East Kent Health and Care Partnership extends remote monitoring pilot

East Kent Health and Care Partnership (EKHCP) is extending its remote monitoring pilot for patients living with frailty and complex needs, to patients living with chronic obstructive pulmonary disease.

EKHCP began the pilot on 29 April 2024 with partners including Kent and Medway Integrated Care Board (ICB), Kent Community Health NHS Foundation Trust (KCHFT), East Kent Primary Care Networks (PCNs), Graphnet and East Berkshire Primary Care (EBPC).

The pilot, which will run until 31 March 2025, is a collaboration between Graphnet’s population health solution and Docobo Remote Monitoring, integrating into the Kent and Medway Care Record (KMCR), which provides healthcare professionals with a joined-up view of someone’s care and treatment from multiple health providers.

Sarah Phillips, chief medical officer at Kent Community Health, senior lead for the remote monitoring pilot and chair of the project programme board, said: “We are really proud of the outcomes of this pilot and the amazing patient feedback we have received.

“Patients have reported a reduction in anxiety levels in using the system and have reported that they feel more in control of their own health while being fully supported by clinicians.”

The pilot so far has been identifying patients that might benefit from remote monitoring, using the Johns Hopkins ACG System population health software’s segmentation model, Patient Need Groups (PNGs), which is integrated into Graphnet’s solution.

The resulting list of 7,000 patients were categorised into PNGs 10 and 11, the most complex segments, and further filtered to identify 1,500 patients for onboarding to remote monitoring.

EKHCP further refined the list to a caseload of 500 complex or frail patients linked to two PCNs in East Kent: Folkestone, Hythe and Rural PCN and Mid Kent PCN.

Patients are provided with tablets which connect to the remote monitoring clinical hub, to discuss their equipment needs and agree their monitoring regime.

The Docobo Remote Monitoring platform enables patients to be monitored by clinicians while at home by filling in questionnaires and submitting observations to the hub at EBPC.

Patients have reported a reduction in anxiety levels when using remote monitoring and have said they felt more in control of their own health while being fully supported by clinicians.