NHS Simple Messaging

Dr Pete Davies

Consultant in Diabetes

Workshop program

• What is Simple Telehealth (MECS)?

• How can it help ‘Integration?’

• How could you put this to work for your patients?

• Clinical case presentation

NHS Florence SMS Simple Telehealth System

SMS

Messages which prompt action & advice Messages too

GP Practices

Specialist Clinicians

Community and SpecialistNursing

Public Health Smoking Pathway

MECS Means Florence…

Simple

Easy to use

Free to patients

Cheap, NHS IP

Customisable

Widely applicable

Automated

MECS USPs

Mobile telecomms promote social inclusion

• 82.7 million mobile subscriptions in UK

• 49% UK adults use their mobile phone for internet

• Tablet ownership 24% of UK households

• 3G coverage now 99.1%

“In 2000, 50% of UK adults said that they had a mobile phone – that figure now stands at 94%”

Ubiquitous!

MECS makes for social inclusion by

• Engaging people

– Allows a power-shift

• Activating people’s native capabilities

– Let’s the customer add value

• Helping you to know your patients better

• Helping to build patient networks

– An “engine for integration”

Future state: Patient Centered Diabetes Care within @SWB CCG Area

• Specialist link teams continue to support Primary Care teams, including advice & guidance, but with increasing/better use of tech.

• Built our relationship with patients through value-added processes and establishing patient/customer networks

• Using new technology to directly support patient centred care, e.g. secured email, PHR, Skype, Florence etc.

Florence-MECS implementation

• CCG use ‘pilot’ 2012-14– Pockets of primary care use

– Greater use by community respiratory team

• Permission for SWBHT use November 2013– Diabetes team (City and Sandwell sites)

– 8 users

– 50 patients

– BP monitoring/weight management/medication reminder

Patients as agents of integration

TECS vs MECS

TECS “expensive boxes with flashing lights”

Legacy of 3ML

TECS vs MECS

MECS

Simple, cheap,Engaging,Easy to customise

How best could MECS help your patients?What would you [your patients] use it for?What would be the benefits?

10 mins discussion, then group feedback

0.0

20.0

40.0

60.0

80.0

100.0

% recommend Confident about taking BP Preferred to SMS vs face to face

BP

BP diabetes/CKD

High Patient Satisfaction

User (patient) satisfaction levelsSummer 2014N=35

It’s for BP monitoring, right?

Tales of the unexpected

Florence: Tales of the unexpected

• 53 yr old woman, local authority manager

• hyperthyroidism and hypertension– BP 186/98

– mother died of stroke disease aged 60

– Prescribed amlodipine

– Decided not to take antihypertensive drugs

– No side effects, but…

– “I don’t want to be someone with a LTC needing to take tablets”

– Enrolled in blood pressure monitoring protocol

Support helped…at first

…but why was BP rising again?

Flo has built-in PROMs

Next consultation…

• We dealt with her medical issues

• I asked if she’d received my text messages

• Gradually, she opened up

• Domestic abuse: physical, emotional & psychological

• Physical abuse as a child

• Her father battered her mother; in her eyes responsible for others premature death

The real story

• Her husband works away from home, she dreads weekends

• She would stop antihypertensive drugs as she wished to die; hoping she would succumb to stroke

• Following our discussion, she was meeting with the emotional support team and considering accepting help

Flo exceeded my expectations for how it could help me get to know my patients and their lives

A New Hope

• Summer 2014

– Accepted help from Women’s Aid & Local Authority

• Rehoused in new location

• Regained her financial independence

– Why Florence?

• “It felt like I was talking to a real person. It felt safe to open up”

Florence-MECS Summary

• Is available already, to you and your teams• Is free* to use, easy to use, and readily

customised• If today you have thought of a job that Florence

can do for you/your patients– You can begin tomorrow– Or at least, very soon

• Great scope for this to help engage our workforce with digital health care– Its simplicity may help overcome adaptive change

barriersFree* as in “free beer”

Thank you for your attention!

Now, any questions?