Since 2017, pregnant women with an increased risk of complications can be monitored at home via SAFE@Home. This e-health program was developed by UMC Utrecht in collaboration with Luscii, a supplier of apps for remote care. Results of a pilot study show that this method of home monitoring leads to fewer clinic visits, fewer ultrasounds and fewer admissions among the participants. The program is now expanding further, with the Jeroen Bosch Hospital being the first to participate in the follow-up study.
In 2016, gynaecologist Dr. Mireille Bekker took the initiative in introducing this new method of monitoring. “I wanted to modernise care for pregnant women, so they would only have to visit the hospital if it was really necessary. That’s how I came up with SAFE@Home”. In Luscii, she found a partner who had the innovative technology readily available and a successful collaboration was set in motion.
In the app, women can measure their blood pressure at home and fill in a questionnaire. This data is forwarded to the hospital. If one of the values falls outside the threshold, the healthcare provider will be notified. The gynaecologist or midwife can then get in touch via the app or telephone to give the pregnant woman the appropriate advice. The app is combined with a care path of a minimum number of hospital visits.
A recent publication in the international trade journal, Pregnancy Hypertension, documented the results of the pilot study of 103 patients. The study showed fewer clinic visits, fewer ultrasounds and fewer admissions related to hypertension in the SAFE@Home group, compared to patients who received regular care. The pregnancy outcomes remained the same.
Both the pregnant women and the professionals were very positive about working with SAFE@Home; pregnant women also indicated that they felt safer with this form of monitoring. Bekker: “Via SAFE@Home, we can monitor the well-being of patients more effectively. This enables us to take appropriate action to prevent unnecessary hospital visits, diagnostics and probably even admissions“.
Follow-up study SAFE@Home II
After an initial pilot study, the SAFE@Home II follow-up study will begin in October, and several hospitals will be able to participate in the program. Bekker: “This will give us a good insight into aspects concerning upscaling and implementation, as well as the effect on medical outcomes. Since the COVID-19 pandemic, we have also witnessed an additional need for “the right care in the right place”, and telemonitoring such as SAFE@Home contributes to this“. The Prevention Early Diagnosis and E-Health Foundation, and Health Holland, a program of the Top Sector Life Science and Health, are making a research and development subsidy available for this purpose. UMC Utrecht is coordinating the study.
Jeroen Bosch Hospital first participant
Dr. Jacques Dirken, gynaecologist at the Jeroen Bosch Hospital, explains the participation of SAFE@Home within the Jeroen Bosch Hospital. “Just like in Utrecht, we already worked with remote CTGs (heart monitors) to keep an eye on the baby in the womb, with SAFE@Home we can also monitor the mother’s blood pressure. These are two important parameters for monitoring a pregnancy, and now we can do both from home. This is a fantastic innovation, which means we can anticipate possible complications more quickly and reduce the need for pregnant women to visit the hospital”.
Gynaecologist Dirken expects approximately 50 patients from the Jeroen Bosch Hospital to participate in the study. With the implementation of this modern care, more control is also given to the patient. “As pregnant women now regularly measure their blood pressure and complete a questionnaire, they learn to assess what the values mean. Because of this insight, I expect them to be more actively involved in their pregnancy and the care that surrounds it”.
Since working at Luscii, I often think about the World Exhibition in Paris in 1900. Electric street lamps, escalators, moving images on a screen. The people couldn’t believe what they were seeing. Was this really possible? All those new inventions brought enormous energy into society. What progress! The beauty is that this wonder and energy was captured in various works of art. The painting Bal Tabarin by Jan Sluijters (1907) is one such striking example. People dancing euphorically under ultramodern artificial lighting.
That wonder of new possibilities that Parisians felt during the fin de siècle; I experience that almost daily at Luscii. As a nurse, I am confronted with developments in healthcare that I had never thought possible. The future, I am learning quickly, is now.
