Not-for-profit organisation Salveo Healthcare has recently introduced a remote patient monitoring technology from the United Kingdom to support its delivery of preventative care in Tasmania.

In February, it started piloting Spirit Health's Clinitouch technology as part of its in-home nursing care service, Advanced Preventative Care (APC). Delivered by registered and enrolled nurses, the service is offered to eligible Tasmanians with chronic diseases. 

Currently being integrated into four disease pathways, including COPD, diabetes, heart failure, and ischaemic heart disease, Clinitouch allows patients to complete health questionnaires and input vital signs from home. It also provides the APC team with the ability to remotely monitor their patients' conditions in near real-time via dashboards, enabling the identification of at-risk patients and early interventions. 

Augmenting home-based care with RPM technology, Salveo says, cannot come at a more opportune time when one in four Tasmanians is currently living with at least two chronic health conditions such as heart disease or diabetes. 

CEO Steve McCullagh shared with Healthcare IT News more details about their ongoing RPM pilot and how they are looking to find success in adopting the digital technology – which has been used for over a decade now in the UK's National Health Service – for its unique program and target patient population.

Q. Can you walk me through the pilot of Clinitouch – how is the technology being received by your staff and clinicians? How were they prepared to assist patients in using remote technology? How about the patients; how are they finding the pilot run?

A. We are currently one month into the four-month pilot. The aim of using this technology is to enable a nurse to remotely monitor their clients, spotting early signs of deterioration, so that they can respond sooner to de-escalate a condition, reduce avoidable hospitalisations, and reduce treatment complexity due to delays.

Our nurses were provided with in-depth training and practical support to upskill them for the pilot, with the team testing the technology out on themselves first to experience the client interface firsthand.

In the pilot, clients use the Clinitouch app to answer multiple-choice questions about their symptoms relating to the management of their chronic condition, along with adding some health metric data. This data feeds into a dashboard via algorithms that triage the responses into a traffic light system, allowing our nurses to easily review how their clients are tracking.

While it is too early to assess the results of the pilot, our nurses can see the benefit of this technology relating to enhanced client care, improved self-management and importantly that we may be more responsive to provide the right care at the right time. They have also commented that they can now see the benefit of this technology creating scalability, allowing more clients to benefit from the APC program.

When it comes to client feedback we are delighted to have early reports that the set-up process and the app was simple and easy to use.

Q. How do you plan to further introduce or expand Clinitouch to your patient base?

A. The purpose of our pilot is to capture feedback from our clients and nurses on their experience using the technology to determine ultimately if it is a good fit. Additionally, we are assessing whether the technology increases nurse capacity so that we can offer the program to more people who may benefit. With success in these areas, we look to roll out the technology more broadly to our current client base and where applicable for future programs. The current pilot focuses on broad health conditions, and if successful, we would trial the technology with people living with more specific, nuanced conditions.

Q. Besides remote technology, what are the other digital technologies that underpin your APC service and how do they enable care coordination, disease management, and personalised care Interventions?

A. Face-to-face, in-home nursing care is integral to the APC program, and we value the use of technology and innovation to support this service to be effective, efficient and ultimately allowing us to do what we do best, delivering the program to people who need it. To do this, we currently use DC2Vue as our EMR; the platform uses APIs to connect to other services; and we are also trialling SNUG in this pilot to ascertain some biometric data.

Q. Among the locally available tech products for healthcare, why choose a platform used abroad?

A. Two of our major considerations in every aspect of delivering our program within our home state of Tasmania are the literacy and average age of our clients. Almost one in two Tasmanian adults is functionally illiterate. So, every aspect of what we do must be simple to understand and use.

When it comes to age, one of the first questions we received every time we mentioned the use of this technology with our clients aged 79 years on average was: "Will they be willing and able to use the technology?" And as I've mentioned, early reports show that clients are finding it easy and simple to use which is also supported by data that the average age of those already using Clinitouch in the UK is 77 years.

Clinitouch was the best technology we identified in our wide search to fit the unique needs of our program and clients. We found that Clinitouch knew that being overcomplicated means being unused, so they developed this technology that is smart yet simple. The platform was designed by clinicians, is award-winning with proven results, and is widely used in the UK’s NHS.

When it came to investment, the nature of our contract meant we had low financial risk, which gave us confidence to dive in and pilot the technology for the APC program. We have also been well supported by Clinitouch’s team who have helped us to set up our pilot successfully.

Q. What's your strategy for keeping patient data secure, particularly in conducting remote health monitoring?

A. Our client’s privacy is extremely important to us, and so we set a high standard for data security in everything we do. Clinitouch, with their software registered locally as a medical device with the Therapeutics Goods Administration and similarly overseas, shares our view on high data safety standards, which is reflected in our data processing agreement. An essential aspect to us in Australia was that our data would be securely hosted in Australia, which Clinitouch can deliver. Additionally, the software is accredited by Cyber Essentials Plus and DSPT certificates, compliant with the international data sharing standard (HL7/FHIR) and hosted via Microsoft Azure which is ISO27001 accredited.