An innovative use of remote health monitoring is benefiting patients who attend the King’s Mill Hospital Pre-op Assessment Unit (PAU) and show signs of ‘white coat hypertension’ or high blood pressure caused by nervousness or anxiety.

High blood pressure is a relatively common reason for an operation having to be postponed, but now patients who may be affected by ‘white coat hypertension’ can monitor their own blood pressure at home for seven days using the FLO telehealth system, to help the nurses decide on the right plan of care for them.

Within the first 12 months 42% of patients using FLO were found to have ‘white coat hypertension’ and were able to go ahead with surgery as planned.

The unit at King’s Mill Hospital was the first PAU in the country to implement FLO, and the team’s success has prompted interest from other units who are now adopting it as part of their services.

The work won two Excellence Awards at the recent FLO Simple Telehealth Action Learning Event in Nottinghamshire, with a special commendation for ‘Most Innovative Use of FLO’ and project lead Carol Turner was the joint ‘FLO Clinical Champion’.

FLO (named after Florence Nightingale) was developed by the NHS in Stoke-On-Trent, allows for remote, personal and secure collection of data through a patient’s own mobile phone.

Where appropriate, patients who may have ‘white coat syndrome’ can take home a portable automatic blood pressure machine and text in their reading twice a day for seven days.

A nurse checks the readings to identify the patients who have ‘white coat syndrome’ rather than the ones who have genuine hypertension. This improves care delivery and reduces the amount of operations cancelled due to hypertension, and patients identified as hypertensive are referred to their GP.

Carol Turner, Senior Operating Department Practitioner and Lead on the implementation of FLO said: “We went ‘live’ with FLO in April 2013, and our aim was to identify patients who have an elevated blood pressure in a clinical setting but not in any other setting.

“For me, the use of FLO is a ‘no brainer’. It can help us reduce short notice cancellation of operations and unnecessary GP or consultant referrals, gives us a more accurate diagnosis of hypertension, and offers financial savings.

“Importantly, it also improves the patient experience, with less upheaval and inconvenience for those who can go ahead with an operation as planned, or treatment for high blood pressure being started for those who need it.”

From April 2013 to April 2014:

· 27 patients used FLO for the detection of ‘white coat hypertension’

· After monitoring, 17 were able to go ahead with surgery without delay or referral

· 11 of those (42%) were found to have ‘white coat hypertension’

· 6 (23%) had Grade 1 hypertension and could still go ahead but with GP input i.e. start treatment with medication.

Over 1,000 patients across Nottinghamshire health and social care services have now used FLO to self-manage their condition with support from their doctor, or other health or care professional. FLO’s uses include medication reminders, supportive messages to help give up smoking, and monitoring of other readings such as weight and blood glucose.