Abstract
Introduction: Use of video links (teleconsultation) to deliver clinical care has most often been used in a professional:professional context. We describe the results of providing 24 hr access to immediate clinical support using teleconsultation in both domestic and residential care settings. Aims To deliver a reliable, safe and effective means of providing clinical support to patients with a wide range of Long Term Conditions (LTCs), on a 24/7 basis. Methods: A dedicated 24/7 Hub, staffed by experienced nurses, supported by a consultant general physician, can receive and make calls to patients over domestic broadband links. Patients may be at their home or in a residential care (Nursing and Care home) setting. Consultations are viewed either on a domestic TV via set top box technology (Red Embedded) or on a dedicated mobile video system (Involve Visual). Consultations are documented using a shared EHR (TPP SystmOne) which is used for communication and audit purposes. Patient feedback is captured using post call questionnaires. Results: As exemplars, 2 groups are reported here. Firstly, a cohort of 25 people with COPD, managed at home. In these individuals, study of their admissions to hospital over the year before and after introduction of teleconsultation showed a 29.5% reduction in hospital admissions and a 36% reduction in length of stay for those admissions that occured. Patient satisfaction with the approach scored 8-9/10 across a range of measures. Secondly a cohort of 14 nursing and care homes were supported using mobile teleconsultation equipment. For each home, comparison of a six month period post introduction of service and the same six months one year previously, showed a 50% relative reduction in admissions compared with similar homes that had no access to teleconsultation (actual reduction 27% vs 18%) and a 74% relative reduction in Emergency Department attendances (47% vs 27%) from the homes. Over the study period there were no clinical governance issues. For care homes, financial modelling of the benefits this approach may
Highlights
Use of video links to deliver clinical care has most often been used in a professional:professional context
We describe the results of providing 24 hr access to immediate clinical support using teleconsultation in both domestic and residential care settings
Patients may be at their home or in a residential care (Nursing and Care home) setting
Summary
Use of video links (teleconsultation) to deliver clinical care has most often been used in a professional:professional context. November 2013 Publisher: Igitur publishing URL: http://www.ijic.org The results of 24 hr teleconsultation with people at home and in residential care settings
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