NEWSFLASH!

Catherine and Rachel were awarded first prize in the service improvement category in the NHS Innovations North awards, for their Telehealth service in June 2014.

They have also been shortlisted as finalists for the Health Service Journal Value in Health Care, Value and Improvement in Telehealth category, which will be held in September 2014.

Please read full story below.

Dietitians Catherine McShane and Rachael Masters, work in Focus on Undernutrition, part of the nutrition and dietetic department of County Durham and Darlington FT; a team that promotes the identification and treatment of undernutrition.

In 2013 they developed a digital health method for monitoring patients who are on prescribed oral nutritional supplements (ONS). Working alongside a project lead, business development and IT specialists, they used patients to help develop a robust telephone system to record patient data – resulting in Health Call Undernutrition Service.

Health Call Undernutrition Service uses automated phone calls – a patient receives a weekly call and using the phone keypad, answers three questions: their weight, what their appetite is like and how they are managing with their ONS.

Clinicians receive an email alert if the information inputted is outside of the predetermined parameters or if they have failed to respond to the call.

Catherine McShane explains why they set up Health Call Undernutrition:

“Dietetic services are constantly under pressure to provide high quality services for less, alongside concerns about lack of follow-up of the effectiveness of diet therapy, such as ONS.   “Using technology can increase the capacity of a service, allowing clinicians to respond quickly and see the outcomes of their recommendations. Telephone technology is particularly cost effective and it can be extended to a far wider number of patients compared to the traditional ‘hub’ system.   “Further, dietitians can train other healthcare professionals to ensure that all patients on ONS are monitored. Long-term, this could be used to monitor patients who are at risk of undernutrition, and prevent the need of ONS through earlier intervention.”

Impact and outcomes

The service has improved the quality of life of the patients using it – patients said they felt more involved in their care, reassured and supported and the service had made a positive difference in them taking ONS. Rachael Masters was surprised by the positive effects of Health Call in the care home setting which is something they had not predicted:

“A focus group of care home staff reported an increased sense of shared care between the home and dietetic staff. They also reported the service gave staff a sense of ownership around diet and nutrition, it was not only the responsibility of dietitians or senior staff but all staff took notice of residents compliance with ONS and recognised its importance in treatment.   “As a result of care home feedback, we launched a web-based version of the service, reducing the number of calls a home receives and increasing their flexibility to input the information.”

Financially the impact has also been tremendous. Between February 2013 and January 2014 Health Call saved approx 61 hours of clinicians time and over £20,000 on nutritional supplements. Rachael continues: “Long-term the Health Call could revolutionise dietetic care. It in no way replaces the role of the dietitian, rather it enables services to direct their provision to where it is most needed, increasing capacity, flexibility and importantly convenience for the patients.”

Patient story

Eric, 91 Eric lives with his wife and adult daughter who has learning difficulties. His other daughter who lives nearby explains the impact of the service on their lives:

“Dad can’t attend the clinic as he is too frail and I was going for him which took a lot of time. Now I can take the calls at the home, or mum can despite her being deaf as it is so easy to use! We can put the phone on speaker so that Dad can hear too. Most importantly Dad feels that he has a voice and is involved in his care. We are able to see his progress, and we can show the results to his consultants who can see a much clearer pattern than the old system – it has been truly life-changing. I feel more confident knowing that someone is looking at the information and within hours a dietitian contacts us if there is a problem. It is a lifeline!”