1. Cross-Cutting Telehealth Programme
Outline that I will be describing the journey from Traditional Approach to Multi Matrix Model 2011 to date PCT to NHS England
Paul Marriott TECS Lead Consultant NHS England Strategic Clinical Networks. 
TECS Clinical Advocate to NHS England &
AHSN NENC Telehealth Programme Lead NENC

2. AHSN Programme of Cross-Cutting Themes
Respiratory \ COPD
Fractures
Mental Health AF
Medicines Optimization
Elderly Care
We are seeking to use new and existing technology to innovate, pioneer and ultimately share with the health economy what we learn in using Technology Enabled Care Services (TESC) in the pinch points within these and many other clinical pathways across the North East and North Cumbria.

3. Paul Marriott TECS Lead
Liz Allan
Pathway and Communications
Rachael Forbister
Sunderland CCG Pathway Development
Jackie Smart
Florence Application
The Resource and Team

4. Tripartite Programme and Partnership
North England TECS Capability

5. Cross-Cutting Telehealth Programme

6. What is Technology Enabled Care Services TECS?
Telehealth is the delivery of healthcare at a distance using electronic means of communication usually from service user to clinician e.g. a service user measuring their vital signs at home and this data being transmitted via a Telehealth monitor to a clinician
Telecare is the continuous, automatic and remote monitoring of real-time emergencies and lifestyle changes over time in order to manage the risks associated with independent living
Telemedicine is the delivery of healthcare at a distance using electronic means of communication – usually from one clinician to another e.g. a non-specialist GP undertaking an ECG on a patient suspected of heart disease and the transfer of that data electronically to a specialist clinician for discussion/comment.
E-Health is health services, information and education delivered or enhanced through the internet and related technologies. E-Health encompasses Telecare, Telehealth and Telemedicine
M-Health is Mobile health monitoring where a patient can be monitored away from home via mobile technologies 3G SMS and 4G and Apps

7. Whole System Demonstrator 1st & 2nd Generation Telehealth

8. 2nd Generation Telehealth Added Cloud Services

9. Telehealth Clinician Led Not Procurement Led
“Practitioners are bloody minded and practice their own medicine following their beliefs and clinical training. If something does not fit with their medicine then they will simply not follow it.”
Dr Hussien El Shakankery GP
SCCG Urgent Care Clinical Lead
It is essential that it is recognised clinicians will not entertain a system that seeks to place a square peg in a round hole

10. The Multi Matrix Telehealth Model Seeks to Cross the Whole Life Perspective by Proportionally Matching Telehealth Systems with the Patients Needs, Lifestyles and the Clinicians Medicine.
Death
Whole Life Perspective
Premature
Death
Irreversible Illness
Chronic Illness
Signs of Illness
Average Health
Good Health
Robust Health
Optimum Health
Conception

11. NHS Florence SMS Simple Telehealth System
Specialist Clinicians
Prompts and advice
GP Practices
Community and Specialist
Nursing
Public Health
And the 3rd Sector
Local Authority Control Room and Adult Social Care

12. NHS Florence Simple and Instinctive
For Patients Who Can Not Use SMS There is a WHZAN Solution

13. Annual Average Cost Per Patient by Generation of Equipment
Type
1st Year Capital Purchase Cost
Annual Leasing Cost
Annual
Maintenance
Cost
Total
1st Generation
Purchased System
£2000
£1000
£3000
2nd Generation Leased System
£1150
3rd & 4th Generation Rapid Deployment Leased System
£365
SMS Florence System
NHS Owned
£45
£29
£74

14. Example of Current Telehealth Pathway Costs
Pregnancy Induced Hypertension £1.20 First Week Subsequent Weeks £0.96p P/P
Gestational Diabetes £4.72 P/P

15. Some of the Current Pathways within the North East Programme (there are now over 150)
Condition Clinical Lead
Heart Failure, Angina etc. FT, GP
COPD and Respiratory etc. FT, GP
Hypertension GP
Diabetes FT, GP
Gestational Diabetes FT
Pre Pregnancy HbA1c Family Planning FT
Parkinson’s FT
Rapid Discharge FT
Deprivation Medicine and Social Prescribing GP and 3rd Sector
Acquired Head Injury and Stroke FT, GP
Primary Care Step Up Step Down GP
Care and Nursing Home GP
Weight Management FT, GP, LA & PH
Smoking Cessation LA & PH
Remote Wound Dressing Monitoring FT
Community Matron Case Load FT
Alcohol Induced Morbidity FT
FT = Foundation Trust GP = General Practitioner LA & PH = Local Authority & Public Health
Example of the 100 Pathways Created to Date

16. Some the Recent highlights:
Over 150 live pathways developed spanning from Breast Feeding and Gestational Diabetes to COPD, HF and End of Life.
Pregnancy Services commenced at City Hospital Sunderland and the pathway is now live in 5 FT’s in the NE with 8 further FT’s scheduled to adopt the pathway and system across the UK in Summer A recent CQC Report at City Hospital Sunderland published 25th January 2015 stated that the “Telehealth Services were adjudged as Outstanding.”
“The use of the Tele-health system in maternity services enabled women to monitor blood glucose levels and blood pressure in their own homes avoiding unnecessary visits to hospital.”
CQC City Hospital Sunderland January 2015 

There has also been a cost saving in clinical practice identified with Pregnancy Services of around £200 per patient per week. Patient satisfaction survey shows between 98% and 100% approval.

17. Potential Test Bed Status
Bringing the Partnership Together of Multiple Organizations Across the North
And
Combining the TECS I.P. of County Durham and Darlington NHS Foundation Trust with its INR and Nutrition Programmes with that of the NHS England and AHSN NENC Telehealth Programme we have a huge head start.

18. A Final Thought About Ascent of TECS in NE&NC
1st Generation
Telehealth
2nd Generation Cloud Based
Telehealth
3rd Generation
Mobile Telehealth
4th Generation Linked to NHS Spine
5th Generation Wearable Technology
And Beyond

19. Contact Details Paul Marriott
TECS Lead Consultant NHS England Strategic Clinical Networks. 
TECS Clinical Advocate to NHS England &
AHSN NENC Telehealth Programme Lead
NHS England Northern Senate
Waterfront 4, Goldcrest Way
Newcastle upon Tyne, NE15 8NY
Mob:
AHSN North East North Cumbria
Biomedical Research Building
Campus for Ageing and Vitality
Nuns’ Moor Road
Newcastle upon Tyne
NE4 5PL

20. Workshop Activity
Can you think of your area of work and specialism and write down the “Pinch Points” or areas you think could benefit from the use of TECS (Telehealth)?
Can we now use the remaining time to discuss your thoughts?