Liverpool Heart and Chest Hospital uses remote patient monitoring to support people waiting for cardiac surgery.

Liverpool Heart and Chest Hospital is using remote patient monitoring to pick up on deteriorations in patients waiting for cardiac surgery. With clinicians able to monitor them at the touch of a button, this innovation provides safety and reassurance for patients in their own homes.

The hospital is one of the largest specialist hospitals for heart and chest surgery in the country, has been twice rated as outstanding by the Care Quality Commission and is a centre of excellence. Bil Kirmani, a heart surgeon, is leading the cardiac surgery telehealth project, supported by Mersey Care NHS Foundation Trust and remote monitoring providers Docobo.

Since the pandemic and the continuing pressures placed on the NHS, waiting lists for surgery are longer than anyone would wish. This nationally funded project was set up to explore communications and reassurance for patients as they wait for surgery. The project also addresses patient safety during the waiting period to spot any signs of deterioration, allowing patients’ operations to be based on clinical need.

Mr Kirmani said: ‘Patients may naturally be concerned and anxious whilst waiting for heart surgery. Remote monitoring allows us to reassure patients that they are being given regular check-ups, without them having to go into a hospital clinic or a GP surgery. It also allows surgeons to review patients much more closely than ever before, ensuring those whose needs change on the waiting list can be picked up and treated sooner.’

How does the cardiac remote monitoring programme work?
The telehealth programme has two main parts – pre-habilitation and symptom monitoring.

Symptom monitoring

• Once a patient has been seen in the clinic and put on a cardiac surgery waiting list, they can be offered remote monitoring.

• Patients will be loaned equipment such as blood pressure and oxygen monitors to take readings at home

• These readings are reviewed daily at the Clinical Hub at Mersey Care

• Specialist nurses assess information and can advise the patient if they need to see their GP, attend hospital or let the patient’s surgeon know of any important changes

• Any major changes can allow the surgeon to bring forward the operation, potentially avoiding the need for A&E visits

Pre-habilitation

• The cardiac remote monitoring programme also gives patients advice on being fit for surgery such as diet and exercise

• There is also extra support for diabetes control, improving breathing including stopping smoking, and psychological preparation for surgery

How does the cardiac remote monitoring programme benefit patients?
‘‘Whereas previously, patients would often have no contact with their surgeon for weeks or months between their first clinic appointment and surgery, it’s now possible for patients to know a specialist surgical team is monitoring them day to day,” explains Mr Kirmani. “With remote monitoring, subtle changes that can alert surgeons to a possible deterioration are picked up and acted on sooner. It is mentally challenging getting ready for an operation and we can help patients with preparation as psychological readiness can help you get the best results from surgery.”

The progamme means that not only can problems be identified sooner, but the team are also better placed to prevent them, too, with a digital pre-habilitation programme. This brings specialist hospital care to patients’ homes through their smartphones, as guided exercise, diet and disease management can help patients be as fit as possible for their operation.

A patient who has been part of the remote monitoring programme said: ‘For me, I found the access to my blood pressure readings and oxygen levels very useful. It would tell me if my blood pressure was out of ordinary or oxygen levels too low, and I would get a phone call. If someone had asked me as a new patient coming in ‘would you consent to remote monitoring again? ‘ I would have absolutely no doubt – it is something I would recommend … simply for the peace of mind – because it really does take away the stress of what’s going to happen moving forward.’

Mr Kirmani concludes: ‘Cheshire and Merseyside serves a population of 2.7 million, and, with a single specialist centre like ours, we wouldn’t be able to provide this level of care in the hospital walls. This is why remote monitoring is so beneficial.’

”Remote monitoring allows us to reassure patients that they are being given regular check-ups, without them having to go into a hospital clinic or a GP surgery. It also allows surgeons to review patients much more closely than ever before, ensuring those whose needs change on the waiting list can be picked up and treated sooner." Bil KirmaniHeart Surgeon and Cardiac Surgery Telehealth Project Lead, LHCH