lance_forbat

My Patient took Doc@Home hub to France on holiday. All data transferred successfully. Another is taking hub to Australia for continuity.

Posted via LiveJournal.app.

My Patient took Doc@Home hub to France on holiday. All data transferred successfully. Another is taking hub to Australia for continuity.

Posted via LiveJournal.app.

0 #1 Lance Forbat 2011-12-06 22:33
At last there is some clarity:

Personal experience with my patients over the last 3 1/2 years has has convinced me that the evidence would emerge.

WSD Trial:

"Early evidence from a trial in Kent, Cornwall and the London Borough of Newham indicates a 45% reduction in mortality - equating to 120 people still being alive who would otherwise have died.

There were also significant reductions in emergency admissions (down 21%), planned hospital admissions (down 24%), visits to A&E (15%), days in hospital (14%) and "tariff" costs for treatment (8%).

"Patients are becoming less anxious, more confident, going out more and getting their lives back."

There is also a clear role in the management of the patient with a new condition and the semi-acute and post discharge patient.

I am convinced the way doctors work will change as rapidly as the adoption of the mobile phone influenced the way the public communicated with text and e-mail and more recently the 'smart phone' era.

Posted via LiveJournal.app.

Dr. Forbat has a new Honorary Consultant Contract at Walsgrave Hospital, Coventry and University Hospitals Trust. He attends a day a month to develop his interventional cardiology skills.

Posted via LiveJournal.app.

I have added a blog on my site to encourage discussion and comments on your experience of PCS.

Posted via LiveJournal.app.

Prof John Cleland presented this highly informative talk on the evidences on remote monitoring in heart failure. After explaining the basis of meta-analysis, he described the recent Cochrane review on Structured Telephone Support (2010), which showed overall statistically significant reduction in mortality and all cause hospitalization. Two latest trials (which were not included in the Cochrane review) – Tele-HF and TEHAF the results of which were in contrast to the cochrane review were also discussed. Reason behind the difference was the flaw in the study design (both control groups were just too well treated to show much between-group difference).

The second Cochrane review discussed was the Home Telemonitoring (2010). Again this showed overall statistically significant reduction in mortality and all cause hospitalization. Further on Prof Cleland elaborated on another recent trial TIM-HF (not included in the meta analysis) that failed to show statistically significant reduction in composite of CV death and HF hospitalization, the reasons being same (as the Tele-HF and TEHAF trials). He shared the early data from the local experience of Telemonitoring in Hull & East Riding of Yorkshire with promising results with respect to reduction in rate of A&E attendances, hospital admissions and annual non-elective hospital costs. He introduced the latest concept of Heart Cycle telemonitoring Programme, with the bull’s eye model of Ideal range, alert range and danger zone.

Conclusion to the talk was by iterating the fact that the first era of telemonitoring is over and “now is the Time to move from Crisis Detection to Health Maintenance”

A new analysis shows that specialist care makes a massive difference to a patient's chances when they are admitted to hospital.

The National Heart Failure Audit studied the records of more than 21,000 patient records - and found how quality of care contributed to survival chances.

The study shows that 32 per cent of patients with heart failure died within a year of admission to hospital. But just 23 per cent of patients who were treated by a cardiologist or specialist services died.

And death rates on cardiac wards were half those on non-cardiac wards - six per compared with 12 per cent.

The analysis was conducted by the NHS Information Centre and the British Society for Heart Failure.

Some 700,000 people in the UK live with heart failure.

Society chair Dr Theresa McDonagh said: "This audit shows that patients admitted to  hospital with heart failure have an unacceptably high death rate.

"Outcomes for these patients can be significantly improved by having specialist cardiology input to their care, administration of appropriate evidence-based doses of key drugs and follow-up by specialist services."

The British Heart Foundation backed her comments.

Dr Mike Knapton, of the Foundation, said: "Treatment for heart failure should be given the same priority as heart attacks. But while there have been huge improvements in the management of heart attack patients, the same cannot be said for people with heart failure, where improvements have been too slow.

This recent heavy snow has affected more people than the volcanic activity. I would have been concerned if, when in London or Bristol, I had patients in Glasgow needing my advice. I would have been very concerned for specific groups of patients had I not had a facility for telemedicine and web based monitoring. Telemedicine has again proved its worth when the heavy snows kept patients and the workforce isolated.

As posted before in this journal i urge purchasers of healthcare to re-consider this service for their patients, in particular those with long term conditions such as heart failure and COPD, even if they are not relying on air transport..

Posted via LiveJournal.app.