Key considerations

Key considerations

HSC trusts have already undertaken some work to identify suitable patients and to establish procedures to manage alerts effectively.
In considering referring patients to the service, healthcare professionals may wish to consider the following;

 

Key points to consider

  • Is the patient is suitable for telemonitoring? See criteria for referral;
  • how will the telemonitoring process work for the patient e.g. will the patient require a carer to take their vital signs reading for them, will the patient need to adjust their lifestyle in order to upload readings on a regular/daily basis, does the patient have mobility issues?;
  • which  Telemonitoring NI service is more appropriate for the patient – Clinical Triage or Track and Trend?;
  • how long should the patient be on the telemonitoring service?;
  • when an alert is escalated to trust local response, who will manage the alerts and when should alert limits be reviewed?;
  • will the patient benefit from being asked pre-set questions about their symptoms and wellbeing?;
  • how frequent should patient parameters be reviewed?;
  • how will it affect the healthcare professional's way of working?;
  • how will the healthcare professional know if the patient has met his/her objectives for telemonitoring?

 

Selecting suitable patients

  • Healthcare professionals including General Practitioners may identify patients from a variety of sources including their own case files, hospital data or GP practice data;

Suitable patients may include those:

  • who are at risk of hospital admission
  • are admitted to hospital on a frequent basis
  • who are ready to be discharged from hospital and may benefit from being monitored at home to pick up any possible deterioration
  • additionally patients with COPD, CHF or diabetes who are frequent visitors to practice or require regular home visits by healthcare staff due to anxiety or exacerbation of condition, or those who at risk of this, may be suitable;
  • patients who you feel may benefit from improved self-care. Support in the management of their condition (COPD, CHF, diabetes).

 

Setting parameters and receiving alerts

  • Healthcare professionals should setting the most appropriate parameters/alert limits specific to the patient· Reviewing the patient parameters on a regular basis and after an alert;

The local response team will get notified when:

  • a patient has been installed with the technology following referral;
  • a validated alert limit breach (note: validated = rested and still outside of limits);
  • validated answer to a high risk question (note: validated = high risk answer confirmed by patient upon call from service desk);
  • when a patient has missed their readings for two consecutive days;
  • when the service desk has spoken to the patient and they have requested contact from the practice.

 

For further information on how to start using the Telemonitoring NI service, please contact your local trust Telehealth Service Manager.