As a key programme of work for Technology Enabled Care, we are committed to extending and expanding remote health assessments, monitoring and treatments for patients, and making it more convenient to access timely services. This will provide a wide choice of ‘digital first’ health experiences, for those that want it, across a range of digital channels across Scotland and aims to provide a significant contribution to the Realistic Medicine strategy and Digital Citizen Delivery plan 21/22.
The Covid-19 response has ‘raised the bar’ when it comes to citizen experiences of health services. It has demonstrated what can be delivered when a ‘digital first’ approach is taken and this has raised public and professional expectations about what modern and effective health services look and feel like.
Clinical services across Scotland have probably never experienced such rapid changes or direct impact on resources as caused by the Covid-19 pandemic. Remote health monitoring had been, and continues to be, able to offer a viable and accessible option for citizens to remotely record and share their symptoms and clinical readings with clinical services.
Obvious benefits in reducing time and travel are coupled with evidence of optimum management and improved clinical outcomes for the user. Not least the ability to maintain or resume necessary management of long-term conditions while reducing the footfall to clinical premises.
Several key pathways are now available to support the management of long-term conditions such as Hypertension (high blood pressure) COPD, Asthma, Heart failure and Diabetes with systems which can alert the user to seek medical advice where required.
The Blood Pressure Scale Up programme has now exceeded the initial targets of 20,000 new users and 50% general practices in Scotland with access. This programme provides a pathway from diagnosis through medication titration to long term monitoring.
The monitoring of acute conditions such as Covid-19 infection through the Covid-19 Remote Monitoring Service is paving the way for other unscheduled or specialist care pathways. Alerts received by users enable faster access to urgent medical care OR reassure them all measurements remain within acceptable limits.
The introduction of a new digital solution for remote monitoring provides access via online, SMS texts or automated telephone call (landline or mobile) options.
Feedback has been overwhelmingly positive with both citizens and staff reporting satisfaction in being able to communicate remotely, and that they feel better informed and engaged with treatment and care.
Accessibility and equity are being robustly addressed by engagement with key partners to ensure remote monitoring is available to as many people as possible across ethnicity, demographics and literacy challenges. We will need to take account of digital exclusion and we are working with the Connecting Scotland programme to help address this.
Innovations being developed include self-access to GPs (online triage and consultations) and the ability to share pictorial images remotely (Digital Dermatology).
Links with the Digital Health & Care Innovation Centre is providing a key route to new digital solutions to consider and test links with academic partners to secure the essential research support. Long Covid support and a digital front door are among the current discussions underway.
Improvement methodology has been at the heart of this programme – developing, testing, implementing and evaluating prior to wider scale up nationally.
Collaborations with the Modern Outpatient programme and National Education Services have proved essential in this process, providing invaluable support and links to other national strategic aims. A staff training resource hosted on the TURAS platform is due to be released shortly.
Lastly, a new national strategic procurement process is in the final stages prior to a preferred digital supplier being identified this summer. This will offer even greater opportunities to make remote monitoring accessible and realistic!
Dr Margaret Whoriskey
Head of Technology Enabled Care programme