People with heart failure measure their own blood pressure and weight at home. The easy-to-use measuring equipment is connected wirelessly to the Luscii app. Values are immediately available in the EPD of the correct healthcare provider. And if there is a risk that things are heading in the wrong direction, nurses make direct contact via a razor-sharp video connection to assess the situation, long before a crisis situation arises. How wonderful and safe would it be for patients if they no longer have to go to the hospital with wailing sirens?
I have seen with my own eyes that new possibilities are transforming healthcare. Nurses have more control. Patients feel more involved in their own treatment. The collaboration between doctors and nurses is improving. New energy is being nurtured in organisations to meet the future challenges of the sector.
Because, let’s face it: those challenges are great. With fewer professionals, we will have to provide more care in the coming years. At the same time, I realise that many doctors and nurses are not even aware of the new possibilities. Until recently I was the same, even though I am naturally quite curious and read a lot about the developments in my field.
That’s why I am making a series of interviews for Luscii. Nurses, doctors, physician assistants, innovation managers, researchers and administrators. I let them all have their say. They can talk about their daily work, how they view the challenges of the sector from their position, and what it is like in practice to monitor and guide patients remotely.
In addition, I offer people a platform that contributes to future-proofing healthcare in other ways. As that is what we need now in the healthcare sector: energy and inspiration. Are you, as a doctor or nurse, working on something special at the moment that is helping to keep healthcare accessible? Then please contact me!
Hugo van der Wedden is a nurse and medical sociologist. He visited bedsides across different hospitals in the most diverse specialisms. He has written a regular column in a Dutch Nursing Magazine for years and published in several news papers. As the “voice of Luscii”, it is his job to make the voice of people within the field resonate in everything that Luscii does.
Doctors and nurses are gaining valuable experience through home measurement and video calling in numerous locations across the Netherlands. They are learning something new every day; how to introduce digital care to patients, how to make video calls, when to adjust thresholds. How useful would it be to bring all those caregivers together and learn from each other’s knowledge during a Sharing Session?
“Very useful”, says a nurse from Dijklander Hospital. Pulmonologist, Erik Kapteijns, begins the afternoon with his lessons learnt from 1.5 years of telemonitoring COPD patients. For example, it was not a good idea to start during flu season due to the increased workload. But since then, the results achieved have been really impressive. One quarter fewer admissions of the research population! The upscaling is therefore in full swing.
Sharing Tables exchanges tips and tricks about inclusion, the monitoring protocol and, of course, the expansion from a few patients to larger populations. Knowledge is multiplied by sharing experiences!
On behalf of Luscii, Daan Dohmen offered a sneak peek of upcoming developments. Luscii’s vision was received with wide eyes and enthusiastic nods. We make the magic of healthcare innovation possible with a little technological help, but mainly thanks to the smart collaboration between pioneering healthcare providers.
Were you unable to attend? No worries! Later this year, we will organise yet another Sharing Session. Whether another magician will be present, we will keep under wraps…for now.
Press Release – Queen Maxima Visits Sensire and NAAST
VARSSEVELD – Clients and employees of Sensire and NAAST were surprised this morning with a visit from Queen Maxima. She visited the organisation to get acquainted with Remote Care, a unique collaboration of digital healthcare in the Achterhoek.
“Thanks to the iPad, I have my freedom back!” This surprising admission was shared with Queen Maxima by 72-year-old Mrs. Mijnten-Schoolderman, during an informal work visit to healthcare organisations Sensire and NAAST. Sensire provides remote care via digital healthcare organisation NAAST to patients with, for example, the lung disease COPD or heart failure. “At first, I didn’t want anything to do with the iPad, but that soon changed”, she says. “I can now decide for myself how my life should be”. Thanks to remote care, patients can decide for themselves when to have contact with care workers. Patients are given an iPad with special software from Luscii, a start-up that develops smart software for remote care. Via video calling, they can make contact with nurses and other specialists who provide care from a distance. “Do you know what the real beauty of it is? The people at NAAST know me and my situation. So I don’t have to tell my story over and over again”.
