Patients with chronic illnesses able to self-manage their conditions with successful telehealth pilot
Tunstall Healthcare has been involved in a collaborative 12-week telehealth pilot project in Ireland to explore how remote technologies can support people with chronic illnesses. With oversight from the Health Service Executive (HSE), the programme has gained international interest due to its success, cost savings and positive population health outcomes.
Undertaken in County Wexford in 2021, the pilot was overseen by a multi-agency Stakeholder Group, which included: Age Friendly Ireland, Integrated Care Programme in the HSE, Wexford General Hospital, Tunstall Emergency Response, Wexford County Council-Age Friendly Programme).
As Ireland’s population ages, there is a corresponding increase in the prevalence of chronic diseases, which are major causes of morbidity and mortality. In 2020, the HSE estimated that 1.3 million people in Ireland were living with one of the major chronic diseases: cardiovascular disease, chronic obstructive pulmonary disease, asthma or diabetes, and this is set to increase by around 40 per cent in the next decade.
Chronic disease accounts for 40 percent of hospital admissions and 75 percent of hospital bed days, as well as leading to additional demand for residential care places, a Government of Ireland National Risk Assessment found in 2019.
The project set out to provide a 12-week telehealth intervention, where Tunstall telehealth equipment was provided to 50 patients with a chronic illness. This pilot was independently evaluated by Waterford Institute of Technology.
The objectives of the pilot project were to establish a proof of concept for the provision of a telehealth service for three identified chronic conditions (chronic heart failure, diabetes and chronic obstructive pulmonary disease) in County Wexford, with a potential to scale up nationally.
Suzanne Denieffe, Head of the School of Humanities at Waterford Institute of Technology, commented: “The Waterford Institute of Technology research team and I were invited to evaluate the pilot study, which took place during the middle of the pandemic.
“The pilot project was designed to explore the potential of telehealth to support patients at home living with chronic conditions, particularly as they were experiencing social isolation at the time, and many were experiencing disruption to their clinical care.”
Research aims to evaluate the pilot telehealth intervention considered: the impacts of the intervention on the patient’s clinical condition and wellbeing; in-person use of health services ascertaining patient and clinician perceptions of the intervention and technology; and an analysis of the cost-effectiveness of the intervention.
There were two healthcare technologies used for the project: the myMobile patient app and the triageManager clinical management software platform.
myMobile is a patient app that enables self-management and monitoring. The app collects data from monitoring devices on vital signals. It provides a range of benefits including automatically updated readings via Bluetooth connected devices and the ability for manual entry of readings and automated alerts and activity reminders.
triageManager is a clinical management software platform that enables clinical and service teams to monitor patients remotely. The system enables a number of outputs including automated prioritisation tools and summary reports for clinicians.
Suzanne Denieffe highlighted the technologies used: “The Tunstall technology was very clear and easy to use, and the Tunstall team offered expert support throughout, helping to deliver a really efficient service.
“Tunstall worked closely with all stakeholders, including patients, clinicians, the county council, and Age Friendly Ireland, which was key to the success of the project. Patients felt very supported, and it became clear how much telehealth helps self-management.”
Patients were highly engaged with the project, according to the telehealth firm, with 98 percent of readings recorded. There were also low levels of attrition, which were partly due to the support provided by Tunstall with any queries they had and reminders to take readings, the company adds.
One participant found that their use of the health service improved: “I suppose I have been in the health service, and I think the change for users is that you can get a check from home without having to constantly go back and forth to the hospital.”
Another patient said that the equipment gave them confidence in their illness management, as the reassurance that their oxygen levels were good gave them peace of mind that they could go about their everyday activities.
James Doyle, Managing Director of Tunstall Emergency Response, added: “Telehealth is the future of healthcare as it offers services that can be designed around the patient, providing support in the community and helping to keep people out of hospital.
“The HSE in Ireland is committed to digital transformation and driving service improvement using technology.”
Gavin Bashar, UK Managing Director at Tunstall Healthcare, commented: “Redesigning healthcare services using digital technologies lies at the heart of national and international policies for future health provision, helping to manage increasing demand effectively and improve population health.
“Telehealth can be used to support people to self manage their chronic health conditions within their own homes, and international research has demonstrated the many benefits of such remote monitoring, including cost savings.”