One of the many joys of working with clinicians to genuinely improve patients ability to self care using the NHS’s Simple Telehealth methodology and Florence (Flo), is each week hearing more moving personal stories of what such a simple change in a patient’s engagement with their own healthcare can achieve. Witnessing the growth and increasing popularity of the Simple Telehealth TECs methodology among clinicians, inspires the continued sharing and dissemination of independent stories, learning and case studies and we look forward to the future with a clear “for patients, not profit” focus though our Social Enterprise, and to a whole host of new and exciting opportunities emerging from the NHS clinical community inspired initiative.
Below we share a few snippets of the most recent developments.
Creator of the NHS’s Simple Telehealth & Florence
‘Telehealth with a human touch’
Since The Health Foundation released their multi award winning film about Flo ‘Telehealth with a human touch’ at www.health.org.uk/flo, it has been showcased at many clinical conferences and shared around the world as an exemplar of an “innovative and impactful improvement project”. In the early days, Florence Simple Telehealth was the subject of a Health Foundation 2011 SHINE project, run by Stoke-on-Trent PCT and has now touched the lives of over 35,000 patients in the UK.
We’re pleased to announce that we’ve launched the Members Zone at https://florence.community/forum/ for members of the Community of Practice. The public side of the site whose main contributors are members of the Community of Practice itself, already contains over 100 articles, case studies and blogs as well as reference sections with videos, journal articles, guidance and other content including ‘Areas of Interest’ such as diabetes or Maternity.
New this month, is the members collaboration zone where resources, forums, local items of interest and regional collaboration and sharing areas are available to facilitate peer to peer working for the collaborative development of new and innovative uses, and the international dissemination of learning.
If you are working with us already and would like to join the Members Zone, get in touch with Karen, Lisa or myself.
In England a Derbyshire based Diabetes Specialist Nurse team are reporting the use of Flo helps patients to better manage lifestyles and thereby avoid the need for medication, delivering significant results all round. They also report; “Notably there has been a reduction in follow-up appointments for newly diagnosed patients when Florence supports the remote monitoring of patients’ blood glucose levels. Florence allows for earlier clinical intervention and guidance without the need for an appointment.” Also from Derbyshire comes a random selection of General Practice case studies showing that the use of the simple methods, techniques and psychology unique to Simple Telehealth & Florence, can produce direct savings as well as avoidance of healthcare costs due to better prescribing, improved safety and reduced risk of complications for incompliant patients.
‘Igniting Clinical Curiosity’, the viral February blog from inspirational ‘Nurse of the Year’ finalist and Flo Clinical Lead, Joan Pons Laplana makes interesting reading for CCGs as he explains what he did and how he captured the attention of busy clinical teams to spread adoption of Florence. Joan was parachuted into an environment where Flo was just one of many initiatives competing for the attention of busy clinical teams, but his approach, as he explains, ignited Clinician’s Curiosity thereby creating that all-important pull to introduce Florence into working practice.
If you’ve not already checked out #FloMania on twitter, click here to see what the excitement is about. The #FloMania hashtag, started by Joan Pons Laplana has seen a fair bit of use over recent months and demonstrates how Social Media can be used by teams to engage people on a scale never before possible.
As a Social Enterprise with a focus on patients and not profit we aim to positively influence the TECs industry for the benefit of patients. We believe that every organisation in the TECs industry should behave ethically, genuinely focussing on the interests of patients and the NHS, which in turn ultimately benefits everyone involved through a larger and respected market. It is with this in mind that we are looking forward to working with members to draft guidelines to help NHS organisations understand and navigate the TECs industry, separating hype from facts, misinformation from substance and commercial spin from genuine integrity. Let us know if you’d like to get involved.
Interest in the Simple Telehealth methodology from overseas also continues to grow and already today teams from Australia and Thailand have been touch. We’re delighted to share our experiences and look forward to welcoming more international members of our Collaborative Community. In the latter part of 2015 Simple Telehealth was discussed at a number of international healthcare conferences in the USA and Europe with Members independently sharing their experiences with the international healthcare community.
Our collaboration with the US VHA on the Annie ( cousin of Flo ) initiative continues, and this week our very own Lisa Taylor is in Minneapolis with a delegation from the UK including Iain Trayner from NHS Western Isles looking to further develop collaboration and shared learning with the VHA. Annie is currently being deployed across the early adopter VHA facilities ahead of a national rollout later in the year and I’m headed to Washington DC in April to talk to the teams involved, and then on to Augusta, Maine to talk about Simple Telehealth alongside the VHA’s Susan Woods, MD, MPH at the Quality Counts 2016 Annual Conference.
