First CCG to launch digital self-monitoring service for warfarin patients
07 January 2016

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

The new automated service created by digital health specialist Inhealthcare, transforms how patients on long-term anticoagulation medication warfarin are monitored, empowering them to self-test at home and receive their adjusted warfarin dose via INRstar anticoagulation dosing software. Previously patients on warfarin needed 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 Practices. 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,” comments  Dr Peter Randall,  Clinical Lead for the home testing pilot on the island.

With the new service, the patient takes a finger prick blood sample and inserts it 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 INRstar (the clinical decision support software) which feeds into the patient record. The patient’s new warfarin dosage is calculated in INRstar – the anticoagulation software already used by clinicians to enable safe dosing, which is then relayed back to the patient. The INRstar interface supports efficiency by reducing the need for manual entry.

The service enables 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.

Dr Mark Sullivan, Medical Director and Founder of SCSLhealth the home of INRstar comments, “For patients, safe self-testing linked to clinically risk assessed dosing software 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”.

Pauline Mairs, IOW CCG Primary Care Commissioning Manager adds, “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, monitoring their INR enabling them to stay within their therapeutic range - reducing their risk of a stroke.  This reflects NICE’s latest guidance on the potential of improving health outcomes with self-monitoring and self-testing.”

The CCG is initially piloting the service to 100 patients in the Sandown area of the Isle of Wight, should this pilot be successful the intention would be to offer the service to others. Person-centred care, enabling individuals to take control of their lives and have a better quality of life and stay well, are key aims of a new care model  initiative on the island called  “My life a full life”. This transformation programme involves the NHS Trust, the CCG, the Council, One Wight Health and the voluntary sector all working in a more co-ordinated way to provide health and social care services for people needing care and support on the island; details are explained on the programme website

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 CEO, Bryn Sage comments:  “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?”

For more information contact the Isle of Wight CCG