Doctor / Practice Manager

Mike Ingram – Lead Clinician

Red House Surgery

Radlett, Herts

"We have been using the Surgery Pod system for nearly two years now and have found that it has made a real and significant difference to the way we manage aspects of patient care.

It has been particularly useful for:-

• Measuring blood pressure objectively before making a decision as to whether to treat or not
• Monitoring those with chronic stable hypertension who need little intervention
• Allowing those who want basic cardiovascular screening to administer this themselves
• Using self administered questionnaires to measure and monitor anxiety and depression

In general the pod has been highly acceptable to a large segment of the practice population and there seems to be a higher than expected uptake by the elderly.

The Pod has also been used for weight monitoring in terms of obesity management and also in patients with heart failure.

The use of the Pod has reduced the tendency to initiate anti hypertension treatment for those with white coat hypertension, to escalate treatment for those whose BP is not accurately controlled and, conversely, to highlight the need for treatment for patients who might be unconvinced.

The place of this system in practice is best illustrated by the way it has rapidly become a management tool as part of the monitoring of chronic disease and the fact that we are looking to broaden the amount of routine data collection managed through it so that the interactive medical consultation can focus more of the patient’s agenda.

I would also highlight the responsiveness of Telehealth Solutions Ltd in developing software solutions to problems that we encounter. At present we are looking to capture date even when patients fail to complete the whole pod process and envisage that this will further enhance the effectiveness of the system."

Kenneth Spooner - Practice Manager

Red House Surgery

Radlett, Herts

“For patients, in terms of access, these machines are a great addition. They are particularly useful in improving access for patients and doctors.  For example, women using the contraceptive pills who have to come in for regular blood pressure checks can use the Surgery POD to take their blood pressure and if all is well get their prescription almost immediately.

"The SurgeryPod also helps GPs and nurses with their workload because they can ask patients to go to the pod before their appointment and answer all the standard health questions such as smoking status, alcohol intake and weight giving the doctor or nurse more time to discuss and review the patients needs. At Red House we see this technology as part of a range of options, including our own website, that helps improve surgery accessibility in its widest sense.”

Tracy Wilson - IT Manager

Todmorden Group Practice

Todmorden

"The Surgery Pod has transformed our waiting room; patients are really impressed that they can monitor their own weight and BP – it makes them feel in control of their own healthcare. Telehealth Solutions have been really helpful and have collaborated with the practice on every idea we have had for the Pod. Hopefully, this two-way process will be beneficial to other users of the Pod."

Rachel Stark - Practice Manager

East Quay Medical Centre

Somerset

"In July of this year, I heard about the Surgery Pod, provided by Telehealth Solutions Ltd. Always interested in new ideas that improve patient services, and increase relevant data recording without increasing staffing, I invited Telehealth to demonstrate their innovation. I assess all new innovations carefully to ensure previous resources are utilised most effectively and I was immediately impressed by the Surgery Pod.

The Surgery Pod provides a very patient-friendly way of undertaking simple health monitoring and collecting health and lifestyle information. This gives the patients an accessible way of monitoring their blood pressure, weight and BMI more frequently than practice resources can provide. Today patients taking responsibility for their health and lifestyle choices are key to improving their health and the Surgery Pod is a useful tool to support this. A key group that has benefits has been out patients whose first language is not English: the Surgery Pod translates the questions into any language required and this has really improved the service we offer to these patients.

For clinicians it has meant that they have access to all of this data and can build up a more comprehensive picture of their patients’ blood pressure and weight. It is particularly useful for blood pressure as self-monitoring can avoid any white coat hypertension. Our doctors have also found it is very useful in supporting a diagnosis of certain conditions, such as depression, as patients can complete a PHQ9 prior to a consultation or in between consultations - this again creates a broader picture for the GP.

For the practice it has increased our data collection of health and lifestyle information without requiring an increase in staffing. We have had an excellent response to the Surgery Pod. We encouraged all of our patients who attended for the 'flu vaccination to use the health pod and they were impressed with the ease of use. For us it was an opportunity to gather a significant amount of data very easily.

The Surgery Pod has been welcomed by patients, staff and GPs: all recognise the many benefits it brings.

I initially felt that the Surgery Pod was rather expensive but having seen it in action and assessing the volume of data it collates and automatically enters onto the patients record it was clearly a cost-effective solution as, promoted effectively and located well, it is an excellent way of collating data required by many QOF targets and enhanced services.

The service provided by Telehealth Solutions was very good; the installation was quick and easy and whilst little ongoing maintenance has been required, the support when needed is always speedy and comprehensive. I am most impressed by the flexibility of the programming team to develop new questions and to tailor the user interface to exactly the way we want it. I continually think of new ideas that the health pod can support patients in maximising their health, how we can support our clinicians in their consultations and in how we can collect more relevant data to help us support existing services and develop new services.

In the future we hope to develop more health educational services on the Surgery Pod, and include the facility they have for patients to print or e-mail themselves health advice tailored to them."

Charlotte Blyth - Practice Manager

Elizabeth Avenue Group Practice

Islington, London

"We decided to introduce to the Surgery Pod to our practice shortly after the decision was made to stop offering new patient health checks to patients under the age of 45. All patients received a comprehensive questionnaire at registration, should any queries arise from this they would be offered an appointment. In addition our HCA was becoming increasingly busy with blood pressure checks. We felt the machine would be able to help register all patients under 45 and ease blood pressure appointments. It would also offer patients the chance to monitor their blood pressure at times which are convenient for them.

