Easy to Swallow Technology

Blackpool Teaching Hospitals NHS Foundation Trust has improved the delivery of care to elderly and vulnerable patients through innovative use of video technology.

Cloud-based video collaboration technology improves care to vulnerable people in nursing homes, providing quick access to specialist practitioners without the need to travel in order to attend hospital outpatient appointments or waiting for a home visit to be arranged.

Elderly and vulnerable people in nursing homes across Lancashire and South Cumbria are benefitting from an innovative and potentially life-saving Video-as-a-Service (VaaS) telemedicine solution, which has been successfully trialled by Blackpool Teaching Hospitals NHS Foundation Trust, thanks to state-of-the-art technology from Polycom and IT services specialist Imerja.

Swallowing difficulties (dysphagia) are common amongst people that have experienced significant neurological illness, stroke or other age related disease. It can also be a reliable indicator of more serious issues, such as likely onset of pneumonia, malnutrition or poor rehabilitation, resulting in an increased length of hospital stay and a reduction in quality of life for the patient.

Patients with access to a swallowing assessment by a qualified speech and language therapist (SLT) have a more positive outcome. Prompt attention can avoid deterioration in health and subsequent admission to hospital. However, with limited trained SLT resources available to carry out the assessments, patients may have to wait for a hospital appointment or home visit to be seen by a qualified professional.

This can mean that by the time a patient is seen their swallowing difficulties may have deteriorated further, which typically results in a decrease in their levels of alertness; an increase in their state of confusion; a requirement of alternative feeding; development of a chest infection and in some cases can result in the patient being medically unfit to travel to the acute care setting. Faced with this challenge, the SLT Team based at Blackpool Victoria Hospital looked at alternative ways of effectively delivering assessments using technology, resulting in the creation of the teleswallowing service.

Initially funded by North West IT Innovations Programme award scheme, and subsequently the NHS England Regional Innovation Fund, the service is based on the video-as-a-service offering from Polycom managed and maintained by Polycom Gold partner Imerja.

The VaaS offering delivers all the benefits of the Polycom RealPresence Platform without the on-premises setup, deployment and operational costs, giving organisations like the NHS the flexibility and scalability they need to tailor a solution for their unique needs.

Veronica Southern, Clinical Lead on the teleswallowing project, has been delighted by the success of the service, which is the result of collaborative working between multiple parties.

“We work in collaboration with our colleagues in the nursing homes to be able to access patients more rapidly – and try to help them before they deteriorate too far and have to be brought into hospital – meaning we can use the time saved for other things such as delivering more intensive therapy for people on the stroke unit.

Not only does this project deliver a modern approach to swallowing assessment, it also can delivery potentially high cost efficiencies.”

Dr. Elizabeth Boaden, a specialist treating elderly patients with swallowing disorders, agrees. She believes the teleswallowing service could provide the wider NHS with significant cost savings, and mentions avoiding the stress of travel for patients attending a hospital visit, reducing the need for hospital admission, and providing a positive outcome for the patient if symptoms are identified and treated quickly.

“The system is brilliant for staff and patients alike,” said Dr Boaden. “It keeps patients in their own homes, saving them the discomfort or distress of coming to hospital and has released capacity for speech and language therapists. Using the Polycom solution we’re now able to undertake a teleswallow assessment in about 30 minutes compared to an hour and a half when we had to travel to meet patients.”

Dr Boaden also said that Imerja was chosen to provide technical support because the trust needed to be confident the project would work efficiently, whilst Polycom provide the clarity of sound and display high quality image making the assessment as if we were in the same room with the patient.

“The Blackpool SLT department working with its technology partners has demonstrated teleswallowing can be delivered to all patients regardless of cognitive state in a UK setting and by NHS therapists.”

The expertise gained and clinical leadership demonstrated in this project can be used to extend the concept of teleconsultation to other therapy professions.

The previous coalition government estimated that telehealth could result in a 20% reduction in emergency admissions, a 15% reduction in accident and emergency (A&E) visits and a 45% reduction in mortality. In addition, Health Secretary Jeremy Hunt set the target of three million people being able to benefit from telehealth by 2017.

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David Dungay

Editor - Comms Business Magazine