Self-management: keeping it simple with “Flo”

Figures & data

Table 1 Application of Flo in hypertension

I Default parameters: systolic pressure (80–134 mmHg); diastolic pressure (60–84 mmHg) II Daily reminder at 8 am (service message)    8 am: “Hi. Don’t forget to take your blood pressure this morning and again this evening, and text it in. Text BP, then your reading, eg, BP 140 80. Thanks, Flo.”    12 hours later, if the patient has not replied to the first message: “Hi. I’ve noticed you haven’t sent in your readings today. Could you please text in BP, then the readings. Thanks Flo.” III Within normal range    “Your BP reading is normal. Flo.” IV Systolic and diastolic pressures above desirable range    “Your blood pressure is high today. Follow the advice in your management plan, and take the readings again at your usual time. Thanks, Flo.” V Systolic and diastolic pressures below desirable range    “Your blood pressure is low today. Take it again, and follow the advice in your management plan. Take care, Flo.” VI Breach message    Triggered when the readings reach either 200 mmHg (systolic) or 105 mmHg (diastolic) or if the BP is below 70 mmHg (systolic) or 50 mmHg (diastolic): “Your BP is outside the safe range – so contact a doctor today, as agreed in your shared management plan. Take care, Flo.”

Notes: Copyright © 2013. Reprinted with permission from University of The West of Scotland. Chambers R. Simple telehealth SMS texting service: Flo clinical protocols AIM for Health version 2. NHS Stoke-on-trent Clinical Commissioning Group.³⁷

Abbreviations: BP, blood pressure; Flo, Simple Telehealth “Florence.”

Table 2 Patient experience of Flo

Patient evaluation (n=37)	Strongly agree	Agree	No change	Disagree	Strongly disagree
Staff can get a good understanding of my health problem using Florence	20 (54%)	15 (40%)	0 (0%)	2 (5%)	0 (0%)
Florence invades my privacy	1 (3%)	0 (0%)	0 (0%)	17 (46%)	19 (51%)
I feel comfortable using a mobile phone	19 (51%)	16 (43%)	0 (0%)	0 (0%)	1 (3%)
I feel confident that sending readings to Florence makes a difference	18 (48%)	18 (48%)	0 (0%)	1(3%)	0 (0%)
Florence is helping me manage my own health better	18 (48%)	17 (46%)	1 (3%)	1 (3%)	0 (0%)
Florence is improving my general health	8 (22%)	19 (51%)	3 (8%)	4 (11%)	1 (3%)
I dislike the lack of human contact when I use Florence	1(3%)	4 (11%)	1 (3%)	19 (51%)	11 (30%)
I find Florence very convenient	15 (40%)	18 (48%)	1 (3%)	1 (3%)	1 (3%)
Florence saves me time	12 (32%)	16 (43%)	3 (8%)	4 (11%)	1 (3%)
I feel very reassured that Florence is helping me manage my health and well-being	16 (43%)	17 (46%)	1 (3%)	2 (5%)	1 (3%)
I believe that Florence should become a standard service in the future	22 (59%)	12 (32%)	0 (0%)	3 (8%)	0 (0%)
I feel that Florence supports existing care I receive	21 (57%)	14 (38%)	0 (0%)	1 (3%)	0 (0%)
Regular contact with Florence means I need to visit my GP less often	17 (46%)	13 (35%)	2 (5%)	4 (11%)	0 (0%)

Abbreviations: GP, general practitioner; Flo, Simple Telehealth “Florence.”

Table 3 Staff evaluation (n=33) of Flo

	Definitely yes	Probably yes	No change	Probably no	Definitely no
Do you believe that using Florence has helped the patients to manage their own health and well-being better	12 (36%)	16 (48%)	3 (9%)	2 (6%)	0 (0%)
	A lot more	A little more	No change	A little fewer	A lot fewer
Have you had more or fewer contacts with this patient since they started using Florence	0 (0%)	6 (18%)	12 (36%)	13 (39%)	2 (6%)
	Definitely more	Probably more	No change	Probably less	Definitely less
Have your contacts with this patient been more or less appropriate since they started using Florence	5 (15%)	13 (39%)	8 (24%)	4 (12%)	2 (6%)

Abbreviation: Flo, Simple Telehealth “Florence.”

Chambers R. Simple telehealth SMS texting service: Flo clinical protocols AIM for Health version 2. NHS Stoke-on-trent Clinical Commissioning Group. 2013.

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