“The visit of Queen Maxima demonstrates that something really special is happening with healthcare in the Achterhoek”, says Maarten van Rixtel, Director of Sensire. Digital resources and techniques are being implemented into healthcare in more places across the Netherlands. “What makes our commitment special is the scope and the fact that we, as different organisations, work together”, says Van Rixtel. An intensive collaboration exists between Slingeland Hospital and health insurer Menzis in the area of remote care.
Sensire has been a pioneer of digital care since 2009 and has remained closely involved with Luscii since 2014, who specialise in healthcare innovation. “Giving people an iPad is not that difficult”, says Daan Dohmen of Luscii. “The point is to build and deploy the technology in such a way that customers regain control”.
Slingeland Hospital sees remote digital care as an important means of getting closer to the patient. “As a hospital, you are actually always too late”, says Erwin Bomers, Director of Healthcare Policy at Santiz Hospitals. “With remote care, you get very close to your patients: in their own home environment. As a result, you have a better picture of the situation, and our people are able to ask other questions”.
For Menzis, collaboration with healthcare organisations, such as Sensire and Slingeland Hospital, is a special step. Olivier van Noort, Senior Healthcare Purchaser at Menzis: “The exceptional thing is that we really entered into this together: we share the risks and the benefits”. Remote digital care not only gives customers more control, it also offers an important means to continue to make healthcare possible in the future.
Healthcare organisation Omring, Dijklander Hospital, Northwest Hospital Group, GGZ North-Holland North and GP organisations are joining forces with VGZ, part of which includes Univé Zorg. Together, they are working on “sensible care”. This relates to better quality healthcare for the patient that remains accessible and affordable.
These institutions can no longer accept the shortage of nurses; the decline in this region caused by the increasing aging of the population. After all, growth requires new, different and creative solutions, and these organisations, and their doctors and nurses, are working on this collectively with VGZ. The basis for the special regional cooperation comes from the office floor itself: doctors, (district) nurses and psychologists are working together with VGZ on over 100 ideas, all contributing to better care for patients. As most residents in North Holland are insured with Univé, they will certainly notice new forms of healthcare arising in the long term.
The healthcare providers involved have signed long-term agreements (or an intention thereto) with VGZ. In doing so, the organisations won’t have to renegotiate their contract with the health insurer every year, and can instead focus on improving care for the client at lower costs. After all, they have certainty for the coming years and a basis of trust. This has already produced good results in various places across the country.
Omring: Together the best care, close to home
In collaboration with VGZ, Omring is working on a new and faster method of compression therapy (support stockings), fall prevention for vulnerable seniors, more efficient supra-regional triage via an app, amongst other things, and oncological treatment at home, which patients greatly appreciate.
Northwest Hospital Group and Dijklander Hospital: Medicines, primary care and wound management
The Northwest Hospital Group has already enjoyed success in its approach to expensive medicines, in improving first-line care so that patients no longer need to visit a specialist, and with its coordinating function for complex wound management, together with nine general practices. Experts from the Dijklander Hospital are working on better wound care through video calling, together with Omring nurses. This saves the patient a lot of appointments and travelling. At the same time, district nurses will be trained accordingly.
GGZ North-Holland North: Mobile care
GGZ North-Holland North has drastically shortened waiting times thanks to its approach to personal and recovery-orientated diagnosis. The direction for the treatment is expressly placed with the client. The organisation has also successfully integrated e-Health, in anticipation of specialised healthcare providers.
GPs pilot: More time for the patient
In West Friesland, seven GPs are participating in a “more time for the patient” pilot. In other regions, this approach has already led to better quality care, an increase in patient satisfaction, a rise in work satisfaction for the GPs, and a decrease in the number of referrals to the hospital.