Patient and nurse stood next to each other smiling
By Inhealthcare
Case Studies 9 September 2021

Ilkley Moor Medical Practice is giving patients in the rural town of Ilkley access to a telehealth service to allow them to manage their health from home, without having to attend in-clinic appointments.

Ilkley Moor Medical Practice is the first GP surgery in the Yordales Health GP Federation to adopt the telehealth service which is available to 100 patients across Ilkley, Addingham and Grassington. The telehealth service is open to any patients on Warfarin within the Wharfe Valley not just to patients registered at Ilkley Moor Medical Practice.


The challenge
Patients who take the blood-thinning medication warfarin have to visit their local clinic every few weeks to have a simple test to check how quickly their blood clots. In the rural setting of West Yorkshire this could mean long car journeys and expensive car park fees. All for something they could easily do in the comfort of their own home.


Solution
Our INR self-testing service enables patients to self-test and receive their new warfarin dose remotely via 4s DAWN anticoagulation software.

As part of the service, patients are supplied with a Roche CoaguChek device® to test their INR. The patient takes a finger prick blood sample and inserts it into the Roche INR self-testing device (CoaguChek®). The patient sends their new reading securely to the local clinic via their communication of choice, including via an automated phone call, an app or by going online. Our technology integrates this data directly into patient records. The patient’s new warfarin dosage is relayed back to them, following a calculation by a specialist nurse or GP, and supported by an anticoagulation computer support software system, already used by clinicians to enable safe dosing.

The improved system reduces the time it takes for the patient’s dose to be relayed back to them, and for their medical records to be updated. Patients can receive helpline guidance and advice from clinicians.

The service will also free up valuable nursing and GP time by reducing the number of face-to-face visits. This means more time can be spent with complex patients, increasing the quality of care for everyone.

 

Results
As the first practice in the Yordales Health GP Federation to offer the service, Ilkley Moor recently ran a survey of the 100 patients on its service:

  • 86% of respondents rated the service ‘good’ or ‘excellent’.
  • 71% of respondents said it allowed them time for travel or to take time off work.
  • Since the launch of the service in 2019, the service has saved the practice more than 4,000 appointments, reducing pressures on staff.

 

Patient case study: Martin Smith
As a successful entrepreneur at the helm of a specialist marketing company, Martin Smith’s busy life was turned upside down in 2009 when he suffered a heart attack.

Martin was put on warfarin for the rest of his life, having to attend fortnightly clinic visits to keep a check on his INR levels. Martin’s busy schedule, including holidaying abroad and working across the country all had to be arranged around his clinic visits.

Martin was enrolled onto the digital self-testing in November 2015 via his local GP practice in rural Ilkley. Martin is now enjoying increased freedom from the service, enjoying month long holidays abroad and travelling for work when he needs to.

Martin submits his INR readings and receives his new medication dose via his smartphone app. Since home testing Martin’s readings have become more consistent which he puts down to the increased understanding he now has into how lifestyle affects his readings.

Ilkley Moor’s warfarin monitoring service places patient convenience at its heart. Our rural location means clinics can be hard to reach for some, so delivering rapid results to patients in their homes makes all the difference. On top of this, we’ve helped to ease waiting room pressures and reduce paperwork for our anticoagulation team. Everybody wins with the benefits health tech can deliver for patients, clinicians and the NHS alike.

Dr Mark French Lead GP for the service.

I’m a big advocate for warfarin as it has allowed me to extend my working life. I welcome self testing because it allows me to juggle my work obligations as well as my personal life and also plan our holidays. It just works for me. Self testing has allowed me to understand how warfarin works and helps me to stay in the ideal therapeutic range to keep myself as fit and healthy as possible. My readings are more consistent. It also helps me to follow a good diet and reminds me to avoid food and drink that cause reactions like broccoli and cranberries. Previously it was a fortnight or a month between clinics and a fair bit can happen in that period. Now I can just test myself and ring the nurse for any advice. This new app is really positive for anybody that is still actively working. It is so portable. I can test myself on the train going up and down from London.

Martin Smith
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