Patients across the South Eastern Trust are benefiting from an innovative Nurse-led telehealth system that allows them to monitor their blood pressure safely and easily from home using a simple text message service.
The system, known as Florence or “Flo”, enables patients to take regular blood pressure readings using a cuff and send the results via text message to “Flo”. The readings are then securely stored on a clinical dashboard, where they are reviewed by the Nursing Team in the Ulster Hospital.
In 2023/24, the first full year of operation, 285 patients participated in the programme. In the last year, this figure has grown significantly to 570 patients, reflecting both its success and increasing demand.
The approach has already received national recognition, with presentations at both the British Geriatrics Society Conference and the UK Stroke Forum.
The system does not require a smartphone, app, or internet access, just a standard mobile phone making it accessible, simple to use and more suitable for older or less tech-savvy patients.
South Eastern Trust, Clinical Lead for Stroke and Consultant Physician, Dr Mark Bowman explained the clinical benefits of the system, “We were seeing patients following a minor Stroke and TIA (Transient Ischaemic Attack) where high blood pressure is one of the most important and modifiable risk factors for a further event. Traditionally, obtaining reliable blood pressure readings required repeated clinic visits, which is not always practical for patients or the service.
“Florence has given us a way to monitor patients in their own environment, obtain more accurate readings and respond quickly when needed, without adding to the burden on either patients or services.”
Dr Bowman added that feedback from patients has been overwhelmingly positive, “Patients tell us they feel more in control of their health and find the system very easy to use. Removing the need to travel for appointments, particularly for older or less mobile patients which makes a real difference to daily life.
“There is also the well-known ‘white coat effect’, where blood pressure readings in clinic can be higher due to Anxiety. Home monitoring through Florence provides a far more accurate picture, leading to better clinical decisions.”
Early data from an initial cohort of 20 patients demonstrated significant clinical impact. Half required no change to their treatment. However, 30% were started on blood pressure medication for the first time and a further 20% required an increase in existing medication. Overall, in 50% of cases, a previously unidentified treatment gap was addressed.
South Eastern Trust, Consultant Physician, Dr Loay Abdelnour, highlighted the wider importance of the initiative stating, “Identifying and treating high blood pressure after Stroke or TIA is one of the most effective interventions we can make to prevent further, potentially more disabling Strokes. Every Stroke prevented represents a significant saving in both acute hospital care and long-term rehabilitation, which can run into hundreds of thousands of pounds per patient.
“Florence allows our Nursing Team to safely monitor a much larger cohort of patients than would be possible through traditional face-to-face appointments, without a proportional increase in resources. The Nursing Team are responsible for patient enrolment, monitoring the clinical dashboard, interpreting results and escalating care when required. It operates within an interdisciplinary neurovascular hub, where clinical decisions are made collaboratively.”
Emphasising its simplicity, Dr Abdelnour highlighted that Florence has been designed to be inclusive and accessible, “The beauty of Florence is that it does not require a smartphone, an app or any technical know-how. If you can send a text message, you can use it. Our Team supports every patient through set-up and remains available throughout the process.
“Patients who were initially sceptical, often become its strongest advocates once they experience how straightforward it is.”