NMAHP Cohort 12 Consolidation Day Technology Enabled Care
NMAHP Cohort 12 Consolidation Day Technology Enabled Care (TEC) Atrial Fibrillation Screening Project Sharon Callaghan TEC Digital Services, Project Manager TEC Team: @TECAyrshire Telehealthcare@aapct. scot. nhs. uk 01292 559867
Policy Drivers • 6 Domains in Digital Health & Care Strategy - Service Transformation (Domain C) • TEC Delivery Plan 2019/20
HMHM Framework
12 Lead ECG Test (not routine)
Why? Cerebrovascular Disease Activity Stats: Age-Sex Standardised Discharge Rate per 100, 000 population (European Age-Sex Standardised Rate - using ESP 20131) Discharge rate per 100, 000 population 800 700 600 500 400 300 200 100 0 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 p Males Females Both Sexes
Practices on Board • • • Dalmellington Medical Practice, Dalmellington Kilwinning Medical Practice, Kilwinning Fullarton Medical Practice, Ayr Frew Terrace Medical Practice, Irvine South Beach Surgery, Ardrossan + + EMIS Template
Annual Checks for Cardiology, Respiratory, Diabetes, Vascular Disease etc. Patient is sent appointment for annual check Patient has ECG Reading using the Kardia App Device Send results to cardiology email address: jim. mcgowan@aapct. scot. nhs. uk ensure to change the subject heading to the CHI Number Inform Practice to save result in patient record and add EMIS code EMISNQAF 5 Normal Reading Cardiologist interprets the readings and sends results to GPs by return email. Abnormal Reading Not interpretable Showing AF Other Factor GP will recall patient for 12 lead ECG within the Practice or refer to Hospital for same and will add EMIS Code EMISNQAF 6 If patient is confirmed positive AF Patient to be referred through AF Pathway in SCI Gateway GP decides whether to anticoagulate the patient (yes/no) and record the anticoagulant drug used warfarin, dabigatran, apixaban, rivaroxaban or edoxaban. All to be recorded on patient record GP to calculate the CHADS 2 Vasc and HAS-BLED scores and enter into patient record
Research Evidence • Kardia device 5 times more effective than standard tests • After 90 days, the smartphone device helped doctors diagnose 56% of patients • only 10% of patients given standard care were diagnosed, in an average time of 43 days/nts, in an average time of 9. 5 days. • According to researchers, the technology also cut the cost of diagnosis from £ 1, 395 to £ 474
Research Clinician’s comments "We've shown that this device is an easy, cheap way to diagnose heart rhythm problems which usually see people attending emergency departments several times before they're diagnosed. "For those with harmless palpitations this device can quickly give reassurance, whilst for those with serious underlying heart conditions it can act as a lifesaver. ” Dr Matthew Reed, from Edinburgh Royal Infirmary
Challenges • Digital Services are supplying the practices with i. Pods which require configuration by IT Security, this has not been completed • Digital Services are supplying the Practices with Wi-Fi, this has not been completed • Digital Services are supplying an EMIS Template for gathering information about the project, this has not been completed Revised launch date of the project – Monday 16 th December 2019
TEC Digital Services team …. we can help you with: • • • Support you to design your TEC intervention Provide the paperwork for Test of Change (To. C) and Project Management and support you with this Arrange for your To. C paperwork to go to the TEC and Digital Services Steering Group for agreement Support you through your test of change and evaluation Support you to write up a final project and evaluation report Some funding available for test of change • • Karen Baker –Programme Manager, TEC Digital Services Sharon Callaghan – Project Manager, TEC Digital Services Nicola Robinson – Senior Information Analyst/Project Manager, TEC Digital Services Gillian Cottingham – Project Support Officer, TEC Digital Services 01292 559867 Telehealthcare@aapct. scot. nhs. uk @TECAyrshire
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