Telehealth: The Future for Primary (and all) Healthcare ~ COPD Monitoring in Primary Care ~

1. Telehealth: The Future for Primary (and all) Healthcare~ COPD Monitoring in Primary Care ~ Dr Julian Neal Senior Partner Portsdown Group Practice

2. Portsdown Group Practice 30,000 patients four sites

3. Innovation “ We will need to create pull for new ideas from patients and the NHS rather than relying on the traditional top down push. We should reward those individuals and organisations that adopt best practice and new ideas and we should ask those organisations that don’t to explain why. We need to have the courage to make changes and be less risk averse, we need to take a longer term view on investments and we need to ensure staff are supported to introduce new ideas and technologies” Sir David Nicholson, Chief Executive of HNS England 5 December 2011

4. A brief history of Telehealth 2006 - a bright idea, Telehealth! Presentation to partners This led to ................

5. Initial misunderstanding

6. The story continues • Ignorance • Cynicism • Scepticism • Ok – let’s try • 2010 South Central SHA Innovation Challenge • Pilot 100 COPD patients winter 2010/11 • Positive outcomes • Partnership with Telehealth Solutions since November 2011 • Two year observational study with Imperial College, London

7. COPD Pilot 2010/11Outcomes • Proof of concept • Technology • Patient acceptance • GP acceptance • Increased patient engagement • Reduced use Primary Care • Reduced use OOH • Reduced unscheduled care – 11 hospital admissions avoided in 3 months • Additional time

8. Portsdown – Telehealth Solutions Partnership • Development of robust clinical algorithms • 100 COPD patients • 100 CHF patients • 100 Diabetic patients • Two year observational study of Telehealth effect on clinical outcomes and NHS usage • Central triage system • Huge potential for integration

9. Portsdown – Telehealth Solutions Partnership • Applying lessons learned in real practice setting • Greater insight into patient selection • Evolving technologies • New algorithms for: • Depression • Post traumatic stress • Hypertension • Parkinson's Disease • Exporting a UK success story

10. Six early lessons • Win hearts and minds GPs • Careful patient recruitment • Communicate with community staff • Integrate with secondary care • Central triage by specialist nurse mandatory • Simple technology with excellent support

11. Innovation – final thought First they ignore you, then they say you're mad, then dangerous, then there's a pause and then you can't find anyone who disagrees with you.” Tony Benn

12. Thank you Dr Julian Neal