Illustrating: shared care, patient centred care and secure communication with other health care professionals

Patient case

PS is a 76 year old man who developed atrial fibrillation in his 60s which was nicely controlled by medical treatment. He also had arthritis that had become  increasingly limiting. He had two other cardiovascular conditions namely high blood pressure and was on treatment for this; he also had mild heart failure.  He was now unable to get out of his house to visit his GP for his INR blood tests for monitoring of his warfarin treatment.

The involvement of the community anticoagulant and stroke prevention practitioner

His GP arranged for the community anticoagulant and stroke prevention practitioner (who in this instance is a nurse) to visit him at home. The nurse is able to check several aspects of his care; she has brought several items of equipment with her. She checks on his blood pressure by means of a sphygmomanometer – she uses an anaeroid machine which is more accurate for patients with atrial fibrillation. She also checks the atrial fibrillation control by measuring both his heart rate and his pulse rate (which can be different in atrial fibrillation).

She has brought an iPad with her and is able to access HeliconHeart on it. She enters the results of the examination. She then proceeds to check his INR by means of a near patient testing machine. She enters the INR result into HeliconHeart and receives advice about the Time in Range (TTR) as well as advice about the next dose – she is advised to reduce this slightly because the INR  is a little high. She accepts this advice. She also is advised about the timing of the next INR result which she also accepts and arranges the next visit accordingly. Finally she checks the tables Mr PS is taking . The shared record displays the last prescription and its data and she is able to confirm that he is taking the correct medications and the remaining tablets in the bottles suggest that he is taking the medications regularly.

How HeliconHeart has helped

  • The use of HeliconHeart using the iPad to access the secure server enables the nurse to have access to the up-to-date information about the diagnoses and the drugs the patient is taking.
  • The access to HeliconHeart enables the entry of the blood pressure and the atrial fibrillation information. This is immediately available for the next person who will see the patient whether this may be the GP or the hospital doctor
  • The access allows her to use the advisory systems included in the system and obtain up-to-date advice and drug dosage (in the case of the warfarin control)  and the optimal drug and dosage for the heart rate (in the case of atrial fibrillation).
  • The entry she makes relating to the visit and the measures she took and which she entered into the HeartBeat system will contribute to the overarching Clinical Governance. This informs the clinicians and the Clinical Governance Board about the quality of the care and highlights any issues which need to be addressed and improved.
  • Since no data resides on the iPad (the data all resides on the secure server) there is no security of confidentiality risk should the iPad get lost or stolen.