Encouraging initial findings from a medication adherence study

The Center for Connected Health, a division of Partners Healthcare, announced Wednesday encouraging initial findings from a medication adherence study

BOSTON, MA, JUNE 23, 2010 — The Center for Connected Health, a division of Partners Healthcare, announced today encouraging initial findings from a medication adherence study, using a wireless electronic pill bottle to remind patients with high blood pressure to take their medication. The ongoing study measured a 27% higher rate of medication adherence in patients using Internet connected medication packaging and feedback services compared to controls.
The randomized controlled study assessed the impact of the wireless GlowCap developed by Vitality, Inc. GlowCaps fit popular pill bottles and signal patients with light and sound when it is time to take the medication inside. An embedded wireless connection enables the GlowCap to respond to the patient with automated calls for any missed dose, weekly progress reports, and refill reminders. GlowCaps also share adherence with physicians and a social network if the patient chooses.
“As healthcare providers, we must find strategies that help patients become more adherent to their medications and care plans,” said Alice Watson, MD, MPH, Center for Connected Health. “We are extremely encouraged by these interim results, showing a high rate of adherence in users of the GlowCap system.”
In total, one hundred and thirty nine patients diagnosed with hypertension and taking an antihypertensive medication were enrolled in a six month study starting in August 2009. Participants were required to have Internet access and an email account to receive reports. Each participant was randomized into one of three groups: those in the control group did not receive any communication or GlowCap services; the intervention group received visual and audio reminders from the GlowCap as well as missed dose reminder phone calls, medication refill reminders and progress reports emailed to the patient, family member and /or their primary care provider. Participants in an intervention-plus group additionally received a financial incentive if they exceeded a monthly adherence goal of 80%.
Three month interim analysis shows study participants in the intervention and intervention-plus group achieved adherence rates of 98% and 99%, respectively. This was significantly higher than the control group, which had an adherence rate of 71%. The study is also measuring blood pressure control and subject satisfaction. Final analysis of the study is anticipated this fall. “GlowCaps use real-time feedback loops to act on a number of behavioral motivators: reminders, doctor accountability, social support and help with refills,” said David Rose, Chief Executive Officer, Vitality. “These are  instructive findings for pharmaceutical manufacturers and payors who have a vested interest in improving patient outcomes with their products and services.”

Each year millions of people fail to take medications as prescribed by their physicians; the World Health Organization estimates that adherence to daily medication averages 50% for those suffering from chronic diseases. Numerous studies demonstrate that poor-adherence reduces the effectiveness of medications, jeopardizes patient health, and increases health care costs. Recent research, including work by the New England Healthcare Institute, calculates the costs resulting from non-adherence at $300 billion annually.

BCS Health Scotland Conference 2010

BCS Health Scotland Conference 2010 NHS Scotland logo

Open for Registrations 22nd and 23rd September 2010

Register now for the most exciting eHealth conference in Scotland this year! Held at the prestigious Glasgow Science Centre you not only have a great programme, wide range of exhibitors, great views over the Clyde and City but complementary entrance to the fun science exhibits as well!

The futuristic building mirrors BCS Health Scotland’s Innovative and Modern outlook See Here

We have an extensive International speaker Programme over both days with three themes held in twin parallel tracks.

Keynote speakers include:

Matthew Swindells, former CIO Connecting for Health, and chair BCS Health

Rikard Lovstrom from Sweden to talk about their National Patient Overview project and eHealth strategy

Dorothy Whittick from Canada talking about the Canadian Health Infoway national developments and a Wellness project in Alberta

Brian Robson from Scotland on the Quality theme and his experiences with IHI in America.

Kathy Dallest from Australia speaking on Clinical Safety Management in eHealth.

New! NHS Scotland eHealth Awards!

An exciting new event will be presentation of the ‘NHS Scotland eHealth Awards!’. These awards are given to winning NHS teams for three categories sponsored by BCS and Scottish Government.

Twin Exhibitions: We are very grateful to our sponsors with 18 commercial exhibitions in a superb bright atrium area and ANOTHER FIRST: 15 public information stands in a separate gallery open to the public. There is plenty to see!

The three main themes to be addressed at the BCS Health Scotland Conference 2010 are Quality, Innovation, and Efficiency. International speakers from Australia, Canada, Sweden, America, Ireland, Wales and numerous UK speakers will position themselves on current relevant issues such as patient safety, the quality strategy, efficiency gains from IT and more.

For the first time, the NHS Scotland eHealth Awards will be presented to eHealth teams in Scotland. These awards will be presented by Scottish Government and by BCS, the Chartered Institute for IT, to help boost the status of the IT profession in NHS Scotland at a time of significant change.

