How to use Messaging Enabled Care Services to build relationships between patients/the public and health professionals

2. Messaging Enabled Care Services
Dr Pete Davies
NHS England TECS Clinical Advocate
Technology-enabled Care Services

3. Workshop program
• What is MECS?
• How can it help
‘Integration?’
• How could you put this
to work for your
patients?
• Clinical case presentation

4. NHS Florence SMS Simple Telehealth System
SMS
Messages which
prompt action &
advice Messages too
GP Practices
Specialist Clinicians
Community and Specialist
Nursing
Public Health Smoking Pathway
MECS Means Florence…

5. Simple
Easy to use
Free to patients
Cheap, NHS IP
Customisable
Widely applicable
Automated
MECS USPs

6. Mobile telecomms promote social inclusion
• 82.7 million mobile subscriptions in UK
• 49% UK adults use their mobile phone for
internet
• Tablet ownership 24% of UK households
• 3G coverage now 99.1%
“In 2000, 50% of UK adults said that they had a
mobile phone – that figure now stands at 94%”
Ubiquitous!

7. MECS makes for social inclusion by
• Engaging people
– Allows a power-shift
• Activating people’s native capabilities
– Let’s the customer add value
• Helping you to know your patients better
• Helping to build patient networks
– An “engine for integration”

8. Future state: Patient Centered
Diabetes Care within @SWB CCG Area
• Specialist link teams continue to support Primary
Care teams, including advice & guidance, but
with increasing/better use of tech.
• Built our relationship with patients through
value-added processes and establishing
patient/customer networks
• Using new technology to directly support patient
centered care, e.g. secured email, PHR, Skype,
Florence etc.

9. Florence-MECS implementation
• CCG use ‘pilot’ 2012-14
– Pockets of primary care use
– Greater use by community respiratory team
• Permission for SWBHT use November 2013
– Diabetes team (City and Sandwell sites)
– 8 users
– 50 patients
– BP monitoring/weight management/medication
reminder

10. Patients as agents of integration

11. TECS vs MECS
TECS
“expensive
boxes with
flashing lights”
Legacy of 3ML

12. TECS vs MECS
MECS
Simple,
cheap,
Engaging,
Easy to
customise

13. How best could MECS help your patients?
What would you [your patients] use it for?
What would be the benefits?
10 mins discussion, then group feedback

15. It’s for BP monitoring, right?
Tales of the unexpected

16. Florence: Tales of the unexpected
• 53 yr old woman, manager working in social
housing
– hyperthyroidism and hypertension
– BP 186/98
– mother died of stroke disease aged 60
– Prescribed amlodipine
– Decided not to take antihypertensive drugs
– No side effects, but…
– “I don’t want to be someone with a LTC needing to
take tablets”
– Enrolled in blood pressure monitoring protocol

17. Support helped…at first

18. …but why was BP rising again?

19. Flo has built-in PROMs

20. Next consultation…
• We dealt with her medical issues
• I asked if she’d received my text messages
• Gradually, she opened up
• Domestic abuse: physical, emotional &
psychological
• Physical abuse as a child
• Her father battered her mother; in her eyes
responsible for others premature death

21. The real story
• Her husband works away from home, she dreads
weekends
• She would stop antihypertensive drugs as she
wished to die; hoping she would succumb to
stroke
• Following our discussion, she was meeting with
the emotional support team and considering
accepting help

22. A New Hope
• May 2014
– Accepted help from Sandwell
Women’s Aid
• Relocation
• New identity & job
• Regain her financial independence

23. Florence-MECS Summary
• Is available already, to you and your teams
• Is cheap, easy to use, and readily customised
• If today you have thought of a job that Florence
can do for you/your patients
– You can begin tomorrow
– Or at least, very soon 
• Great scope for this to help engage our workforce
with digital health care
– Its simplicity may help overcome adaptive change
barriers

24. Thank you for your attention!
Now, any questions?