Telemonitoring provides freedom to patients

A renal patient from Cookstown has described how a new technology in the Northern Health and Social Care Trust has helped her feel in control of her condition and improved her quality of life.

Alice Quinn is 54 has Type 1 diabetes, which has caused chronic kidney disease (CKD), and a history of hypertension.

The Telemonitoring NI service allows patients to monitor their health from their own homes by combining technology and services that enable patients with chronic diseases to test their vital signs such as pulse, blood pressure, body weight, temperature, blood glucose and oxygen levels at home on a daily basis. The service is available to patients across the Northern Trust area.

Alice was first referred to the telemonitoring service in 2012 as a track and trend patient, which means she takes her blood pressure readings on a regular basis using the telemonitoring system, and these readings are then automatically uploaded to the monitoring centre. Alice’s Renal Nurse Specialist Louise Sloan then accesses the information collated to monitor Alice’s condition and determine the best course of treatment. Alice has used the system pre and post-transplant.

In January 2012 Alice’s renal function dropped below 20% and treatment commenced to prepare Alice for haemodialysis and kidney transplant. By November 2012 Alice was considered transplant-ready and she received her new kidney in April 2013, before she required dialysis.

Alice said, “Before telemonitoring I had to go to the centre to have my blood pressure taken and have my Erythropoietin (EPO) injections. I used to get stressed about appointments which sent my blood pressure up, and I ended up missing some. Having the telemonitoring installed meant I could take accurate blood pressure readings to suit myself at home, which meant I could do EPOs myself, like I do my insulin. Even now, after my transplant, the whole thing is so much easier because I’m not having to go for appointments all the time. It’s been so useful and helpful, I know much more about how to manage my own health now, and what to do if I’m having a bad day.”

“Unfortunately I had an acute episode recently which meant I had to be admitted to hospital, but having telemonitoring meant I was discharged early, as they were confident I was being monitored. I also feel I’m getting more specialised care – I don’t really see my GP much as the telemonitoring helps the renal team keep an eye on me and they can call me or visit when they need to.”

“I would absolutely recommend telemonitoring, its fantastic. I feel much more in control of my health, and I know if anything goes wrong or my meds need changing I have all the backing I need. I used to stress myself out worrying about my health but now I can just check my blood pressure at home in the morning then go on about my day. My family are much less worried about me now too.”

Louise Sloan, Renal Nurse Specialist in Antrim Area Hospital said: “Telemonitoring has had a really positive impact on the way we manage a wide range of renal patients, from general nephrology right up to haemodialysis. Generally speaking we monitor blood pressure and sometimes weight, and use the dialysis script.

Blood pressure is a vital measure for my patients; if it becomes too high it can be an indication that haemoglobin levels aren’t right and that medication needs to be adjusted. We’ve also found that telemonitoring gives a truer baseline for blood pressure. In some cases, particularly for hypertensive patients like Alice, the system is really useful for helping to titrate medication, giving us an accurate picture of reactions to changes over time.

Telemonitoring means we’re able to provide better standard of care. Patients have welcomed it too, they feel more empowered and comforted. For patients with hypertension, feeling reassured because they are being reviewed regularly can improve health outcomes in itself, as it reduces anxiety.

The telemonitoring service has undoubtedly prevented hospital admissions in a number of cases through early identification of deviations from the norm, as well as decreased primary care use as patients can self-administer with the support of telemonitoring rather than visiting the health centre. It also makes life easier for community staff, giving them more information without the need to make visits. The consultants we work with also like telemonitoring, as it bridges the care gap between appointments.

The Telemonitoring NI service is a regional health & social care service which allows patients to carry out their own health checks and to be monitored by health professionals without having to leave their own homes.

Anyone interested in this service should speak to the healthcare professionals involved in their care.

27th November 2013