NHS Wakefield District:

Chronic illnesses pose an ever-growing problem for healthcare providers. People are living longer and an increasing number of patients are having to cope with long-term, often permanent conditions. These frequently require expensive hospitalisation which in some cases are unforeseen and unnecessary and, more importantly, could be avoided with improved monitoring. With healthcare providers around the world facing financially challenging times and with the urgent need to curb spiralling healthcare costs, telehealth, or the remote management of patients, is being viewed by many as the ideal solution to a pressing problem.

NHS Wakefield District looked to a pioneering telehealth trial with BT to address challenges it faced. With the area it serves having a higher recorded incidence of patients with heart disease than the national average it was decided that the focus of the trial would be patients with chronic heart failure. The Primary Care Trust (PCT) wanted to see how they could better manage patients’ conditions, improve their quality of life while at the same time finding a cost-effective solution to an expensive issue – the long term care of patients with chronic illnesses.

BT is one of the largest suppliers of IT and communication services to the NHS and has a long history of providing the health service with innovative products and services. It has recently extended its portfolio by working with Intel to deliver the Intel Health Guide® system as a managed service, which means the system can be configured and managed remotely.

This interactive personal health application allows patients to self-monitor their vital signs, along with key data such as blood glucose and weight. This information can then be sent over a standard broadband connection to the patient’s care team for analysis. The system also features an in-built videoconferencing application, which allows healthcare professionals to consult with their patients remotely rather than either party having to travel. This not only ensures better levels of care, but also provides sustainability benefits.

BT worked closely with NHS Wakefield District from the beginning, starting with a feasibility study to determine the Intel Health Guide’s potential, helping the PCT to prepare an internal business case and putting together a project plan. This had to take account of the need to get clinical approval together with consent from approximately 35 patients to be involved in the trial.

BT agreed to use existing home broadband connections where present, to minimise the inconvenience for patients and to cut overheads. The BT trial was one of the first of its kind in the UK to do this and, in this way, the telehealth solution was rolled out more quickly than in previous trials where new lines had to be installed. Ten patients already had BT broadband connections. Of the remainder, approximately half had connections from other providers, and the other half did not have broadband, requiring BT engineers to install BT Plusnet lines in their homes.

The technology for the pilot was installed over a period of four weeks at a rate of up to four patients a day. BT provided the managed infrastructure and its engineers connected the Intel Health Guide to the broadband service and were given detailed guidance on where and how to install the technology in each home. The peripheral measurement devices such as blood pressure monitors were connected by the community nurse and the patient trained in how to use them.

The benefit of the Intel Health Guide system is that nurses can more easily detect early warning signs that a patient’s health may be deteriorating, and proactively respond to their needs. For example, if chronic heart failure patients do not take their medication, they can experience rapid weight gain over a few days due to water retention. The system means this can be spotted early so that action can be taken.

Alan Wittrick, Chief Executive of NHS Wakefield District, says: “The feedback we are receiving from patients and community nurses is encouraging. Patients say they feel more in control of their condition. In some cases it has transformed their lives.”

“We know constant visits to hospital or clinics can be debilitating and we are looking to see if this trial could in the long term help to reduce the need for these,” Alan continues. “The system provides reassurance to patients that changes in their condition can be picked up through timely analysis of data.”

Wakefield patient David Ward had a heart bypass 12 years ago. The 69-year-old brings to life the personal benefits of Intel Health Guide: “The confidence I have in this system means I don’t worry about my health like I used to. I sleep better and don’t have the panic attacks. I’ve started to walk small distances again. I’d go as far as saying it’s given me a new lease of life.”

• BT-managed Intel Health Guide service
• BT Plusnet broadband
• Customer premise equipment installation
• Logistics management
• Third party service integration