The machine has proven popular with patients, young and old. Patients like the fact they can pop in at any time, some even come in at 8am for a blood pressure check. Some find they are more relaxed and get better readings. During our flu clinics we used the opportunity for some QoF point catch ups and encouraged patients who were overdue a blood pressure check to visit the machine there and then, at times there was quite a queue of patients. Patients are amazed that their results are in their medical records immediately.

We were lucky with our machine because we used our GPsoc monies to purchase it, however the benefits have been felt all round. Patients find the machine easy to use, and we have chosen the languages based on our practice population. Installation was easy once our PCT had organised the cabling, with Telehealth working with one of the GP’s here to have the settings exactly to our preference. We hope to expand the use of the pod to include further questionnaires for up and coming LES’s and feel it has been a successful purchase for the practice."

Mike Turner - Practice Manager

The Baffins Surgery

Portsmouth

"Although I was aware of such systems, I first saw the Surgery Pod at the EMIS Users Group Conference in September 2007. At that time I thought it would be helpful, but didn’t offer what I thought it should – it was really a machine able to take BP and weight, and then enter this data onto clinical systems. It therefore only provided a convenience over equipment that printed this data to be passed to staff – and expressed these thoughts to those at the Conference stand. However the concept was good, and I felt I could work with the developers to get closer to what I thought would work in General Practice. However not being a Partner I wanted to work on the concept before presenting the Partners with a potentially expensive item of equipment. By December I had spoken to Duncan (Mills) on several occasions with my thoughts, as developed with colleagues in this Practice. These included major potential savings to Practices in staff time – and therefore costs.

Somewhere in my thoughts were those of patient convenience – and privacy. We have about 10 suffering with (varying degrees) of anorexia, for whom the thought of coming into the Surgery and talking to someone is difficult, so should their normal clinician be on leave they “miss” a week or two … then often need personally picking up by that clinician. How about a system that allows them to come in at a time best for them; to enter their details then use the scales – in the knowledge that this information can easily be viewed by their preferred clinician – hence regular monitoring takes place (this system has now been working well for seven of our patients for several months).

In early 2008 Duncan offered us the opportunity to pilot the system for three months, with some of the amendments we had proposed. The Partners approved the pilot and as the installation process is very simple, the only delay was finding a mutually convenient date! Not only do we now have a system for patients to check weight and BPs privately, we also have equipment able to complete much of our new patient check requirements and other routine questionnaires (such as depression screening). Working with Duncan, we developed the questionnaires to meet other areas of patient care helpful to Practices, including smoking habits and other items required for QOF. At the end of the pilot, the Partners agreed to purchase the equipment outright (but with a maintenance contract also in place) as the benefits were becoming clear. We also arranged for a check in screen to be purchased using Telehealth Solutions – this being a valuable asset with the advent of extended hours.

From the outset we wanted to keep an eye on POD usage, not only as part of the pilot review, but also to check for any clinical concerns for individuals. With EMIS LV this is a simple search run weekly to find patients using the machine, and the main new clinical data (i.e. BMI and BP) being listed. This whole list is passed to a GP for review; simple Excel formulae/functionality highlight any that are outside “normal” expectations, making this piece of work relatively simple. For those patients the GPs ask to use the POD on a regular basis the data is easy to view as it is in the same format as if they had seen any other clinician, and with the advent of EMIS WEB as the upgrade to EMIS LV the functionality is even better as it can shows trends.

By the end of June all new patients registering here are asked to use the POD as part of their registration process. They use a set of questions that update all smoking, alcohol and other data helpful not only for QOF purposes, but also patient care. Many patients have benefitted from the system to enter core personal data, thereby reducing the need for appointments with clinical staff (these are now 10 minutes long – reduced from 20 minutes); in cases of patients re-registering here (e.g. students returning form University) we find the POD completes all our formalities so no clinical time is required – unless there is a clinical need to review. The bottom line is that, despite a low turnover of patients at around 40 - 50 per month, we are saving about 10 hours of clinical appointments. Practices with higher patient turnover could see even better savings, and this is only one aspect of the POD.

As we approached the end of Summer we received the news that there would be new DESes. On reading this news, it was obvious that again the POD could be used to garner the required information with minimal impact on Practices. The adjustments have been made to the software enabling us to complete the FAST questionnaire and to confirm whether or not English is their main language (due to our location and low levels of ethnicity this works for us). For us, given new patients are asked to use the POD, completion of these new DESes will result in income for negligible staff time. In the current financial environment that, as a minimum, has to be helpful."

Dr. Suzanne Brannan - Telehealth Project Manager

NHS Fife,

Dunfermline, Scotland

“The Home Pod project in Fife arose because clinical COPD is one of the long-term conditions that does result in a significant number of hospital admissions. Of the patients take into hospital, about half of them will be re-admitted within a few months of their initial admission.

"Now, however, the technology exists where a lot of the clinical information could be gathered and monitored remotely, giving doctors the opportunity to intervene earlier when there are adverse indications or changes in the patients' results.

"The Home Pod will enable us to deliver tailored healthcare in the comfort of the patient’s own home thereby improving quality of life for chronic obstructive pulmonary disease (COPD) patients."

Dr. Colin Selby – Clinical lead for respiratory medicine

NHS Fife

Dunfermline, Scotland

“These HomePods have the potential to provide early warning to local healthcare providers with opportunities for even earlier intervention; supporting at home rather than hospital admission. I am looking forward to their continued use in Fife.”

Dr. Andrew Kilpatrick – Clinical lead

NHS Fife

Dunfermline, Scotland

"As well as potentially reducing time in hospital and episodes of illness for patients, the HomePods help to empower patients to care for them selves and to maintain their self esteem."