Simple Shared Healthcare
January 2016 saw the culmination of years of work by all involved with Flo to create an international Community of Practice. Under an NHS Simple Telehealth licence, Simple Shared Healthcare Ltd (SSHC), aka ‘simple.uk.net’ was officially incorporated as a Social Enterprise without share capital. It has been set up as an NHS members organisation with a Social Objective to use the NHS’s Simple Telehealth intellectual property (IP) to help organisations to use the NHS IP for the benefit of the patients they care for. Whilst SSHC has a small number of professionals working within, similar to a charity, directors are unpaid for their work and are elected by members. We’ve had a huge amount of help over the last six months from the Shropshire Doctors Co-operative Social Enterprise (Shropdoc), and we’d like to take this opportunity to thank Shropdoc for their unwavering support, inspiration and assistance.
Scottish Health boards continue to build on the work done in the West Midlands, East Midlands and North East & Cumbria AHSN areas. Initiatives are delivering measurable clinical results, particularly around diabetes and heart failure. A large trial is also underway in Lothian, headed by Edinburgh University whereby patients will monitor their blood pressure via Flo, and on a clinically appropriate basis the data is analysed and results fed back into GP systems, indicating if a patient’s hypertension is controlled or not controlled. Flo is also featured in the NHS Scotland CEO’s Annual Report due to results of innovative uses of the system such as the validated 39 mmol reduction in HbA1c over 12 weeks in a previously poorly controlled patient. We’d encourage you to also check out the recently published down to earth video “Working with Florence” made by NHS Western Isles featuring powerful diabetes and heart failure stories
The new article by Lisa Taylor and Jayne Birch-Jones published in the British Journal of Healthcare Management “Implementing a Technology Enabled Care Service” discusses implementation lessons learned over the previous years via a number of local and large national projects shedding light onto why some are successful and others aren’t.
Florence is used in a large number of General Practices and although the most popular (and well published in the BMJ and BMC Family Practice) uses are focussed on hypertension diagnosis, titration and long term monitoring, Practices are expanding use into other areas where compliance to treatment for some patients has proved problematic. Targeted use for even the simplest of engagement issues can yield positive results for the patient and the General Practice as demonstrated recently by Castle Street Medical Centre in Bolsover where in a random selection of case studies they talk about the impact of the transformation of three patient’s DNA rates.
Other benefits accrue in General Practice from the use of Florence, such as in Roundwood Surgery, Mansfield where their implementation of Florence played it’s part in securing a CQC rating of “Outstanding”. Florence is cited throughout the CQC’s report on the Surgery.
Although we’ve wanted to integrate Florence with clinical systems and patient portals for some time, it’s not quite as simple as just pushing reams of unfiltered ‘Patient Generated Data’ (PGD) into a clinical system, which would be not only clinically inappropriate, but would also create medical defence risks and increase workload. Avoiding the dangers related to the integration of PGD in clinical systems, members have worked together with Flo’s technical team and have established a clinically appropriate, safe, and effective method of PGD data integration with third party systems. I am delighted to advise readers that work is underway with the HSCIC to implement this safe GPSoC and clinically appropriate method of PGD integration with clinical systems.
We are excited to be part of the NHS England LCIA Test Bed, lead by Lancashire Care NHS Foundation Trust and Philips. This week, the test bed partners met face to face at Lancaster University and I have to say that the combined experience and technologies to be brought to bear in Lancashire looks set to create a compelling solution. Adding to the excitement, is the prospect of a robust academic evaluation of the outcomes, something today the majority of the TECs industry sadly lacks.
We are pleased to welcome Joanne Harding to our board as a clinical non-Executive Director. Joanne has worked in healthcare since 1983 starting out as a nurse with a passion for urgent care, acute medicine and cardiology. Joanne has held strategic management roles leading large scale transformation programmes and has specific interests in integrated care, management of long term conditions, self care and digital health. Joanne manages a Partnership Exchange Programme between the US Veterans Health Administration and the NHS as well as working with the CQC as a Specialist Advisor and is a Senior Associate with International Foundation for Integrated Care.