Moreover the new Vidiowiki delegate social networking tool will be used for linking up delegates before and after the event. Users can navigate a mind-map of delegates, speakers and exhibitors to create linkups and watch short clips about presentations and demos. This will help planning and networking before coming to the event.

A selection of posters will be available to view during the conference:

  • A novel security risk assessment model – Napier University
  • Clinical content modeling – NHS National Services Scotland
  • Trans-national exchange of eHealth innovations in northern Europe- Aberdeen University
  • A Study to evaluate the effectiveness of an electronic dashboard – Ulster hospital
  • A Study to evaluate the response times for alerts – Ulster hospital

Around 250 participants are expected to take part in this open event. Online registration is possible here. Details about fees and early bird registration can be found online.

A draft programme for the event can be found online at the event website.

Exhibitors are also leading a fun social evening at 5pm on the first day.

Yet again BCS Health Scotland has been able to produce all this for the incredibly low delegate registration prices starting as low as £30.

So register soon for the early bird rates, find us here BCS Health Scotland Conference

CollaboRhythm – Redefining the doctor-patient relationship

Redefining the doctor-patient relationship – John Moore MD

The doctor-patient relationship is deteriorating. And today’s information technology solutions are exacerbating the problem. They perpetuate paternalistic decision-making and episodic care, and they fail to assist doctors in making persuasive arguments to their patients.

CollaboRhythm is a technological framework that encourages new paradigms in doctor-patient interaction to improve health outcomes and the patient experience. It uses ubiquitous connectivity, collaborative decision-making, and compelling interfaces and visualizations to educate patients, improve treatment adherence, and deliver care at any point in time or space with seamless transitions.

New Media Medicine from nextlab on Vimeo.

Click the link to see the full article about CollaboRhythm – Redefining the doctor-patient relationship

Minimising patient waiting times

TechnowaiT provides innovative solutions in queue management systems for health organizations serving patients on a first come, first serve basis.

TechnowaiT’s 1-2-3-GO! service is:

  • An innovative technology offering a practical solution for the probleme of over full waiting rooms
  • A proven, robust and reliable solution
  • A unintrusive, turn-key service, free for the clinic (certain conditions notwithstanding)

The 1-2-3-GO! service from TechnowaiT is designed to allow patients to leave the waiting room to avoid long waiting periods. Patients register with the service, and via an interactive phone based system, obtain information about the progress of the waiting line. This allows them to return to the clinic in a just in time fashion.

This turn-key service does not require any change for the physician or clinic personnel. It really is as easy as 1-2-3-GO!

With TechnowaiT, you improve the waiting conditions of your practice in several ways, providing a better workplace environment, greater efficiency and optimising your available floor space.

More information can be obtained by contacting us

Health chief warns of age timebomb facing the Hebrides

Exclusive: Mike Merritt

30 May 2010

The Western Isles’ director of public health is warning the Outer Hebrides faces a population timebomb, with the young leaving in droves and the area becoming an enclave for the elderly.

In her annual report, Dr Sheila Scott says that of all 40 community health partnerships in Scotland, the isles have the lowest percentage of men and women of working age.

And it has the second highest percentage of those aged 65 and over.

Over the last decade, the isles have lost nearly a sixth of their young and those up to early middle age – and even greater falls are predicted.

Latest projections from the General Registrar’s Office Scotland predict there will be an overall 5% decrease in the population between now and 2031.

This will include: a decrease of 23% in the population aged 0-16 years; a decrease of 18% in the working age population plus an increase of 47% in the population aged 65 and over.

Dr Scott said the isles’ population had fallen to just 26,200. In the last decade there has been a decline in the number of people aged 0-14 and 25-44 years – drops of 16% and 15% respectively – while the number of those aged 45-plus has risen by 8%.

Looming job cuts in the dominant public sector on the islands would exacerbate the population problems.

There are fears 450 jobs could be lost due to council cut-backs, and NHS Western Isles has to make over £13m of savings in the next five years. A further stress is the lack of cheap housing, with the isles having one of the highest totals of holiday homes.

An Outer Hebrides Migration Study predicted a decline in the number of women of child-bearing age from 4,500 in 2004 to 3,500 by 2019, a fall in the numbers of primary school-aged children from 2,100 to 1,800, a secondary-school population drop from 2,100 to 1,900 and an increase in the average age of the population from 42.4 to 45.3.

Follow the link to read the full article about age timebomb facing the Hebrides

UK better placed than the US to manage chronic disease: lessons from the US

A major new report published today by Healthcare at Home Ltd explores which technologies and models used in the US for chronic disease management could successfully be adopted here in the UK.

The report – Lessons from the US: using technology and homecare to improve chronic disease management – is based on the observations of a US study tour of NHS and Healthcare at Home representatives who visited colleagues in Kaiser Permanente and HealthTech to look at how they use remote technology to manage chronic disease. Whilst they found there to be some exciting hi- and lo-tech innovations and lessons to glean, the group found that the US was not as far ahead in this field as expected.

