University Hospitals of North Midlands NHS Trust

About one-third of U.S. heart-related emergency department visits are for high blood pressure or related conditions, according to a study of more than 20 million emergency department visits from 2016 -- 2018. The top cardiovascular (CVD) diagnoses from U.S. emergency departments suggest that many cardiovascular emergencies are due to poorly controlled high blood pressure, according to a study of more than 20 million emergency department visits published Sept. 8 in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association. The researchers found that 13% of all heart-related emergency department diagnoses, representing more than 2.7 million people, were for "essential" hypertension, which is high blood pressure not caused by other diseases. Most cases of high blood pressure are essential hypertension. "These visits resulted in hospital admission less than 3% of the time and with very few deaths -- less than 0.1%. This suggests that these visits were mostly related to the management of hypertension," said lead author Mamas A. Mamas, M.D., a professor of cardiology at Keele University in Stoke-on-Trent, and a consultant cardiologist at University Hospitals of North Midlands NHS Trust, both in the UK. For the 15 CVD conditions detailed in the study, about 30% were hypertension-related diagnoses. The study analyzed cardiovascular diagnoses made during emergency department visits that were part of the Nationwide Emergency Department Sample from 2016-2018. The sample was 48.7% women, and the average age was 67 years. The majority were Medicare or Medicaid participants. Men in the sample were more likely to have other diseases in addition to cardiovascular disease, such as diabetes, while women had higher rates of obesity, high blood pressure and medical conditions that affect blood vessels in the brain. The most common heart- or stroke-related diagnoses for women seen in the emergency department were high blood pressure (16% of visits), high blood pressure-related heart or kidney disease (14.1%) and atrial fibrillation (10.2%). The most common diagnoses for men were high blood pressure-related heart or kidney disease (14.7%), high blood pressure (10.8%) and heart attack (10.7%). "Previous studies have shown sex differences in patterns of CVD among hospitalized patients," Mamas said. "However, examining CVD encounters in the emergency department provides a more complete picture of the cardiovascular health care needs of men and women, as it captures encounters prior to hospitalization." He also points out that previous studies of CVD emergency visits are limited to suspected heart attack visits. "Therefore, this analysis of 15 CVD conditions helps to better understand the full spectrum of acute CVD needs, including sex disparities in hospitalization and risk of death." The study found that outcomes from the emergency CVD visits were slightly different for men and women. Overall, women were less likely to die (3.3% of women vs 4.3% of men) or be hospitalized (49.1% of women vs 52.3% of men) after an emergency department visit for CVD. The difference may be due to women's generally lower risk diagnoses, said Mamas, but there could be an underestimation of deaths in women. "We did not track deaths outside of the hospital setting," said Mamas. "Given past evidence that women are more likely to be inappropriately discharged from the emergency department, and strong evidence for the systemic undertreatment of women, further study is warranted to track outcomes beyond the emergency department visit." An additional limitation of the data includes potential misdiagnosis errors in cases where the final diagnosis did not match the emergency diagnosis, particularly after a hospitalization and additional bloodwork and other health information could be obtained. Furthermore, the data is limited in that it does not capture information related to severity of disease, which may make comparisons around mortality differences between different patient groups challenging. "Our work with this large, nationally representative sample of cardiovascular emergency visits highlights differences in health care needs of men and women, which may be useful to inform planning and provision of health care services," said Mamas. "We also encourage further research into understanding the underlying factors driving the differences in CVD patterns and outcomes between men and women."

