Towards Scaling Up Home and Mobile Health Monitoring in Lanarkshire – An evaluation towards scale-up, spread and sustainability June 2019
We are pleased to announce the publication of “Towards Scaling Up Home and Mobile Health Monitoring in Lanarkshire – An evaluation towards scale-up, spread and sustainability” where the substantial high quality evidence base helped support the further £1.2 million investment into Scotland’s National BP Scale-Up with Florence.
NHS Lanarkshire received an exciting opportunity to be part of the National Home and Mobile Health Monitoring (HMHM) Programme which looked at how HMHM could improve clinical outcomes and explore the potential for sustainable scale-up with Florence. This document provides an in-depth and detailed independent evaluation of evidence gathered over a number of years, where the passion and commitment of clinicians combined with Flo’s unique persona and methodology were able to over deliver on targets and demonstrate that HMHM can be successfully integrated into multiple conditions including hypertension, mental health, health lifestyle/health improvement, diabetes and pain management.
Examples of the highlighted outcomes for patients are “people have positive experiences of services, supported by HMHM”:
- More people self-manage their health and care – one piece of evidence gave a total of 7,455 patients supported with Flo by 28.4.2019
- Condition control improves – “One person who refused to believe they had hypertension accepted their diagnosis after using Flo. Their blood pressure was 183/87 before remote monitoring and 135/80 after accepting the diagnosis and medication”
- Face to face contact are optimised – “3,545 people have texted BP readings to their GP surgery to support diagnosis and medication titration, ensuring that accurate readings are available to support diagnosis and hypertension management”
- Access to services increase – “HMHM is particularly useful for people whose working hours clash with surgery opening, who are stressed by the time they get to their appointment, and then have high readings. Now after an initial visit to start Flo we follow up the readings sent in remotely by phone”
- Resources used effectively and efficiently – “An average of 4.3 blood pressure monitoring appointments were avoided per patient. For 3,545 patients each avoiding 4.3×10 minute Practice Nurse appointments = £82,467 (greater savings where GPs did the BP monitoring)”
While key learning of HMHM on effectiveness and efficiency:
- “HMHM appears to be a catalyst for shifting responsibility away from healthcare professionals to people/patients, thus increasing the effectiveness of interventions.
- HMHM can increase engagement with services e.g. more people start an on-line programme, it is easier to text readings from the workplace than get to a GP surgery.
- Fewer HMHM efficiencies are observed when the service doesn’t have someone to lead or it is not highly valued by staff, even when people/patients appreciate the support.
- Where HMHM enables more accurate diagnosis e.g. hypertension, it can also save ‘White Coat’ prescription costs.
- HMHM has been most effective in Lanarkshire when those using it appreciate its value, the set-up is relatively straightforward, and there is expert support to resolve any issues.
- HMHM avoids the need for some appointments e.g. remote blood pressure monitoring increases staff capacity and reduces patient travel costs. “