Iain Trayner
Home Health Monitoring Programme Manager
NHS Western Isles
Email: [email protected]
Florence – text messaging with a human touch
transforms monitoring of diabetes and cardiac patients
What was the problem?
What next/key learning
Based on feedback received at Living It Up co-production events,
patients informed staff of the desire to use technology to manage
long-term health conditions.
Although in initial stages, the system has already had big successes
within the Western Isles, particularly in Diabetes, where it has
transformed the life of one teenage girl, Erin.
This developed into a range of initiatives in our TEC Fund, including
Florence (Flo). Florence is a very modern way to monitor patients
using the humble text message.
Erin’s story has been
so remarkable, in fact,
that the Western Isles
Flo project is now being
cited around the world,
by the inventor of
the system, as a great
example of what is
possible in telehealth.
What is the situation now?
Currently, patients are sent regular texts asking them
for information, be it blood glucose, blood pressure
or weight. They then collect and send in the results
themselves.
All their readings are collated on a web interface,
which can be viewed by clinicians, but it feels just
like sending a text message to a friend.
Crucially, if their readings fall out with certain parameters, such as
those agreed in their patient management plan, a text will be sent
back to the patient advising them that, for example, their blood
glucose is a bit high and what to do next.
An alert can also be sent to their clinician to allow for ‘remote’ early
intervention to reduce the need for a clinical appointment.
Previously admitted to hospital with an HbA1c of 112 mmol, Erin
was at a very high risk of developing other complications.
After using ‘Flo’ for 6 weeks her condition was under control with
HbA1c coming down to 83mmol.
Florence inventor Phil O’ Connell of NHS Simple, said: “(The NHS
Western Isles) team have latched onto it and just got on with it.
They’ve understood the concept of how it works. They hit the
ground running at full speed.
“They took the learning and know-how that we’ve got and
accelerated the implementation of that at a level we’ve not seen
anywhere else.
Model for improvement
Having been originally launched in Diabetes, it has since been rolled
out to Heart Failure, Cardiac Rehabilitation, Smoking Cessation and
Dietetics. The team are also working with two GP practices who will
be using Flo for patients with suspected or confirmed Hypertension.
The system allows a GP practice to screen for Atrial Fibrilation (AF)
42 times in 1 week from home without the patient having to travel
to the surgery. AF is the No1 cause of stroke in the UK so this could
make a huge difference to people at risk of stroke.
Phil O’ Connell
Florence Inventor
Iain Trayner
Home Health Monitoring
Programme Manager