |
(RCNi) Primary Health Care, 2016, 26(7):24-30 http://dx.doi.org/10.7748/phc.2016.e1137 Caroline Poole, Janice Maslen, Lisa Joanne Taylor | Enabling Supported Self-Management of Wound Care in the Community Setting to Increase Quality and Efficiency of Service Delivery Primary Health Care |
Innovative Practice in Higher Education; Vol. 2 (3) Elizabeth Boath, Richard Machin, Martin Dixon, Nigel Thomas, Phil O’Connell, Lisa Taylor | Stop with the FLO: using text messaging to improve retention rates in University Students |
British Journal of Healthcare Management 10.12968/bjhc.2016.22.1.23 Lisa Taylor, Jane Birch-Jones | Implementing a technology enabled care service |
BMC Family Practice 2015, 16:83 doi:10.1186/s12875-015-0301-2, Elizabeth Cottrell, Tracey Cox, Phil O’Connell, Ruth Chambers | Implementation of simple telehealth to manage hypertension in general practice: a service evaluation |
Gastrointestinal Nursing – 10.12968/gasn.2014.12.Sup1 Mark Holmes, Sian Clark | TECHNOLOGY-ENABLED CARE SERVICES: NOVEL METHOD OF MANAGING LIVER DISEASE |
BMJ Open – 2015;5:e007270 Elizabeth Cottrell, Tracey Cox, Phil O’Connell, Ruth Chambers | Patient and professional user experiences of simple telehealth for hypertension, medication reminders and smoking cessation: a service evaluation |
Dove Press – 10.2147/NRR.S72791 Audrey Cund, Jayne L Birch-Jones, Martin Kay, Patricia Connolly | Self-management: keeping it simple with “Flo” |
Public Health England – Blood Pressure System Leadership Board | Tackling high blood pressure From evidence into action |
BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3030 Brian McKinstry, professor of primary care ehealth, Janet Hanley, principal research fellow, Sarah Wild, professor of epidemiology, Claudia Pagliari, senior lecturer, Mary Paterson, research fellow, Steff Lewis, statistician, Aziz Sheikh, professor of primary care research, Ashma Krishan, statistician, Andrew Stoddart, health economist, Paul Padfield, professor of hypertension | Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial |
BMJ Open 2013;3:e002671. doi: 10.1136/bmjopen-2013-002671 Janet Hanley, Jenny Ure, Claudia Pagliari, Aziz Sheikh, Brian McKinstry Author affiliations | Experiences of patients and professionals participating in the HITS home blood pressure telemonitoring trial: a qualitative study |
BMJ Open 2012;2:e001392 Elizabeth Cottrell, Kate McMillan, Ruth Chambers | A cross-sectional survey and service evaluation of simple telehealth in primary care: what do patients think? |
NICE – Hypertension (CG127) | Interactive simple telehealth for the management of blood pressure |
BMJ Open – 2012;2:e001391 Elizabeth Cottrell, Ruth Chambers, Phil O’Connell | Using simple telehealth in primary care to reduce blood pressure: a service evaluation |
Journals – Others of Interest
Publication/Reference | Title |
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US National Library of Medicine National Institutes of Health 2015 April; PMCID: PMC4406229, Amanda K. Hall, Heather Cole-Lewis, and Jay M. Bernhardt | Mobile Text Messaging for Health: A Systematic Review of Reviews |
Digital Health 2019, Volume 5: 1–21, Cigdem Sahin , Karen L Courtney, PJ Naylor and Ryan E Rhodes | Tailored mobile text messaging interventions targeting type 2 diabetes self-management: A systematic review and a meta-analysis |
BMJ 2018;361:k1959 Rosie Dobson, Robyn Whittaker, Yannan Jiang, Ralph Maddison, Matthew Shepherd, Catherine McNamara, Richard Cutfield, Manish Khanolkar, Rinki Murphy | Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial |
BMJ 2017;358:j3203 Iona Heath, former general practitioner | Commentary- Information without Wisdom |
