NHS Digital Pioneer Awards: winner profile

Award for Sustainability through Digital

“Application of modem technology as standard care for patients receiving
non-invasive ventilation (NIV) at home.”

Name: Stephanie Mansell
Role: Consultant Physiotherapist
Organisation: Royal Free London NHS Foundation Trust

Problem articulation
Patients receiving non-invasive ventilation (NIV) at home often struggle to attend outpatient appointments, due to reduced mobility and distance required to travel. Furthermore, if patients encounter problems, an outpatient appointment is necessary to adequately assess them. Additionally, some patients have conditions which can rapidly deteriorate, e.g. motor neuron disease (MND). Traditionally, many patients
commenced on home NIV are admitted to hospital to initiate treatment. Patients at other hospitals requiring commencement on home NIV prior to discharge, would have to wait many weeks for a bed to become available.

Introducing innovation
Stephanie has introduced the application of modem technology as standard care for patients receiving NIV long-term at home. Developed by the manufacturers of the ventilators, this technology uses a web-based interface (eu.EncoreAnywhere.com). Data from the ventilators is transmitted daily via the modem to the web-based interface, enabling access of clinical information regarding patients’ interactions with the ventilator. This data includes: compliance with therapy, non-invasive mask fit and adequacy/effectiveness of treatment.

As well as viewing the ventilator data, clinicians can make amendments to ventilator prescriptions which can then be transmitted via the modem resulting in changes in device settings. Data can also be utilised to facilitate health behaviour change interventions and give visual demonstrations to patients regarding their concordance and interactions with the ventilator.

Outcomes and benefits
Using the modems and EncoreAnywhere system has ensured that the Trust is delivering optimal therapy for patients. They are increasingly able to avoid admission for commencement on NIV and 70% of their work is now either outpatient or day case initiation. Patients’ compliance can also be monitored, and data from the modem provides a powerful tool to increase compliance with therapy, or enables the Trust to stop therapy and use resources more appropriately. The Trust has also been able to offer more remote problem solving, reducing the need for outpatient appointments, increasing efficiency and improving patient experience.

Diffusion and plans for scaling
Stephanie has been able to develop this system in order to meet the needs of her service users, and manufacturers have showcased her versions to other Trusts and services. She has run sessions about the use of the EncoreAnywhere system at international events and conferences, including one in the Nordics – a part of the world with a small but sparse population, where this system could prove highly efficient.

Moving forward, Stephanie plans to further implement the technology’s DreamMapper app, to further enable remote clinic appointments and ensure optimal treatment for patients. Plans are also underway for a research project involving the DreamMapper app.