Thousands of Londoners with heart conditions will receive better care following the launch of the London Cardiac Remote Monitoring Programme using technology from Ortus-iHealth.
The programme has been commissioned on behalf of the South and North London Cardiac Operational Delivery Networks, with £750,000 of transformation funding from NHSX.
It will enable the eight tertiary heart centres based at the capital’s major hospitals to adopt the Ortus-iHealth platform, which was developed by Dr Debashish Das, a consultant cardiologist at Barts Health NHS Trust.
Initially, patients waiting for heart surgery will use the system to complete questionnaires and submit data to a ‘virtual ward’ dashboard monitored by their clinical team.
Patients showing deterioration will then be identified, prioritised, and offered support by message, video consultation, or at an in-clinic consultation as appropriate.
The procurement of Ortus will deliver a baseline capability for London, providing cardiac and other services with the tools to develop innovative new ways of working
Stephen Edmondson, NHSE Cardiac Network clinical director for the London region, said: "We have a responsibility to keep our patients as safe as possible while they wait longer for life-saving cardiac surgery due to the impact of the pandemic. This means we have to identify those patients who are deteriorating and offer early intervention when needed.
“The Ortus digital platform, which has been procured on behalf of all the major London cardiac centres, creates a patient and clinician user-friendly digital ward environment to continuously monitor and reprioritise our patients.
“We were keen that any such digital solution would improve the overall patient experience and the Ortus platform, which can be web or app based, also provides digitised information concerning their particular treatment, digitised consent, and digitised aftercare and follow up.”
Crucially, at a time of stretched resources and capacity, the Ortus platform will also facilitate earlier discharge into a safer and more-responsive aftercare setting.
London is the first city in the UK to run a remote monitoring programme on this scale.
The initial focus is on the heart surgery pathway because post-pandemic there are 1,400 patients on the cardiac surgery waiting list, and it is growing by 100 patients a week.
Region-wide access to cardiac information will improve the quality, efficiency, and safety of care for patients cared for by London trusts
All the hospitals involved in the programme will adopt the same patient pathways, the same state-of-the-art technology, and deliver the same service to patients, wherever they live.
Gary McAllister, chief technology officer at OneLondon, a collaboration between London’s integrated care systems and London Ambulance Service, said: “Remote monitoring and virtual wards are a fundamental enabler for sustainable and transformed clinical pathways.
“The procurement of Ortus will deliver a baseline capability for London, providing cardiac and other services with the tools to develop innovative new ways of working.
“Fundamental to the delivery of transformed cardiac services is the interoperability of Ortus with the London Care Record, extending the reach of cardiac information to all services across the region.
“Region-wide access to cardiac information will improve the quality, efficiency, and safety of care for patients cared for by London trusts.”
Ortus-iHealth can also be used to support patients on other cardiac pathways, to give them information about their condition, help them prepare for treatment, and to make sure they spend as little time in hospital as possible.
This means that, once implemented, there will be the opportunity to extend the use of the Ortus platform to support the 1.2 million people in London with heart conditions.
For example, there could be the opportunity to support patients who have been discharged after treatment for a heart attack. These patients need to take increasingly-strong doses of medicine to strengthen the heart, in a process known as titration.
It’s the first, real, pan-London remote monitoring programme for any clinical specialty and we’re delighted that our solution has been recognised as the best option to support both clinicians and patients
Dr Das and his team originally developed Ortus-iHealth because they wanted to make sure the patients treated at Barts Heart Centre were being titrated properly, and were responding to ongoing care.
During the COVID-19 pandemic, Ortus-iHealth meant they could also discharge patients 1-2 days after surgery, rather than the usual 3-5 days, to reduce their risk of contracting the disease in hospital.
But Dr Das stresses that to be safe and effective they must use technology to collect and analyse data and to keep patients in touch with their clinicians.
“You cannot just send somebody home with a blood pressure monitor,” he said.
“You need a dashboard to collect and analyse that data, and you need easy communication between the patient and the clinician.
“If I am working at my hospital, I will do a ward round, look at the observations, talk to the patient, and make a plan; and if I am working on a virtual ward, I need to be able to do exactly the same things. That’s why we built Ortus-iHealth.
What is so exciting about the London Cardiac Remote Monitoring Programme is that it has been developed by experts who have already tried out virtual wards and who understand what is needed to make them work
“It collects quantitative data, like blood pressure readings and patient-inputted symptoms, and qualitative data, like responses to questionnaires. It displays that data on a dashboard, alongside a communications link to the patient.
“That means I can message you to say: ‘I’ve seen your observations, and they look fine’ or: ‘I’ve been alerted to a problem, and this is what we are going to do’.
“What is so exciting about the London Cardiac Remote Monitoring Programme is that it has been developed by experts who have already tried out virtual wards and who understand what is needed to make them work.
“It’s the first, real, pan-London remote monitoring programme for any clinical specialty and we’re delighted that our solution has been recognised as the best option to support both clinicians and patients.”