Ruth Poole, Group Clinical Director, Healthcare at Home Ltd, says: “We were pleasantly surprised to find that the UK is in many ways better resourced and structured than the US to overcome the challenges related to increasing demand for services and chronic disease management. Specialist out-of-hospital care providers like Healthcare at Home Ltd are well established in the UK, and the NHS is already embracing innovation and major transformation in service design in certain areas, but we need to see this progress on a much wider scale if the NHS is to achieve the significant benefits that can be gained.

”The report found that in the “[US] healthcare follows the money, not the population’s health needs. The UK has an opportunity to look beyond this and concentrate on longer term benefits”.

One of the key recommendations is that the move to deliver more care closer to the home has to be underpinned by new models, technologies and systems: “If we simply transplant the same model of care used in hospitals to another setting we will not achieve the changes needed”.

Other reflections and recommendations from the report include:

  • The UK must concentrate on longer-term benefits and consider the population’s health needs as much as the return on investment
  • The NHS set-up allows it to look beyond immediate costs and benefits to start developing more innovative solutions that will lessen the cost of future services.
  • Technologies delivered through everyday devices such as TVs and mobile phones will encourage greater compliance
  • SHAs have access to innovation funds and should therefore take the lead in system development
  • Transplanting the same model of care to another setting closer to home will not achieve the necessary changes
  • Enabling an efficient flow of information between different health organisations is essential to effective disease management
  • Capital investment should not just be about buildings
  • Commissioners need to look beyond their usual providers and pathways and embrace more imaginative commissioning
  • GPs and other primary care staff will play a key role in providing care closer to home
  • The NHS must place more emphasis on managerial analytical competency

The overall purpose of the study tour was:

  • to explore how diagnostics and care are delivered in the home
  • to see how clinical interventions are managed using technology and support workers for increased value, and
  • to glean any lessons for the UK from how the US is addressing these issues.

NHS Fife & Tayside battle to reduce missed health appointments

NHS TAYSIDE and NHS Fife have brought in a number of initiatives to drive down missed hospital appointments, which are costing the region’s health services over £2 million a year.

Other schemes are also being explored in a bid to reduce the drain on NHS resources.

Over 20,000 new patients last year failed to turn up for their first hospital appointments in Tayside and Fife.

The figure included 1422 appointments for general surgery.

A spokesperson for NHS Tayside said, “We are currently exploring a range of initiatives which could help reduce the number of patients not turning up for their outpatient appointments.

“One of these is a system called ‘patient-focused booking’ where we write to patients six weeks before they are due to attend an outpatient clinic and invite them to call us to arrange an appointment time and date which suits them.

“We are also currently piloting an automated telephone reminder service in our renal department.”

This pilot will be closely monitored over the next three-six months to assess whether a patient reminder does have a positive effect on missed appointments.

Another project about to start works directly with patients themselves to look at what kind of appointment systems suit them best to help understand why people do not turn up for scheduled appointments.

“We believe all these initiatives can make a difference but we would still urge people to contact us as soon as possible if, for any reason, they are unable to attend the outpatient clinic,” the spokesperson added.

“This allows us to give someone else the original appointment and rearrange a more suitable date and time for the patient.”

Public spending watchdog Audit Scotland puts the cost of an average outpatient appointment at £112.

Figures show 9.5% (12,223) of 128,671 new outpatients missed appointments in Tayside in 2008, costing £1,368,976.

Last year there were 131,491 and 9.2% were skipped (12,097), costing £1,354,864.

There was also a rise in missed appointments on the other side of the Tay.

The figures show 8.6% (7228) of a total of 84,051 new patients missed outpatient appointments in Fife in 2008, costing £809,536 on average.

That went up to 8.8% (7906) of 89,850 in 2009, costing £885,472.

A spokeswoman for NHS Fife said, “The cost of missed appointments varies from specialty to specialty. NHS Fife has implemented a number of schemes to reduce the number of missed appointments.

A ‘patient-focused’ booking system has also been in place for a number of years in Fife and initially reduced missed appointments.

“To reduce the number of missed appointments further, NHS Fife has piloted a text reminder system in a few specialities over the last year and is examining how this can be extended,” she added.

In addition, as waiting times have reduced over the last few years, referral management and outpatient booking systems are being reviewed to ensure they are able to respond to the shorter waiting times.

Last year across Scotland 10.3% (150,502) of 1,461,190 appointments were missed, costing £16,103,714.

The figure has gone down from 10.4% (144,240) of 1,386,929 appointments skipped in 2008, costing £15,433,680.

