The past few months have been rather busy for Florence Simple Telehealth (Flo), as various activities serve to accelerate the pace and scale of adoption of this technology which makes use of a mobile phone text service to communicate with the patient. Flo is used across the UK in general practice, community and hospital healthcare settings, and is now spreading to Scotland and attracting attention from even further afield.
Since the Health Foundation released their multi award-winning film about Flo, Telehealth with a human touch, it has been showcased at many clinical conferences and shared around the world as an exemplar of an innovative and impactful improvement project.
January 2016 saw the culmination of years of work by all involved with Flo to create an international Community of Practice. Under an NHS Simple Telehealth licence, Simple Shared Healthcare Ltd (SSHL), was officially incorporated as a social enterprise without share capital. It has been set up as an NHS members’ organisation with a social objective to use the NHS’s Simple Telehealth intellectual property (IP) to help organisations to use the IP for the benefit of the patients they care for. While SSHL has a small number of professionals working within, similar to a charity, directors are unpaid for their work and are elected by members.
The social enterprise team is further opening up the website to members of the Community of Practice. The site, whose main contributors are members of the Community of Practice itself, already contains over 100 articles, case studies and blogs, as well as reference sections with videos, journal articles, guidance and other content, including areas of interest such as diabetes and maternity. A recent development is the members’ collaboration zone, where resources, forums, local items of interest and regional collaboration and sharing areas are available to facilitate peer to peer working for the collaborative development of new and innovative uses, and the international dissemination of learning.
Scottish Health Boards continue to build on the work done in the West Midlands, East Midlands and North East and Cumbria AHSN areas. Initiatives are delivering measurable clinical results, particularly around diabetes and heart failure. A large trial is also underway in Lothian, headed by Edinburgh University, whereby up to 2,500 patients will monitor their blood pressure via Flo and on a clinically appropriate basis the data is analysed and results fed back into GP systems, indicating if a patient's hypertension is controlled or not controlled. Flo is also featured in the NHS Scotland CEO’s Annual Report due to results of innovative uses of the system such as the validated 39 mmol reduction in HbA1c over 12 weeks in a previously poorly controlled patient.
In England, a Derbyshire-based Diabetes Specialist Nurse team is reporting that the use of Flo helps patients to better manage lifestyles and thereby avoid the need for medication, delivering significant results all round. They also report: “Notably there has been a reduction in follow-up appointments for newly diagnosed patients when Florence supports the remote monitoring of patients’ blood glucose levels. Florence allows for earlier clinical intervention and guidance without the need for an appointment.”
The article by Lisa Taylor and Jayne Birch-Jones published in the British Journal of Healthcare Management, “Implementing a Technology Enabled Care Service”, discusses implementation lessons learned over the previous years via a number of local and large national projects, shedding light onto why some are successful and others not.
‘Igniting Clinical Curiosity’, a blog from inspirational nurse and Flo Clinical Lead, Joan Pons Laplana, makes interesting reading for CCGs, as he explains what he did and how he captured the attention of busy clinical teams to spread adoption of Florence. Joan was parachuted into an environment where Flo was just one of many initiatives competing for the attention of busy clinical teams, but his approach, as he explains, ignited clinicians’ curiosity, thereby creating that all-important pull to introduce Florence into working practice.