The Digital Health team and the supporting technology have been in development since March 2017. Since this service has been deployed to all 42 nursing and residential homes in Tameside & Glossop covering circa 1000 residents. It complements the Community Response Team which supports a further 2,000 people to remain in their own home ensuring that only those people who require an attendance at the Emergency Dept are transferred there from their home. As part of the CRS offer it will be utilised to support those patients identified as having a high frailty indices within our neighbourhoods, many of whom are currently unknown to services but are vulnerable and with this intervention could have hospital admission avoided through pre-emptive intervention. This will be in the range of circa 500 people.
1773 bed days have also been saved over the last nine months from May 2018 the team will partner with NWAS to further reduce demand generated by category 3 and 4 calls.
During 2018 the technology will be deployed to assist patients (and their families) at the end of life through the provision of clinical advice and support. This will provide both practical interventions such as advice for example of titration of medications but also appropriate reassurance without which people may feel unsupported and obliged to deviate from their plan for a preferred place of dying, resulting in an attendance at ED in the final stages of life which is a distressing experience for all involved.
This means of communication has also proven to be an excellent opportunity to provide education and training. This has been evident in the work undertaken with care homes since it can, following initial training programmes, provide direct supervision of tasks being undertaken for those who require some further reassurance on repeating an intervention previously covered in the training. This has included interventions such as wound dressing changes which may have previously required a return visit to hospital as a result of a perceived lack of competence by care home teams rather than as a result of clinical necessity. It is planned to explore this with home care teams over the forthcoming months.
The examples are not an exhaustive list of the potential for the use of Digital Health and we are currently exploring the benefits that moving to a cloud based platform can deliver in terms of the capacity of the technology to remain robust. Experience to date evidences that this is versatile service model well accepted by users with the potential for broad usage in a range of settings and can be delivered at scale across the GM footprint”.