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Owen Hughes, Valmai Davies and Kara Price

Powys Teaching Health Board and Phillips Healthcare Clinical Respiratory Service

The technology is a combination of remote healthcare monitoring and supported intervention. It enables the local management of patients presenting with Obstructive Sleep Apnoea (OSA).

Within most sleep services, there exists a lack of visibility of patient performance until device data can be interrogated. This inevitably results in unnecessary face to face review if the patient is already compliant.

More significantly the majority of compliance issues can easily be resolved over the telephone, provided therapy data is readily available to direct the clinician.

By combining technology that makes this data remotely available to the care giver, together with a resource that can manage day to day patient needs, we have developed a care pathway that utilises our resources only when the patient needs it. This is particularly important in the rural communities of Powys, where patients will have to travel a significant distance, often at their own expense, to receive the same level of healthcare in more populated areas.

The care pathway that incorporates this technology sits in line with Prudent Healthcare.

The association of OSA with cardiovascular disease and diabetes, has ensured that managing Sleep Apnoea is high on the agenda for respiratory service across the NHS. This is particularly significant for Powys, where the British Lung Foundation has identified Powys’ population to exhibit the highest prevalence of risk factors for this disease.

Anticipated Benefits:

The implementation of this technology in Powys will help us to meet the key actions identified in the Respiratory Health Delivery Plan and ensure that Powys patients are treated closer to home, in a timely fashion and in a way which improves their quality of life (all of which will be monitored during the pilot).

It is anticipated that this will also be a more efficient way of treating people in the community rather than relying on expensive secondary care based services and may serve as a model which could be implemented in neighbouring Health Boards.

Patients will be diagnosed and treated a lot quicker resulting in reduced admissions, Philips healthcare will also provide a 5 day per week Clinical Support Service to the patients. These reasons being the key motivation points and drive behind the project.

Increase in workforce as additional resources has been secured for the project to include a Project Manager and Consultant Physician. Additional external training has been sourced to aid our Clinical Nurse Specialists’ successful delivery of the Master Class. The opportunity to work with external contractors will also strengthen the team.

Philips Sleep and Clinical Respiratory Services is the Industry partner. Philips is a multinational company with Global Head quarters in Amsterdam and UK offices in based in Guildford.

We will enter into a contractual agreement with each to support a pilot of 50 patients over the course of a year. At the end of one year, a separate agreement will be entered to ensure that patients are appropriately supported depending upon the outcomes of the Pilot.

Clinical Respiratory Service will be contracted by Powys Health Board to provide and maintain equipment and consumables that are associated with delivering Continuous Positive Airway Pressure (CPAP) therapy. Philips will supply the network infrastructure to allow remote monitoring of patients’ performance as, well as supplying a database to securely record all interactions with the clinical team while on therapy. This Database is called Encore Anywhere.

Any face to face review of patients will be at Bronllys Hospital. We anticipate this will amount to a maximum of 200 hrs. for 50 patients over the course of a year. We expect the cost of the pilot will be in the region of £15k, some of which will be met from existing resources.

This Project Supports Prudent Healthcare:

The care pathway that incorporates this technology sits in line with Prudent Healthcare.

This project allows patients to receive first class care in their own home, working together with healthcare specialists.

This project is aimed to reduce the current waiting list in Powys and get patients the treatment they require quicker and more efficiently.