Click the link to read more about missed healthcare appointments

Heart patients in the Lothians to monitor their condition using television

NHS Lothian lets patients monitor heart condition via TV

Published Date: 27 April 2010

HEART patients in the Lothians will be able to monitor their condition through their television thanks to a pioneering a new project.

NHS Lothian has teamed up with electronic giants Philips to develop the system which means cardiac patients – some of whom have limited mobility – will be able to keep on top of their own illness using nothing but a remote control.

Those taking part in the project will be given a special set-top box which can connect to a range of devices, such as monitors which clip onto a patient’s finger.

And like other “e-health” initiatives across the area, the patient’s GP or consultant is able to access results and intervene if necessary thanks to an automatic feed straight to their computer.

NHS bosses believe this represents a way of bringing technology to elderly people who may not be computer literate but are comfortable using their television.

Martin Egan, director of eHealth for the health board, told the Evening News: “NHS Lothian is at the forefront of a range of telehealth initiatives allowing patients more control in managing their own healthcare and the heart manual is another example of our staff delivering innovative programmes that bring real benefits for patients.

“Investing in the latest technology means patients can monitor their conditions more conveniently from their own homes, as well as providing additional reassurance.”

The patient is also handed a list of targets – such as exercise routines, activities and diets – which also help to build an up-to-date picture of their health.

The concept isn’t new in itself, but thanks to digital televisions the process can now be carried out without the need for a PC or laptop.

Other successful projects include one in West Lothian in which chronic obstructive pulmonary disease patients were hooked up with a mini-home computer which allowed them to take blood pressure and sugar level tests.

Louise Taylor, heart manual lead for NHS Lothian, added: “None of our team is an IT specialist and none of the team at Philips is a cardiac specialist, so it has been a complete learning curve for us all.”

Another motivation for the health board to extend the service is the growing number of elderly people predicted to be around in years to come.

It is estimated that the number of over-65s will double by 2050, with a significant jump in the number of over-80s.

This will increase the number of cardiac patients by default, and doctors want to help patients help themselves, rather than have a trek to hospital be the only option.

‘This has really changed my life’
ADVANCES in technology helped 50-year-old Raymond Bowes manage his health in ways he could never have expected.

He was sceptical when his GP told him a small home computer could revolutionise his life and help manage his own health.

Now a year on, the Blackburn man, who suffers from chronic obstructive pulmonary disease, is a convert.

The father-of-four and former steel foundry worker has battled the illness for five years, and since using the small machine he’s reversed the trend of declining health and reduced his visits to the GP.

He takes an interactive questionnaire every day, with the option of blood and sugar levels testing.

He said: “This has really changed my life. When you have chronic lung disease there is a very fine line between being well and unwell.”

You can read this article in full in the Evening News

Medical and Dental Defence Union says poor handover procedures at shift changes pose a risk to patients.

Shift handover risk to patient

Published Date: 10 April 2010

POOR handover procedures in hospitals pose a “significant risk” to patients, doctors’ representatives have claimed.

The Medical and Dental Defence Union of Scotland said there were now an increasing number of shift changes, following the launch of the European Working Time Directive, limiting the hours doctors are allowed to work.

It said there were renewed concerns of a breakdown in continuity of care as patients were being repeatedly handed over to different shifts. The union is backing a Royal College of Physicians investigation into the issue and wants doctors to report any incidents.

Click the link to read this article about handover procedures

Is the Solution mobile data capture?

Kelvin Connect are a Scottish Company &  innovative developer of mobile data capture and management systems based on hand-held computers (PDAs) for use by large organisations with a mobile workforce. Our development techniques overcome the complexities of handling structured documents on hand-held computers for both data capture and data access applications.

In General Hospitals, Team Talk has been deployed in many hospitals to enable ‘Hospital at Night’ services to be implemented, enabling fast, efficient and accurate data to be collected at the point of care and this data to be efficiently handed-over to the next shift.

The benefits of a system like this are:

* Complete, mobile IT systems customised for specific disciplines

* No transcription from paper forms

* Clean, validated data collected at the point of care ensures consistently high-quality care

* Reporting time dramatically reduced

* A highly effective mobile front-end to EPR systems

* Safer and more accurate handovers

Click the following link to find out more about Kelvin Connect and mobile data capture

MPs 'need to be open and honest' over hospital closures

By Nick Triggle
Health reporter, BBC News

Hospital ward

Hospital closures are inevitable, many believe

Politicians are “not being open and honest” about the issue of hospital closures, a coalition of charities and patient groups says.

Jeremy Taylor, head of National Voices, said the parties were happy to talk about the need for savings and moving care into the community.

But he said they were “shying away” from the flip-side – services closing and even whole hospitals shutting down.

All the main parties claimed they had clear policies to tackle the issue.

Mr Taylor said his organisation did not oppose hospital reorganisation and in many cases it can make sense medically.

Read more about hospital closures