Integrating Telemedicine into mental Health Care

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1 Integrating Telemedicine into mental Health Care learning from a Care Homes Vanguard Rachel Binks Nurse Consultant Digital & Acute Care Airedale NHS Foundation Trust Chris North Care Home Liaison Team Bradford District Care Trust

2 Digital Health Telecare Telecoaching Telemonitoring Teleconsultation

3 A system designed by default Some people seem to do quite well without waiting for healthcare support

4

5 right care today Teleconsultation Prison health care Care at home Nursing & residential care Supporting end of life patients 24/7 clinical hub improving patient experience changing patient flow reducing costs Electronic shared record connecting primary & secondary care now connecting whole health & social care economy tomorrow

6 right time care anywhere

7 right place - replicable model 475 Nursing/Residential Care Homes + 50 in implementation Supporting > 14,000 residents

8 Aims of the service Provide, safe, effective high standards of care To support residents to stay at home Support residents/nurses/ carers in the planning and delivery of care Escalate to community teams out of hours

9 Other services delivered from the digital care hub Gold Line GP Triage Intermediate Care Hub Acute Care Team Single Point of Access Complex Care Team Registered practitioners Shared record Visual contact

10 Video insight into our telemedicine and Gold Line Service

11 Data from End of Life Care Profiles PHE and district wide reporting (CSU) National data England 2013 AWC 2013 Bradford District 2013 Bradford City 2013 GSF/Gold Line Year 2013/14 All deaths in hospital All deaths at home All deaths in care homes All deaths in hospice % % % 5.5% %

12 Call sheet

13 Reporting Nursing Homes Residential Homes Day Current Last % YTD Day Current Last % YTD Month Month Variance Month Month Variance Monday % 213 Monday % 347 Tuesday % 191 Tuesday % 295 Wednesday Wednesday % 273 Thursday % 155 Thursday % 232 Friday % 196 Friday % 305 Saturday % 213 Saturday % 327 Sunday % 186 Sunday % 305 Time Current Last % YTD Time Current Last % YTD Month Month Variance Month Month Variance Morning % 550 Morning % 835 Afternoon % 770 Afternoon % 1,249 Hours Current Last % YTD Hours Current Last % YTD Month Month Variance Month Month Variance In Hours % 673 In Hours % 885 Out Of Hours % 647 Out Of Hours % 1,199 Total

14 Reason for call Nursing Homes Residential Home Purpose Current Last % Variance YTD Current Last % Variance YTD Advance Plan/DNAR Agitation/Confusion Anxiety % % 19 Bowel concerns % 1 Breathing difficulties % % 48 Catheter concern % % 48 Cerebral event % Chest infection % % 114 Chest pain % % 16 Death Dehydration % % 31 Emotional distress % % 14 EOL Symptoms Eye Infection (eye) % % 28 Falls % % 210 General Deterioration Head Injury Medication issue % 1 Nausea % % 11 Other % % 649 Pain Management % % 118 Seizure % 13 Skin complaints % % 192 UTI (suspected) % % 185 Vomiting % % 28 Wound care % % 47

15 Outcome of calls Nursing Homes Referral Residential Homes Current Last Current Last % Variance YTD Month Month Month Month % Variance YTD collaborative care team % % 3 community matron % % 16 district nurse % % 132 palliative care service % palliative care physician % 1 Referral to social services % Referral to GP % % 481 GP out of hours service % % 361 Intention (would have) Current Month Last Month % Variance YTD Current Month Last Month % Variance YTD called their GP % % 1,230 attended A&E or called an ambulance % % 153 contacted community nursing % % 127 Not have contacted an alternative healthcare provider % % 50 Not applicable % % 213 Outcome Current Month Last Month % Variance YTD Current Month Last Month % Variance YTD Patient remained in place of residence % 1,145 1, % 1,797 Ambulance request for patient % % 233 Hospital notified of death %

16 What would you have done? Called an ambulance 200 Contacted a GP 150 Contacted a community nurse 100 Done nothing 50 Question not asked (follow up etc) 0 W/C 07/12/2015 W/C 14/12/2015 W/C 21/12/2015 W/C 28/12/2015 W/C 04/01/2016 W/C 11/01/2016 W/C 18/01/2016 W/C 25/01/2016 W/C 01/02/2016 W/C 08/02/2016 W/C 15/02/2016 W/C 22/02/2016 W/C 29/02/2016 W/C 07/03/2016 W/C 14/03/2016

