Case Study

Leveraging technology-supported care for chronic conditions: Liverpool telehealth-based self-care program

Aging In Place
Crisis Settings
Healthcare Access

The UK’s National Health Service (NHS) is implementing and expanding a telehealth intervention known as the More Independent (MI) program in Liverpool, with the aim of empowering older adults to self-manage chronic conditions.

The focus: Starting in 2013, the program was designed to improve the efficiency of Liverpool’s health system by reducing avoidable hospital admissions, which account for 16% of total emergency admissions in the UK, while improving healthcare quality.

How it works: The program uses technology with human-centered design to provide both healthcare and health education. Participants receive virtual training on managing their conditions, and regularly complete self-assessments of their symptoms and health status. Patients access services including disease management and monitoring and coaching, and communicate with health professionals through telemonitoring equipment using a TV or tablet interface. A clinically staffed hub monitors patients and facilitates communication between them and primary care physicians. Over time, the service has been adapted to improve care pathways and individualized care plans.

Enabling environment: This program is the product of the NHS’ ongoing initiatives in technology and innovation, and was first developed through the MI program as part of the broader Delivering Assisted Living Lifestyles at Scale initiative. Funding was provided through government innovation funding from the UK’s Technology Strategy Board, regional health system funding from the Liverpool Clinical Commissioning Group and private sector support from health technology company Phillips. The program has since been mainstreamed using a different technology provider, Docobo.

Impact: The program has resulted in positive health outcomes and improved health workforce capacity in the Liverpool region. Fifty-five percent of participants report decreased healthcare utilization, and 90% reported more confidence in their ability to cope with their condition. Additionally, 79% reported improved health management, and 52% reported improvement in their lifestyles. Furthermore, evidence has shown that the program can help to expand nursing service capacity in the region by almost sixfold. With steady funding and an iterative design process, the program expanded from supporting 3,717 patients in 2015 to over 5,300 patients in 2018. Most recently, the MI initiative has been used during the covid-19 pandemic to support vulnerable populations while preventing potentially dangerous hospital-acquired infections. 

Sources Include

Sources include:

Berkel, C, et al. (2019). Retrospective observational study of the impact on emergency admission of telehealth at scale delivered in community care in Liverpool, UK. BMJ Open. 2019; 9(7): e028981. 

Van Berkel C, Smith M, Horsfield D, et al. Evidence for supported self-care at scale: A  population approach to evaluating technology enabled support for long term condition management. Liverpool, UK: Philips and Liverpool Clinical Commissioning Group. 2016.
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Teleheath service expanded [Internet]. NHS Liverpool Clinical Commissioning Group. 
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EUROPEAN INNOVATION PARTNERSHIP on Active and Healthy Ageing. Technology Supported Self Care (at Scale) [Internet]. European Commission. 2020.
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