First CCG to launch digital self-monitoring service for warfarin patients

The Isle of Wight (IOW) Clinical Commissioning Group (CCG) is the first to launch an INR self-monitoring service to allow patients to lead a less-disrupted life and relieve pressure on warfarin clinics.

The new automated service, created by digital health specialist, Inhealthcare, completely transforms how patients on long-term anticoagulation medication warfarin are monitored, empowering them to self-test at home and receive their adjusted warfarin dose. Previously patients on warfarin were obliged to attend clinic every few weeks for a simple blood test, to check how quickly their blood clots, which is measured using the international normalised ratio (INR).

“All warfarin clinics on the island are experiencing a high volume of patients accessing the service, so enabling patients to self-test will alleviate pressure on general practice. The reduction in patients attending the clinics will allow more time to be spent with more-complex patients, increasing the level of care for all,” said Dr Peter Randall, clinical lead for the home testing pilot.

With the new service, the patient places a fingerprick blood sample onto a test strip inserted into the Roche INR self-testing device - CoaguChek. The patient sends their new reading securely to the local clinic via their communication of choice, for example by a pre-arranged phone call or by going online, and Inhealthcare technology integrates this new data into INR star which feeds into the patient record. The patient’s new warfarin dosage is calculated in INRstar – the anticoagulation software developed by SCSLhealth which is already used by clinicians to enable safe dosing - which is then relayed back to the patient. This gives patients the freedom to live a normal life, enabling them to go on holiday, and still send in their readings remotely. Patients will no longer have to take regular time off work, pay for travel or clinic car parks.

Pauline Mairs, IOW CCG primary care commissioning manager, said: “We’re thrilled to be leading the way with the launch of this service. In addition to patient convenience, we hope that this digital service will allow patients to take a greater interest in their condition by monitoring their INR, enabling them to stay within their therapeutic range and reducing their risk of strokes. This reflects NICE’s latest guidance on the potential of improving health outcomes with self-monitoring and self-testing.”

The simple-to-use software means that patients and carers of all technical abilities can benefit - as long as they have a landline, mobile or access to the internet.

Inhealthcare chief executive, Bryn Sage, said: “Digital health should enable care by being simple and easy to use. It shouldn’t be a barrier to anyone. It’s great to see the IOW CCG championing our digital service. Technology is transforming every aspect of our lives – the way we shop, the way we bank – so why not our health?”

Dr Mark Sullivan, medical director and founder of SCSLhealth, added: “For patients, safe self-testing offers convenience and control giving them the choice to manage their condition and to avoid frequent and often inconvenient trips to the clinic to have their INR checked. For healthcare professionals, this service gives them the peace of mind that as well as freeing up time in practice, self-testing can be delivered and audited safely.”

The CCG is initially piloting the service to 100 patients in the Sandown area of the Isle of Wight. Should this be successful the intention would be to offer the service to others.