Telehealth service keeping patients healthier and at home for longer

People living with chronic disease are benefiting from SMILE 2, a virtual health support service which monitors their health remotely. Participating patients’ health is monitored daily by a team of triage nurses through wearable devices, offering early intervention and care as needed.

Dr Orlaith O’Reilly, Clinical Lead, HSE Chronic Disease Management Programme, explained:

“The SMILE 2 project is turning out to be a really exciting project with huge benefits for patients here in the South East.  The project is providing remote monitoring and case management to very high need patients with several chronic diseases.  We find that patients really appreciate this service and it has greatly helped them to better understand their condition and how to manage it, avoiding episodes of deterioration and the subsequent visits to hospital.

The service across counties Carlow, Kilkenny, South Tipperary, Waterford and Wexford was developed by the HSE in direct response to a need from patients. We know patients with several chronic diseases often end up in emergency department (ED) or admitted to hospital, often because they don’t recognise the deterioration of their condition and seek support in time. The remote monitoring and timely advice from the triage nurses is proving effective in addressing this for patients. The SMILE service is delivered by Caredoc out of hours GP co-operative in partnership with the HSE Enhanced Community Care (ECC) programme, South East Community Healthcare and Sláintecare.

We have recently received funding to increase the number of patients accessing the project this year. Our hopes for the future are that we will continue to receive funding following the initial project’s end in December 2024.”

Preliminary data collated by the service show that for patients who have been in the project for at least six months:

• 48% have had less ED attendances this year as compared to before they joined
• 52% had less nights in hospital
• 79% have had to attend their GP less on an urgent basis. 
• 64% have had a reduction in periods of deterioration in their condition, which set off the remote monitoring alerts

Retired ships cook Tony Reck (60s) from Wexford is living with COPD, type 2 diabetes, and arthritis which he attributes to his years on the stormy seas, often having to use his knees as ‘shock absorbers’ in the ships galley during particularly turbulent weather:

“It really gives a peace of mind, knowing your health is being constantly monitored. You don’t always notice changes yourself but the nurses will. Everything is uploaded, all meds uploaded, how you’re feeling, your mood, general wellbeing are all included. I log in twice a day. If somethings odd they ring me.”

SMILE monitoring devices including blood pressure monitors, blood sugar monitors, oxygen monitors, weighing scales, and activity monitors. These are allocated to participants based on their requirements. Participants record their healthcare data at home and submit the readings from devices to a specifically designed software program, which is monitored daily by the telephone triage nurse.

Mother of four and Nanny of nine, Eileen O'Donnell (70s) is living with COPD and Bronchiectasis. Eileen from Tipperary Town explains she has a history of respiratory infection traced to a bout of measles and whooping cough during her childhood:

“While I am still getting used to, and trusting the project technology, it has made me much more confident. I am blessed to be part of this project. The SMILE project is my security blanket.”

Margaret Curran, Caredoc General Manager, said:

“The Caredoc nursing team deliver remote care to a specific high need cohort of patients with multi-morbidity in the SMILE service. Support, education and monitoring is provided to patients by the triage nurses, with the aim of maintaining optimal health and avoidance of exacerbations and episodes of illness.”

For more information on the service watch back a recent Sláintecare webinar here.