Patients can relay readings back to their nurse via a communication method of their choice. If patients choose to use the My Inhealthcare app, the app connects to the Bluetooth Roche CoaguChek INRange, meaning readings populate automatically within the app.
Integration into 4S DAWN
The readings feed into decision support software including 4S DAWN where the next dose is calculated. Patients are then automatically sent their next warfarin dose and date and time of next test via their communication channel of choice. All readings are fed directly into leading GP systems.
GP system integration
If readings fall outside of pre-determined clinical parameters, alerts can be generated to the appropriate NHS team. The GP is able to refer the patient onto the service directly through the patient record, removing the need to log onto multiple systems.
As part of the service, all patients are provided with a self-testing device. Our service also works for patients that already own a self-testing device.
Who uses the service?
Inhealthcare is the UK's leading provider of self-testing for warfarin patients, with services live at County Durham and Darlington Foundation Trust, Berkshire Community Healthcare, Ilkley Moore Medical Practice, Medway Community Care, Newcastle upon Tyne NHS Foundation Trust, East Lancashire Hospitals NHS Trust and Pennine Care NHS Foundation Trust.
Inhealthcare’s anticoagulation pathway has been in use at County Durham and Darlington NHS Foundation Trust since April 2014 and currently has 500 self-testing patients. The first 200 patients were evaluated for INR control after 6 months, and again after 24 months.
After 6 months, 70% of the INR self-testing patients saw their time therapeutic range (TTR) improve by 20% compared to 6 months before starting the pathway. The other 30% maintained their TTR. The average TTR across all patients in the group improved by 16%, from 59% to 75%.
After 24 months, the group’s TTR remained high over the 2 year period, and actually increased slightly to 76%.
These findings and the subsequent reduction in adverse events is consistent with INR self-testing patients globally. Patients in standard INR care have an incidence of thromboembolic events of 2.6% per year, whereas for patients that self-test, the incidence of events halved to 1.3%.