PROXIMIE COMPLETES PILOTS WITH VODAFONE 5G AT WELSH HOSPITAL London-based health technology company focused on digitising operating rooms, Proximie, has partnered with Vodafone to pilot the use of 5G in the areas of remote assistance and training in cancer care. The first successful pilots took place in University Hospital of Wales and University Hospital Llandough last week. Proximie's platform enables clinicians to virtually transport themselves into operating rooms, cath labs and hospitals to visually interact, engage and guide procedures. The platform combines human expertise with augmented reality (AR) and artificial intelligence (AI). Vodafone's 5G coverage system will be used to power Proximie's platform and to carry out training remotely during COVID-19. MALAFFI SUPPORTS ABU DHABI COVID-19 VACCINATION CAMPAIGN Malaffi, the established Health Information Exchange in Abu Dhabi has been a key part of the Emirate’s pandemic response. It has connected electronic medical records to centralise patient information and created a database of COVID-19 test results in the Emirate. As part of the National Vaccination Programme, Malaffi enables frontline healthcare workers and health authorities to manage patient vaccination data within the Emirate, which ensures that the right patients are getting the right dose. The three main ways in which Malaffi is supporting the vaccination campaign include: centralising vaccine information from points of vaccination, confirming eligibility for vaccination and monitoring and reporting of adverse events. "We are seeing good progress on a daily basis. Vaccination programmes are a challenge to manage but having Malaffi’s health information exchange technology in place is a significant enabler of the success of vaccination in the UAE. We can look at overall vaccination rates at an Emirate-wide level and monitor different indicators over time, that provides insights for the capacity planning, and at the patient level, we can record adverse reactions and check for any contraindications such as allergies. This makes the process more efficient and improves safety," said Dr Farida Al Hosani, official spokesperson for the UAE health sector. UK DOCTORS OFFER TELECONSULTATIONS TO INDIA'S HOSPITALS As last week saw India's average daily COVID-19 death toll exceed 4,000 for the first time, the UK has stepped in to provide daily teleconsultations for hospitals that have struggled with the virus surge. Over 700 British physicians are currently providing free virtual medical appointments via Zoom before their shifts start in the UK, in order to alleviate the burden on the Indian healthcare system. So far, India has received aid from over 40 countries, including the UK, however, it still has a shortage of oxygen supplies, 6000,000 doctors and two million nurses, according to a study published in The Lancet. UK LAUNCHES INNOVATION FUNDING SERVICE FOR HEALTHCARE The UK government is set to launch a funding competition on 7 June 2021 whereby UK registered organisations can apply for a share of up to £18 million to develop innovative healthcare products, technologies and processes. The funding is from Innovate UK, part of UK Research and Innovation and can address the following needs: disease prevention and proactive management of health and chronic conditions earlier and better detection and diagnosis of disease, leading to better patient outcomes tailored treatments that either change the underlying disease or offer potential cures This competition combines the early and late-stage strands of the Biomedical Catalyst and applicant's project total eligible costs must be between £250,000 and £4 million. NORTH CUMBRIA TO IMPLEMENT BETTER MEDS EPMA UK-based North Cumbria Integrated Care NHS FT (NCIC) has appointed electronics prescribing and medication administration solution, Better, alongside CGI as the implementation partner, to provide e-prescribing and allergy monitoring across its acute and community hospitals. The agreement marks the next step in the trust’s aim to move away from paper-based systems towards a central EPR model, intended to improve the delivery of hospital and community health services. The Better Meds solution is built on an openEHR platform which will allow for integration between existing and future systems, supporting the trust on its digital transformation journey. This will include the immediate integration into NCIC’s existing decision-support systems, as well as its Pharmacy and Omnicell Automated Dispensing Cabinets. NHS SCOTLAND AND MICROSOFT DEVELOP TRACK AND TRACE SYSTEM NHS Scotland and Microsoft have developed a digital track and trace system to help businesses protect their customers as COVID-19 restrictions start to ease across Scotland. Through an app, the new solution uses QR codes that, when scanned with a phone or tablet, take the user to a secure government website to fill out their name and contact details. The contact information from the QR codes is fed into NHS Scotland’s cloud-based data lake that runs on Microsoft Azure. The data is fully encrypted and only available to NHS Scotland contact tracers who have the right digital key. NHS Scotland worked with Microsoft to build a robust QR solution that could cope with hundreds of thousands of interactions per minute. The Azure technology then scales up and down, depending on demand. UHNM SET TO LAUNCH ROBOT ENABLED PROCESS University Hospitals of North Midlands (UHNM) has launched an automated process to enable patients to select their own X-ray appointments. Previously, patients could come for an X-ray without an appointment, but due to social distancing rules formal appointments were introduced. The robotic process automation (RPA) mimics human actions on the hospital’s digital appointments system and sends a text message to the patient’s mobile phone with a unique web browser link where they can select their preferred imaging location and date and time for an appointment. The RPA automatically assigns an appointment based on the investigation and the patient’s preferences. The system sends automatic reports to the scheduling team with those people who failed to book their appointment using the automated system. These patients will receive an appointment through a non-automated route, so patients who do not have access to the internet will not be disadvantaged. IMPRIVATA LAUNCHES VIRTUAL SMARTCARD FOR NHS SPINE US-based digital identity company for healthcare Imprivata has announced a new virtual smartcard solution to provide no click access to NHS Spine-enabled applications without the need for physical cards. Imprivata OneSign Spine Combined Workflow Plus aims to improve security by eliminating smartcard workarounds and supports compliance with NHS information governance standards. It also removes the need for login details, consequently saving clinician's time as they access the NHS Spine, allowing greater focus on delivering patient care. Gus Malezis, CEO of Imprivata said: “The COVID-19 pandemic has driven rapid adoption of new technology within the NHS and changed forever the way that care services are delivered. At Imprivata we are committed to enabling digital transformation by providing solutions that solve healthcare’s highly complex clinical workflow, security and compliance challenges. This latest development in the Imprivata OneSign platform recognises our NHS customers’ need for a fully integrated virtual smartcard that will remove barriers to technology at the point of care.”