Case Study: Royal Devon University Healthcare NHS

Replacing manual home spirometry with a digital approach for ILD patient care

The ILD centre at Royal Devon University Healthcare NHS Foundation Trust manages a largely rural patient population over a wide area. The unit had previously used manual home spirometry, but in response to the multiple challenges of this approach introduced digital remote monitoring using the patientMpower platform in April 2022. Sarah Lines, ILD Nurse Specialist at Royal Devon, shares details of the team’s experiences of switching to a digital approach for ILD patient care.

Background: “In reality manual home spirometry was unworkable”

Despite being convinced of the benefits of home spirometry in theory, in reality the team found manual reporting to be unworkable. “We simply couldn’t cope with the amount of data coming in,” explains Sarah. In particular, there was no way of comparing results over time without opening multiple reports, making this a laborious process.

Introducing the patientMpower platform: “Switching was straightforward”

Switching to the patientMpower platform was straightforward. Automated reporting removed the need for patients to separately record and then email their home spirometry results, making the process simpler and more reassuring.  Sarah recommends that initial education is important, sharing that although patients can be trained on using the app remotely set-up  during a face-to-face visit can make things run more smoothly.  

Outcomes: “Moving to a digital approach has been transformative”  

Moving to a digital approach has brought a number of specific benefits for both the clinical team and patients.

Managing data and clinician workload: With a single monitoring portal versus hundreds of individual PDF reports a digital approach has made it much easier for the clinical team to track patients’ health.

Rapid identification of complications: Automated alerts ensure the team identifies complications early; alerts come via mobile phone with patients triaged accordingly. “We have picked things up as a result”, explains Sarah.

Additional monitoring of oxygen saturation, PROMs and more: Using patientMpower has enabled monitoring of more than just spirometry, which has been key for holistic patient care. Sarah shares one memorable experience; “From oxygen saturation data we rapidly identified what turned out to be pulmonary embolism. It was successfully managed in the outpatient department as a result  - something that would have been impossible previously.”

Data-enabled virtual consultations: Whilst the team had been using telemedicine even prior to the COVID-19 pandemic, the lack of data on patients’ clinical parameters limited greater use of virtual care. Since using the platform the number of telephone and video consultations has increased, with  data collected via the platform being used to inform care decisions. “We have increased the number of virtual visits for some patients, but this is because we are identifying and responding to things straight away, so it’s a good thing for patient care” states Sarah. 

Reduced out-patient consultations and PFTs: The increase in virtual consultations has been associated with a decrease in the need for face-to-face visits and clinic based pulmonary function tests.  If remote data raises concerns then patients are brought into the clinic for full PFTs, but the majority of day to day care can now be managed remotely.

Reduced hospitalisation and emergency visits: The team have been able to keep a number of patients out of hospital using a digital approach. Complications such as chest infections have been managed by referral to primary care or the out-patient department, and early identification of events has reduced emergency department presentations. This is beneficial for both services and patients. “Patients are really keen to stay out of hospital, and because of exposure to other infections patients are just so much safer if we can manage them at home,” states Sarah.

Scaling: Without the workload associated with manual home spirometry, the number of patients being monitored remotely has increased. “We’ve switched all of the patients we had on manual home spirometry, and added even more” states Sarah. Whilst the initial set-up increases work in the short-term, the team now finds it is much easier to manage patients.  A digital approach may not be suitable for all patients, particularly those without device access, but Sarah shares that patients with limited previous digital experience needed little assistance and are now enjoying managing their own health.

We would like to thank Sarah for her contributions for this case study, and all the ILD team at the Royal Devon NHS Trust for permission to share. If you would like to discuss moving from manual home spirometry for remote care of patients with chronic respiratory conditions please get in touch at info@patientMpower.com

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