There have been huge strides in the successful treatment of cancer over the last 20 years, with aggressive chemotherapy regimens often forming the core element of therapy. Such treatments are associated with common and significant treatment effects; the most serious being neutropenia resulting in sepsis. It is widely accepted that the ability to recognise evolving effects of chemotherapy at an early stage is likely to both make their management easier and to reduce the chance of an unplanned hospital admission, which is both risky to an immunocompromised individual and highly costly. In addition, patients clearly state that the time between appointments can be the most worrying, as questions crop up that often cannot be answered at the time, leading to heightened anxiety for both patient and their family.
Living beyond cancer
In an active project with Shrewsbury and Telford Hospital NHS Trust, Dynamic Health Systems is developing a suite of digital services to help patients receiving chemotherapy self monitor at home, receive personalised information about their treatment and communicate in real time with specialty clinicians in order to address new queries as they arise. Through a series of events involving service users and providers, an approach has been developed which will give 24×7 visibility of a patient’s current status, provide immediate access to specialist support and optimise the flow of patients who do require unplanned hospital care. As has been seen in other VitruCare deployments, people with cancer greatly value a connection with healthcare staff that does not depend on a time (appointment) based approach to support: “How wonderful to feel you are connected – you are not alone” .
In parallel, VitruCare is also being made available to people who have completed their cancer treatment and are now in long term (and infrequent) follow up. Many comment on the relief of completing active treatment being coupled with anxiety over the loss of what had previously been intensive support. VitruCare is being used in this context to maintain a sense of connection without need for frequent face-to-face contact.
This exciting programme is underway and the results are becoming clear. Comparing the patient using the digital health service connected to the 24×7 support centre with a group of similar patients still on the traditional pathway, the improvement is striking: Shorter hospital admissions, closer monitoring for safety and patients who feel they are treated by the NHS as if they are with a private hospital. The achievement by the care team was honoured with the 2017 HSJ Patient Safety Award.