London Borough of Bexley deploys DOC@HOME remote patient monitoring technology across care and residential homes

Background

London Borough of Bexley wanted to support resident wellbeing and help residents to be cared for in their homes, while reducing and delaying the need for a move to higher levels of care. The team also wanted to support the diagnosis and monitoring of health conditions, to help staff to be able to quantify and record when a resident becomes unwell and to help rule out health conditions, if and when people need support, advice and interventions around mental health. Bexley chose to work with Graphnet, which provides remote monitoring technology and population health analytics across the UK and has an excellent track record in delivering digital health successfully.

Successful remote monitoring pilot

The Bexley team started a pilot in October 2018 at Northbourne Court, a large 120 bed care home. While the care home had a good CQC rating, there was quite a high usage of ambulance services and also a prevalence of falls, which were a challenge for both carers and residents. Bexley used the pilot to bid for funding, which was successful, and started to roll out the system across the care home.

Rebecca Watson-Morse, Commissioning Programme Lead at the London Borough of Bexley says:

It was a question of working with staff – and to see how we could support them to manage the wellbeing of their residents. Docobo had a good reputation for collaborating with clients and providing excellent results, which was important to us.

What is remote monitoring and how does it work?

Remote monitoring uses the DOC@HOME platform to do the following:

• Care home staff record vital signs and symptoms onto the DOC@HOME tablet (using thermometer, blood pressure monitor, pulse oximeter etc).
• Information is transferred to the GP clinical system.
• Care home staff can track information on the DOC@HOME system.
• GPs respond to any requests or alerts within two hours and the alert is triaged.
• Baseline readings can also be recorded monthly with a ‘Resident of the Day’ process, to help monitor a person’s wellbeing over time.

Remote monitoring enables users to update personal healthcare data using different kinds of question sets, which are then recorded and submitted to clinicians using a secure web interface. This pilot involved two types of question sets.

The first was for cases where a resident themselves or a staff member felt that the resident required a consultation with a GP. By answering the questions on the DOC@HOME tablet and submitting the observation, the GP is able to review comprehensive information and quickly determine the course of action and whether or not a visit is necessary. The GP then responds within 2 hours with a call to the home, which avoids wasted time for care staff waiting for a call to get through or waiting for a return call. The question sets were developed in consultation with the surgery and the care home.

The second type of question set is the ‘Routine wellness check’ which is used to carry out monthly wellness checks on residents. During these wellness checks, care plans are reviewed, and residents’ health needs are discussed both with residents and their families. Readings are taken, which go on to the resident’s record which is then submitted to the GP. Once submitted, if there are any observations which exceed agreed parameters, the GP or pharmacist will automatically be alerted.

Rebecca explains:

We find this method really helps us build a picture of residents’ health and it is really helpful to refer back to – other professionals have access to data, which is also really useful. We are looking to inform GP intervention and support their visits to care homes, by building a picture of the wellbeing of residents, which – prevents increased acuity and supports residents to stay in their home where possible.