“Late last year I was given an Alivecor portable ECG device to use in work. Since the device arrived I have used it practically every day. More patients can have the reassurance of a simple quick test, some will still need the full 12 lead ECG, but the barriers in terms of time and cost have been removed, the delay in results reporting has also gone. This device will not replace the ECG department, but it will make it quieter. The fact that the device worked first time, was easy to use and required no training meant that from the start it looked like a winner.”

Dr Chris Mimnagh, Liverpool GP

What was the problem?

There are currently around 220 strokes in the North West Coast region each year caused by non-identified atrial fibrillation (AF). Nationally, it is estimated that nearly one million people in the UK are affected by AF, which can lead to stroke. At the age of 40, we all have a one in four lifetime risk of developing AF.

Heart specialist nurse Linda Hilton and patient Albert Edwards

Heart specialist nurse Linda Hilton and patient Albert Edwards

What we did and why

The Innovation Agency and partners achieved a reduction in strokes in the North West coast area, by spreading the use of a mobile technology to identify atrial fibrillation (AF), a type of irregular heart rhythm.

We tested 502 pulses and detected 46 abnormal pulses and recommended ongoing support, reducing the likelihood of stroke – saving £23,000 per person in NHS and care costs in the first year alone – potentially £1 million in total. In addition, we deployed 100 AliveCor Kardia AF detection devices with GPs and community nurses, to enable instant detection of AF.

Innovation Agency 46 pulsesThe campaign included raising public awareness of the importance of checking for an abnormal pulse, working collaboratively with charities, NHS providers, Strategic Clinical Networks and the media. In addition the Innovation Agency worked with clinicians to develop a commissioning toolkit for the treatment of AF, which could potentially save 600 strokes in our region per year – a total saving of £13.8 million.

Working with the Clinical Network, an evidence into practice programme was delivered for patients with heart failure, from which more than 200 patients have benefitted. The focus of this work was to prevent stroke, reduce admissions to hospital, improve health awareness and encourage self-care. The strong network of partners around the region enabled support from CCGs, GPs and community nurses in different parts of the region – in Lancashire, Merseyside and West Cheshire.

After introducing AliveCor to clinicians and nurses, the devices are now in regular use in around 100 care settings. The promoter of AliveCor, Francis White, is an Innovation Fellow supported by the Innovation Agency through the NHS National Innovation Accelerator.

AliveCor is attached to the back of a mobile phone and when placed in a person’s hands, the screen lights up with a graph and heart rate readings – showing whether or not there is cause for concern. AliveCor is not currently available from the NHS, but people are buying it from Amazon on the advice of their GP, and last year, 8,000 were sold in the UK.

Which national priorities does this work address?

Stroke prevention – reducing AF related strokes

Results

In campaigns held by the Innovation Agency in Merseyside and Lancashire:

  • 502 pulses were tested and 46 abnormal pulses detected and recommended ongoing support, reducing the likelihood of stroke – saving £23,000 per person in NHS and care costs in the first year alone, a potential £1 million in total.
  • Workshops, drop-in events, and symposia for clinicians were held.

“The AliveCor device is now part of my toolkit along with my blood pressure machine and stethoscope.”

Linda Hilton, Liverpool Community Health specialist nurse

“If it gives a second opinion on the spot then that suits me.”

Albert Edwards, patient with a heart condition

Tips for implementation

  • Engage with partners, such as charities or third sector bodies, to achieve more and with a greater reach.
  • Aim to empower patients by helping them learn about the condition and take their own pulses.
  • Engage with sports clubs.
  • Engage with clinical staff to support the campaign and provide advice and support at workshops etc.
  • Dedicate a few months of a project manager’s time to pull this together.
  • Engage with a local media figure to inspire media coverage.
  • Take part in events locally where you can engage with the public.
  • Focus your efforts on maximum coverage and reach.

Next steps and spread

Continued roll-out of pulse detecting devices in new areas and with different staff groups – with pharmacies, adult social care, care homes, and with health trainers.

Find out more

Visit the Innovation Agency website.
Visit the AliveCor website.

Contact for help and advice

Dr Julia Reynolds
julia.reynolds@innovationagencynwc.nhs.uk
07852 562791

Programme duration: 2014 – ongoing