BMJ 2016; 6(7): e010853. doi: 10.1136/bmjopen-2015-010853Claire Reidy, Anne Kennedy, Catherine Pope, Claire Ballinger, Ivo Vassilev, and Anne Rogers | Commissioning of self-management support for people with long-term conditions: an exploration of commissioning aspirations and processes |
JAMA Intern Med.doi:10.1001/ jamainternmed.2015.7667, Jay Thakkar; Rahul Kurup; Tracey-Lea Laba; Karla Santo; Aravinda Thiagalingam; Anthony Rodgers; Mark Woodward; Julie Redfern; Clara K. Chow | Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease A Meta-analysis |
Fam Pract Manag. 2000 Mar 7(3):47-51. Martha M. Funnell, MS, RN | Helping Patients Take Charge of Their Chronic Illnesses – The best thing you can do for your patients with chronic diseases is to let them run with the ball. |
BMC Family Practice 2015, 16:80 doi:10.1186/s12875-015-0289-7, Natalie Leon, Rebecca Surender, Kirsty Bobrow, Jocelyn Muller, Andrew Farmer | Improving treatment adherence for blood pressure lowering via mobile phone SMS-messages in South Africa: a qualitative evaluation of the SMS-text Adherence SuppoRt (StAR) trial |
NICE Medicines Evidence Commentary | UK study finds evidence for the effectiveness of text messaging on adherence to cardiovascular preventative treatment |
PubMed; J Med Internet Res. 2014 Oct 17;16(10):e222. doi: 10.2196/jmir.3442; Kannisto KA, Koivunen MH, Välimäki MA | Use of mobile phone text message reminders in health care services: a narrative literature review. |
PubMed; Worldviews Evid Based Nurs. 2014 Apr;11(2):81-8. doi: 10.1111/wvn.12030. Epub 2014 Mar 5; Jones KR, Lekhak N, Kaewluang N | Using mobile phones and short message service to deliver self-management interventions for chronic conditions: a meta-review. |
BMJ 2013;347:f6070 Hilary Pinnock, Janet Hanley, Lucy McCloughan, Allison Todd, Ashma Krishan, Stephanie Lewis, , Andrew Stoddart, Marjon van der Pol, , William MacNee, Aziz Sheikh, Claudia Pagliari, Brian McKinstry | ** Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial |
Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No. CD006611. DOI: 10.1002/14651858.CD006611.pub Whittaker R, McRobbie H, Bullen C, Borland R, Rodgers A, Gu Y. | Mobile phone-based interventions for smoking cessation. |
Journal of Hypertension:doi: 10.1097/01.hjh.0000379198.08164.51, Wizner, B; Gaciong, Z; Narkiewicz, K; Szykula, D; Grodzicki, T | HIGH RISK PATIENTS BENEFIT MOST FROM THE SMS-BASED INTERVENTION: PP.20.272 |
Clinical – Florence
About Florence
Publication/Reference | Title |
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The Health Foundation | How Flo is making a difference |
The King’s Fund | Florence: telehealth for long-term conditions |
U.S. Department of Veterans Affairs | Mobile app empowers Veterans to be full partners in their own care |
The Health Foundation | Flo: telehealth with a human touch |
U.S. Department of Veterans Affairs | More about Annie |
Inside Commissioning – Dr Ruth Chambers OBE | Tackling Telehealth (2014) |
Inside Commissioning – Dr Ruth Chambers OBE | Tackling Telehealth2 (2015) |
U.S. Department of Veterans Affairs | VA & NHS – Simple Telehealth conference June 2014 |
U.S. Department of Veterans Affairs | Annie briefing |
Inside Commissioning – Jayne Birch-Jones | How a patient champion can help spread telehealth innovation |
UKAuthority.com | Hundreds of patients sign up to taking their own health readings (Bucks County Council) |
The Health Foundation | Shine: Improving the value of local healthcare services |
NHS England -Domain 2 Commissioning Guidance | STOKE-ON-TRENT AND COVENTRY TELEHEALTH CASE STUDIES. |