I was fortunate to be the Project Lead on the implementation of the innovative Florence Simple Telehealth system, to identify ‘white coat hypertension’ (high blood pressure caused by anxiety or nervousness in a clinic environment only) in patient’s pre-operatively.
High blood pressure is a relatively common reason for an operation having to be postponed, but now patients who may be affected by ‘white coat hypertension’ can remotely monitor their own blood pressure for seven days to help the nurses decide on the right plan of care for them and prevent unnecessary postponement/cancellation of surgery and inappropriate GP referrals.
Florence Simple Telehealth (STH), named after Florence Nightingale, is an interactive text messaging system that patients can use for remote, personal and secure collection of data through their own mobile phone. ‘FLO’, as she is better known, can also be used as an ‘alerting’ tool that offers individually tailored advice, reminders and support.
We went ‘live’ with FLO in April 2013. Patients who give their consent can take home a portable automatic blood pressure machine and receive a reminder to text in their reading twice a day for seven days. The nurse checks the readings to identify the patients who have ‘white coat syndrome’ rather than the ones who have genuine hypertension. This improves care delivery and reduces the amount of cancelled operations due to hypertension, and patients identified as hypertensive are referred to their GP.
Within the first 12 months 42% pf patients using FLO were found to have purely ‘white coat hypertension’ and were able to go ahead with surgery as planned.
To maintain the stability and sustainability of the NHS and ensure quality and efficiency, we need to harness technology to empower people to take charge of their own healthcare. FLO enables us to do that simply and effectively.
Some of the benefits of using FLO in pre-op include a more accurate diagnosis of hypertension, reduced short-notice operation cancellations, reduced unnecessary GP or consultant referrals, better communication between patient and clinician, greater patient satisfaction, improved information sharing and financial savings for both the Trust and the patient: the cost of using FLO for seven days is £3.15 per patient.
The King’s Mill Pre-operative Assessment Unit was the first PAU in the country to implement FLO, and the team’s success has prompted interest from other units who are now adopting it as part of their services. It is also now part of the local policy working in line with NICE Guidelines for Hypertension.