Lesley’s Lessons on Communication and Remote Care

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Lesley Blaikie is the only CF nurse serving both paediatric and adult CF patients at Scotland’s NHS Highland Raigmore Hospital. Here, Lesley shares how she utilizes the platform to remotely care for her patients and how communication plays a key role.

How is your role as a CF nurse perhaps different than that of CF nurses across the UK?

My patients live across a large geographical area in the North of Scotland and travel is an important part of my job. For me, that can mean traveling up to 3 hours each way for essential home visits. For those that live on the Western isles, I fly and then hire a car to see them. With Covid-19 travel restrictions, however, I’m limited to one home visit a day. As physical distance keeps us apart, good communication remains vital.

I’m also very fortunate in my role as I see patients through their lifespan, from infant diagnosis to adult service. I utilize what I call my “CF toolkit” of knowledge and experience, gained over 15 years of being a CF nurse, to adapt to the different ages and stages of my patients, together with the geography and weather of the area I cover.

What has been your experience with virtual clinics and remote care?

We ran a pilot with the NuvoAir Home platform before Covid-19. We started to use the platform with 10 patients and realized quickly the benefits both for patients and the clinical team. The pilot evaluation showed that most patients found NuvoAir easy to use and reported that the technology increased contact between the CF team. One patient responded, “It has made contact seem easier because it brings us closer together.” We currently have 80% of our adult patients using NuvoAir and 40% of the children.

Data shared via NuvoAir allows us to closely follow and track alongside our patients and families. We can watch them perform the spirometry via our NearMe technology. If patients are not well, I might say “Give me a lung function, and we can see if we need to start antibiotics.” We are also starting patients remotely on modulators, which we couldn’t do without NuvoAir.

How does the NuvoAir Home clinical portal support your work?

I log into the portal at least twice a week to see who has taken spirometry tests. I use the portal to triage those who I need to contact directly. The platform identifies these patients in red, which helps at a glance to see who has dropped. I also send a gentle reminder using SMS, WhatsApp or email to those who have not performed a test in a while.

The portal dashboards have helped us as a team to carry out meetings virtually, including during shared-care pre-clinic meetings. In consultations, we have up to four clinicians look at the portal screen together with the patient, which is a great way to engage the patients and the team. This has been very helpful when tracking the effectiveness of interventions including CFTR modulators.

Any advice to other hospitals?

An important message to patients is NuvoAir’s use for self-management, so they can follow their own status, including how they are doing between consultations. This helps patients to have better scheduled clinics, to discuss their problems and take ownership of actions, reactions, and strategies.

Communication with patients around their results is key. Of course, we follow-up when there is a drop in lung function, but we also provide positive feedback when we see improvements which provide encouragement. Patients often send a quick message to us to check out their lung function – they want to share the readings instantly.

Using the trend curves in conversations with patients is also important. We share these with patients to show long-term changes or short-term responses to changes in treatment. We have also used these to share the success of CFTR modulators.

We have really felt supported by the whole team at NuvoAir from planning the pilot, to delivery of shipments and customer service for our patients. For the most part, our patients seem to like using the technology and how it supports our work together.