As part of HTN Now September 2021, we were joined by Jamie Innes, Product Director at Inhealthcare, for a live discussion and presentation on how digital solutions can support recovery in elective care.
As we continue to recap the sessions, through a series of write-ups and video releases, we next turn to this talk, which also covers how digital solutions can improve access to diagnostics and treatment.
After first introducing the wide-ranging agenda for the session, Jamie said: “As we’re all aware, the COVID-19 pandemic has had a major impact on the delivery of the health service’s ability to provide planned treatments and the NHS is now facing a backlog of approximately five million operations. You’ve all seen that this has kick-started a number of initiatives within NHSX, to see how digital services can support that recovery of services and go through that backlog of procedures and appointments.”
Introducing Inhealthcare, which provides digital tools to support everything from hypertension and chronic pain to care home monitoring, weight management, vital signs, COPD and heart failure, Jamie briefly explained a little bit about the company’s background and interests. “We’re a provider of digital health solutions across the UK and support over one million patients using our digital health platform. Our services are in use in over 50 NHS trusts in England and also, in regional health boards across Scotland and Northern Ireland. At Inhealthcare, we provide over 100 digital solutions across a wide range of different clinical specialities and we support patients with a variety of long and short term conditions in their own homes, including in care homes,” he stated.
He also added that one of the key things that the company appreciates is, “every NHS organisation is different”, meaning there is a focus on working in partnership to develop programmes that are “bespoke” to local populations.
On patient-centred design, he added: “[It’s] an important philosophy that we follow, and whenever we’re designing digital services, we always consider the patient and the impact that the service is going to have on the way that they access care. If the service doesn’t change it for the benefit of the patient then, ultimately, it will fail, and the patient will revert to previous ways because it’s easier for them. There always needs to be motivation for the patients when you’re considering new digital services.”
Providing some examples of how Inhealthcare has helped the NHS with its COVID-19 response, Jamie highlighted care homes. “[They were] traditionally areas that were slow on the adoption of digital services, partly due to funding but also because the workforce didn’t receive training on using digital services,” he explained.
“COVID-19 has changed that dramatically and, as part of our response, we worked with some of our customers on care homes and remotely monitoring their patients – because they were some of the hardest hit [by] the pandemic. They relied heavily on face-to-face contact previously, [and] suddenly, community nursing teams and GPs were unable to visit.”
Having been approached by one customer about a digital service for wound care, Inhealthcare worked with them on a “digital service” that would “allow care plans and assessment forms to be completed, and images and video consultations to be shared, so that the care home providers could remain in constant contact with those community nurses and be able to share information – as they would do face-to-face.”
This, Jamie said, allowed the care homes to take on some of the activities that would typically “be done by the community nursing teams” and to collect data to be used to provide insights, including information about which areas might be seeing growing COVID-19 infections.
Explaining the evolution of virtual wards, Jamie stated that they weren’t a new concept and had been around for over a decade. However, he added: “The way in which we provide these services has dramatically changed and the technologies that are available have shifted, to allow patients to use their own devices in their own homes, without the need for expensive equipment…it’s allowed virtual wards to become much more scalable. Previously, we were relying on expensive Bluetooth equipment that was connecting to the patient’s internet – now digital services can make use of more modern technologies.”
Using the example of Oximetry@Home, Jamie told the audience that Inhealthcare had been using its digital platform to support patients in the south of England who had COVID-19, and who required remote monitoring to check for signs of deterioration and to try to avoid hospitalisations.
He also noted that the extension of such programmes into different areas was now leading to more work with customers and providers into deploying similar innovations for respiratory patients – such as those with COPD and asthma – to give people greater guidance, education and control. Heart failure is another area that the company is working with the NHS to support remotely, and Jamie used an example of a collaboration with Norfolk Community Health and Care NHS Trust, who had used the pathway with patients that had recently suffered heart failure and needed to have their vital signs monitored.
“You can see some of the outcomes that we’ve had as part of the programme”, he continued, citing an 88 per cent reduction in bed days, 89 per cent reduction in A&E admissions, and a 65 per cent reduction in GP visits.
After running through other areas where education for patients around self-management and remote monitoring has been successful, such as INR self-testing in the North East, Jamie went on to talk about a new digital outpatient service. “What we want to do is provide an all-encompassing digital service to support outpatient departments. The service is designed to provide a full end-to-end journey for patients and digital outpatient departments, to manage those interactions and manage their caseloads. The idea behind the service is to manage all types of appointments – everything from face-to-face appointments, including COVID-secure check-in, all the way through to video consultations, and telephone consultations.”
Jamie also discussed teledermatology, as a response to the reduction of referrals to dermatologists during the pandemic, which is now causing backlogs in some areas as services open up. As an area that typically relies on face-to-face consultation, he explained that Inhealthcare has worked with a CCG in London to develop a digital service that “allows for remote assessment and review of images” that can be submitted by patients or professionals.
His final example focused on working with the manufacturer Olympus to expand diagnostic capacity in endoscopy to support providers with the challenges and demands they were facing. Together they collaborated on a digital service that would “support patients throughout their journey”, covering everything from initial appointment booking through to questionnaires about attendance and early warnings to identify those at risk of not attending.
In conclusion, Jamie summarised the “vital” role of digital in supporting elective recovery care programmes. He stated: “Digital services can add additional capacity into the health system by avoiding unnecessary face-to-face contact, supporting better triage and monitoring of patients with long-term conditions, and providing healthcare professionals with the ability to support their ever-growing caseloads of patients in a more efficient way.”
To watch the entire session, and the audience Q&A with Jamie, see below: