My M Health – Asthma

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Background

Asthma care in the Wales is the worst in the UK and the UK is the worst in Europe. 2/3rd of UK Asthma deaths are preventable. Adolescents account for the biggest proportion of asthma related hospital admissions. Adolescents are embracing tech so to engage with them, we in healthcare need to be embracing tech in order to address health needs.

Basic Asthma care is defined as having the following three things:

  1. Inhaler technique training
  2. A written Asthma action plan
  3. An annual Asthma review

There is a commercially available app that can provide all three of these things and lots more. Most notably patient education, which is key, if a patient doesn’t understand Asthma this can lead to inappropriate use of inhaled treatments.

Aims

  • To get adolescent asthmatics within a selected GP surgery within ABUHB, to engage with and use a commercially available web-based application, to improve the basic level of Asthma care for adolescents
  • To assess the engagement with app technology for healthcare, in order to structure future roll out
  • To show if the use of an app for Asthma self-management can reduce hospital and GP contacts for Asthma exacerbation's
  • To consider the role of the Physicians Associate within a GP surgery, for the management of stable Asthmatics

This project fits with the prudent healthcare model by:

  • Co-production - involving patients more in their own care by promoting self-management
  • Patients with the greatest need first - Patients that are not controlled can be flagged to the surgery so these are seen before those who are well controlled. Currently there is no a robust way to know if a patient is well controlled and needs to be reviewed
  • Doing only what is needed - as there are no additional unnecessary interventions

Reducing inappropriate variation and provided health equality - as it would eventually be offered to all Asthma patients regardless of location.

Topics
Apps Data Medical Technologies
Health Board
  • Aneurin Bevan University Health Board
Partners / funding sources
  • Bevan Commission
  • Aneurin Bevan University Health Board
  • Project Lead: Victoria Richards-Green, Chronic Conditions Lead Pharmacist
Start date
  • Lessons learnt
  • Outcomes
  • Outputs
  • There have been many challenges within this project, but for me the main one has been around the process of approval for new technologies. Knowing who to speak to and at what point in time.
  • In order to overcome this links have been made with the multiple departments within the health board, to come up with a flow chart for the implementation of future technologies. 
  • This will be shared across the health board to prompt due diligent and process for all implementations going forward.
  • Procurement, to ensure the appropriate tender process has been followed and documented
  • Information Governance, to ensure all data is handled appropriately

What We Hope to Achieve

For Patients

  • Better access to information, medications and health care professionals, in a more timely manner
  • Fewer exacerbations needing rescue medications
  • Fewer appointments with the GP surgery or Hospital
  • Overall better Asthma control
  • Less time off due to Asthma (both for the patient and in the case of adolescent asthmatics the parents)

For the Health board

  • Reduced GP appointments
  • Reduced Hospital admissions
  • Reduced prescribing of rescue inhalers and oral steroids
  • Reduced Asthma deaths
  • Better utilisation of staff in primary care, shifting the management from practise nurses to practise pharmacists and Physician’s Associates
  • Increased flu vaccine uptake

Anticipated outputs include:

  • Evaluation of the data to show how to engage with technology for healthcare going forward and what benefits this can bring, not only to patients for also to the healthcare providers.
  • Once established the plan would then be to roll out app technology for self-management to the whole of ABUHB, both in primary and secondary care setting.
  • Present the findings to other GP surgeries to show the overall benefits of investing in technology.
  • Explore usage of other applications covering diseases such as COPD, Diabetes, MI and heart failure, which could then be rolled out in the pilot surgery.