17 Actual GP referrals 80% 70% Referred to OOH GP % 60% 50% 40% Referred to In Hours GP % 30% 20% 10% 0% Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Referred GP (both In & Out of Hours ) %

18 Reason for Hub on-referral to GP Random 30 cases audit for GP Triage Homes in September 53% for GP Visit 20% Medication review 20% Prescription 2% Advanced Care Planning 5% other

19 Impact NW CCG - Care Homes Innovation Programme (CHIP)

20 Impact 2 NW CCG - CHIP

21 GP triage Clinical assessment by Hub nurse Onward refer if required to HCP for home visit Request prescription GP surgery informed by NHS secure mail

22 GP feedback "Of all the changes in the 15 years I have been working this is the greatest change which has reduced workload I can remember. I don't mind the extra "late" duty doc visit as this is more than made up in the drop in other visits. A big thank you to all involved."

23 Innovation potential The innovation that telemedicine promises is not just doing the same thing remotely that used to be done face to face, but awakening us to the many things that we thought required face to face contact, but actually do not. David D Asch MD, MBA, Perelman School of Medicine, University of Pennsylvania

24 Mental Health First Response Link to the Mental Health Trust Advise for physical health issues Advice for mental health issues Access to experts Visual contact for both teams Potential Outcomes Reduced attendance to ED Reduced admissions Clinical Support and Advise for both teams to enable immediate robust assessment and care

25 Care Home Liaison Project Team can access hub Team can access each other Access to First Response hub Access to Digital Care Hub Remote consultation and appointments Potential Outcomes Reduced travel Immediate response Reduction in crisis calls

26 BDCFT Care Home Liaison Virtual Clinics (1) people in the district with dementia (PWD) Expected to rise to 6000 by About 4000 with a diagnosis, 1000 without diagnosis 1000 new cases expected each year 2/3 rds of PWD living at home 80% of care home residents are PWD c care home residents are PWD 25% of hospital beds occupied by PWD

27 BDCFT Care Home Liaison Virtual Clinics (2) Older People s Community Mental Health Services Over 65 popn = 92500, 4 x Community Mental Health Teams: AIREWHARFE / CRAVEN / BRADFORD (CITY & NORTH) / BRADFORD (SOUTH & WEST) Domiciliary Support (lots of travel for clinical staff) Out-Patient Clinics (lots of travel for patients & families) Memory Clinics (as above) Acute Hospital Liaison ( captive audience) Care Home Liaison (lots of travel for clinical staff)

28 BDCFT Care Home Liaison Virtual Clinics (3) Craven OP CMHT / Care Home Liaison (CHL) Based at Skipton General Hospital Over 65 popn = Care Homes, spread over 450 square miles Referral-led model 0.5 x wte Band 6 Care Home Liaison Nurse (RMN) c.100 referrals per annum to CHL 150 face-to-face contacts per annum c. 350 referrals and 950 contacts per annum in Bradford (South & West), popn = Delivery of Dementia & Delirium training CQUIN to 8 care homes across the district in

29 BDCFT Care Home Liaison Virtual Clinics (4) Telehealth Craven CHL Pilot (Dec 2016 Mar 2017) Weekly virtual clinic with 5 most remote care homes Ingleton, Settle, Thornton-in-Craven, Grassington Test out concept of virtual mental health support Attempted / successful telehealth contacts Failed telehealth contacts & reason: Technical problem No response at care home Other (state) No of care home residents consulted about Total time of consultation

30 BDCFT Care Home Liaison Virtual Clinics (5) Telehealth Craven CHL Pilot Monitor / evaluate impact and outcomes : PATIENT OUTCOMES LIAISON ACTIVITY Advice only Change of care plan Visit by CHL arranged Mental Health Act Assessment Admission to MH facility A&E attendance Admission to hospital Referral to other health or social care professional GP / Practice Nurse District Nurses Community Matron / ANPs Community MH Team Complex Care Team Social Services Telemedicine Hub Other (state)

31 Remote training and clinical support Support for care home staff using the VTR Support for DNs and community teams do they need to attend? Overview and clinical support of care home staff developing enhanced roles Remote outpatient clinics

32 Questions Technology Enabled Health the art of the possible

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