Heart and circulatory diseases kill 3 in 10 people in North Devon, and around 1,100 people have a diagnosis of heart failure (HF).
This rural and coastal region has some of the most deprived areas in the country, longer travel distances to attend outpatient appointments and a significant elderly population that is at greater risk of heart disease.
The North Devon Community HF Team from the Royal Devon University Healthcare NHS Foundation Trust (RDUH) has embraced digital technology to support remote management of patients with HF in North Devon.
The remote monitoring service allows people living with HF to have their condition monitored closely for a period of time following a hospital admission or recent diagnosis. The initial consultation is offered face-to-face to allow the patient and the HF team to develop a treatment plan, distribute monitoring devices and explain their functionality. Patients upload a symptom questionnaire, their blood pressure, pulse, and weight readings either daily, or on alternate days. The combination of the data and the answers to the questionnaire are then combined into a triage grading of red, amber or green by the remote monitoring platform ‘CliniTouch’. This enables the HF team to assess patients daily, address any worsening of symptoms quickly and efficiently optimise medications that help patients live longer and improve their quality of life. Once optimised and stable, patients are discharged from remote monitoring to free up capacity for future patients.
During the duration of the trial, 86 people from predominantly deprived areas were successfully onboarded and 67 were discharged.
The service has supported earlier discharge of patients and avoided re-admissions. Notably, and thanks to the digital functionality of ‘CliniTouch’, the HF team was able to optimise patients’ medicines within 10 weeks as opposed to up to 18 months through traditional out-patients appointments.
As well as improving patient health, the remote monitoring technology has helped free up clinic time and reduce waiting lists. Finally, this service has significantly improved access to innovative healthcare for people living in deprivation in rural and coastal communities, with over 75-80% of surveyed patients rating their experience of remote monitoring as very good and feeling that remote monitoring had helped them manage their HF better.
This project was made possible through fixed-term funding from NHS England aimed at addressing local health inequalities and collaborative working between NHS Devon, Health Innovation South West and Devon Council.