The service uses a combination of education, remote monitoring, automated alerting rules, plus access to experienced nurses to support people living with lung conditions, heart failure or diabetes.
It has grown steadily, so that its clinical hub is now supporting around 900 patients at a time, and to date more than 5,300 patients in total have benefited from it.
However, with the new Docobo platform, the CCG intends to scale this up to 4-5,000 patients a year, and use the system to support new clinical pathways and conditions.
Carol Hughes, the clinical and operational lead for health technology at Liverpool Community Health NHS Trust, said: “Liverpool has been a trailblazer for delivering telehealth at scale and has produced some great improvements in our local patient outcomes and wellbeing.
"However, this is something that we now want to see used for the benefit of all patients, across the wider local health economy. It is embedded into the local health economy, and now is the time to grow. This is a really exciting time."
Evaluation of the Mi Programme showed that it can reduce both emergency admissions and the demand on other health services, as well as making patients feel more confident and in control of their own health.
However, Dave Horsfield, NHS Liverpool CCG’s digital care and innovation lead, also said it had wider ambitions for the service.
"We've shown that a high level of professional telehealth support gives reassurance to people and produces good results, but we wanted to stretch the technical capability to open up other options," he explained.
"For example, when people came off the previous programme, we couldn't offer a step down option that would enable them to use their own smart device to continue to access self-help advice.
"Because the programme aims to guide people towards longer-term self-management of their conditions, this was one of the gaps we were keen to fill.
" "Docobo won the contract because they were best-placed to deliver everything we wanted. We were particularly impressed with the flexibility of their solution and their general attitude towards collaboration."
Docobo was set up in 2001 and has developed the Doc@Home solution to securely collect, analyse and display patient data.
Patients can be given a small recording device, CarePortal, that was designed with Age UK to be easy to use. With support and training, they can use the CarePortal to enter information into the Doc@Home portal.
Patients who are more comfortable using technology can use their own devices to record information. Clinicians simply use a browser to securely access the information displayed on Doc@Home.
The CCG was keen to implement the Docobo system as soon as possible, to support patients over the winter period, when health services are under severe pressure.
Although the contract was only signed a month ago, the new system has already gone live, and around 50 patients per week are currently being recruited onto it. This is expected to ramp up as the number of patients using the previous system gradually wind down over the next couple of months.
"Successfully implementing a new system in such a tight time-scale is testimony to the commitment and experience of both Docobo and the cross-organisational telehealth team we have in Liverpool," said Horsfield.
The CCG has set the maximum potential value of the contract at £11.5 million, if it extends from three to five years, in recognition of the range of patients and pathways that may justify further investment.
Adrian Flowerday, managing director, Docobo, said: "Liverpool is one of the most experienced users of telehealth in the country, by some distance, so we are particularly pleased that they have chosen Docobo to move forward from where they are today.
"Technology has a huge part to play in helping the NHS to cope with rising demand, while delivering a great service for patients. The message is that you need to use technology that delivers results, and that is what Liverpool has chosen to do."
About Healthy LiverpoolHealthy Liverpool (www.liverpooltalkshealth.info/) aims to ensure that the city's health services are set up right to meet the needs of this and the next generation. Healthy Liverpool is split into five areas:
- Living Well - helping the whole city get moving, so that we can all enjoy the physical and mental health benefits of physical activity.
- Digital Care and Innovation - using the latest technology to help people stay well, plus improving information sharing both across health and social care and with citizens.
- Community Services - providing more services closer to home, including looking at ways to support people which aren’t about medical treatments but affect our health.
- Urgent and Emergency Care - making it easier to find the right service when you need it, seven days a week, and helping people avoid unnecessary time in hospital.
- Hospital Services - ensuring that all of our hospitals offer consistently high standards of care by working more closely together.
About Liverpool Community Health NHS TrustLiverpool Community Health NHS Trust delivers services in Liverpool. The organisation has around 2,000 staff, delivering over 80 health services, including District Nursing, Community Matrons, School Nursing, Health Visiting, Dental Services, Walk-in Centres, and Sexual Health Services.
From 1 November 2017, Mersey Care NHS Foundation Trust has entered into an interim management agreement to provide management and other support to the trust. The trust will remain an independent statutory body, which itself will be responsible for the management and delivery of Liverpool Community Health services to its commissioners and regulators.
The interim management agreement is expected to stay in place until such time as Mersey Care is approved as LCH's acquirer.
About DocoboDocobo is a UK digital health company, that has worked with the NHS since 2001. The company’s remote patient management and population intelligence systems enable the health and care system to increase capacity and cope with the rising demands of our ageing population.
Deployment enables community trusts and their nursing teams to provide an efficient and effective service to care for patients in their own homes. It reduces visits to A&E and GP practices and helps users to better manage their own conditions.
Docobo's products and services continue to evolve through close, practical collaboration with NHS partners. Together, we are delivering on the practical aspects of the Five Year Forward View with ‘easy adoption technology’ driven by clinical need and patient preferences.