On Friday 20 April, PharmaPhorum hosted a webinar for health professionals in MS, supported by Biogen, the MS Trust and QuDoS in MS. The topic was Digital Health: how can technology be used to engage hard-to-reach patients and assist with patient monitoring? If you didn’t catch the webinar, here’s a brief round-up on what you missed…
PharmaPhorum welcomed three speakers to the panel:
- Trishna Bharadia, Independent Patient Advocate
- Jo Sopala, Director of Development, MS Trust
- Rachel Morrison, MS specialist nurse, NHS Western Isles
Trishna, Jo and Rachel were invited to share their views on the existing and potential utilisation of technology in MS care – in communication, tele-health, equipment, wearable technologies, Social Media… The list goes on! It’s fair to say that there’s a general consensus that using technology in an effective, efficient and user-friendly way, can have a huge positive impact on health services, and can go a long way in supporting many people with MS across the UK.
Trishna opened the discussion by talking about how technology can help people with MS. She highlighted three main areas where digital health and technology could support people:
- Information. Information about MS, symptoms, treatments and care is readily available on the internet now, but what’s also available is information about services, resources and performance. This results in more informed patients, encouraging shared decision making.
- Support. Many people with MS access peer support through forums and Social Media, as well as support from health professionals, which can have a significant positive impact on individuals’ self-management of their condition, and provide emotional support.
- Monitoring and engagement. Digital health can also be utilised to remotely monitor patients and maintain engagement in care. Trishna gave the example of clinical trials here: by reducing the frequency of trips to hospital through remote monitoring, the rates of drop-outs and non-adherence would decrease.
The result of all this is a more informed and empowered patient, who has the knowledge, tools and confidence to self-manage symptoms more effectively and efficiently.
However, there are obviously a number of concerns to highlight too. Trishna gave a few examples:
- Practicalities of implementing technology
- Ensuring equitable access to technology (for instance, supporting less “tech-savvy” people and perhaps some people with cognitive problems in using technology)
- Ensuring actionable insights, resulting from the use of the technology in question
- Privacy and security concerns (especially in the current context of GDPR!)
- Ensuring solutions are “problem-driven, not technology-driven”
Summarising her points, Trishna said:
“The end goal is for technology to create an environment in which patients can:
- Change behaviour for the better
- Feel empowered and like advocates
- Notice a reduction in the burden of MS on daily life
- Share responsibility for healthcare and decisions about care"
Jo Sopala echoed Trishna’s sentiments, particularly that technology should be used fundamentally to improve patient experience, not for using technology for technology’s sake.
Jo highlighted that people with MS require holistic care, delivered by a comprehensive multidisciplinary team, members of which would have different levels of input depending on the stage of their MS journey someone was at. However, the biggest issue facing MS services today is capacity. Technology could be usefully utilised to use capacity in MS teams more efficiently, streamlining care and improving service delivery.
MS Forward View highlighted the need for more efficient DMD (disease modifying drug) services, using databases, alerts and other digital tools to enable the effective, efficient and safe monitoring of DMDs. This improves patient care and safety, and also frees up capacity of the MS team to also support those people not on DMDs. Just a quarter of DMD prescribing centres have electronic systems to manage and monitor people with MS on DMDs. Investing in this kind of technology will save valuable time and ensure critical information is available to MS specialists providing care to people with MS on DMDs.
Jo also highlighted several case studies on the MS Trust examples of innovative practice resource, including a weekly Skype clinic for MS nurses to reach people in remote and rural areas who struggle to travel. MS services across the UK are already utilising technology to streamline pathways and ensure MS care is as efficient, effective and convenient for people with MS as possible.
Finally, Rachel Morrison, MS specialist nurse in the Western Isles, Scotland, described how her service is using technology to engage patients in an incredibly remote setting. Rachel highlighted a number of examples of home health monitoring solutions to improve patient care.
One example is Florence, a web-based clinical interface which collects data from patients via their mobile. Flo is most frequently used for text alerts and is not an app. The Western Isles MS service is currently using this tool to monitor patients’ symptom management, medication compliance, exercise and weight, and much more.
An MS nurse from the Royal Stoke MS Centre following the webinar on Twitter told us:
“We are also using Flo in our service – a busy MS team with a caseload of over 2,500 patients. We have found this highly beneficial in terms of encouraging people with MS to self-manage their symptoms and condition and we have set up specific protocols around DMDs, MS fatigue and mood. However, it has sometimes been difficult to engage nurses in our team to promote this tool to patients in time-stretched consultations, so it has been helpful to hear about how other MS services have been utilising Flo. Overall I think this is a tool with huge potential, but one that requires tailoring to the needs of individual teams and services.”
Rachel also described the benefits of Attend Anywhere, a video conferencing tool to allow health professionals to reach patients in their own homes for consultations and even diagnoses. In the remote area she covers, Rachel has several patients who have to travel over a number of days (and pay the cost of this) for a face-to-face consultation with a consultant on the mainland, so this kind of tool is especially beneficial to this group.
A number of other examples, including bespoke solutions for patients, were also outlined, highlighting the variety of tools out there that MS services could benefit from and tailor to the needs of their caseloads. For instance:
- Kubi – telepresence robot, caller controls direction and angle of screen
- Beam – remote control video conference unity
- Morse – mobile app bringing together primary, secondary and social care
You can listen to the webinar again (1 hour) here.