IfG.CC -
Institute for eGovernment

Researchers from City University London's School of Health Sciences and other institutions collected self-reported physical and mental quality-of-life scores relating to mobility, self care, ability to perform usual duties, pain and discomfort, anxiety and depression from patients diagnosed with either chronic obstructive pulmonary disease, diabetes or heart failure. Researchers recruited 1,573 patients between May 2008 and December 2009 from primary-care practices, specialist nurses and hospital clinics from the regions of Cornwall, Kent and Newham. Baseline scores were recorded, and scores were collected again at four months and 12 months.

The project, dubbed 3Million Lives, is in its infancy, agency officials admit. The detailed plan--including who will provide the technology, which patients will participate and which hospitals will provide the monitoring services--"is still in the early stages of development."

Trials in virtual health services have many healthcare experts, in the US and the UK alike, convinced that ‘Telemedicine’ is poised to reshape health services in the home to meet the challenges of an ageing population.

The £2.7m scheme will see patients – initially with COPD and heart failure – relaying information about their blood pressure, weight and blood gases via touchscreen devices.

The information will then be analysed and, if necessary, acted on by specialist nurses.

A review of Northern Ireland's health and social care services has identified technology as a key to creating the "new model" for services that will improve patient outcomes and drive up quality of care.

The document, titled Transforming your care, sets out initiatives which mirror those made in England in recent years. It says: "Changes should be supported by up-to-date technology to ensure vital information can be shared quickly among professional staff, duplication eliminated and that the latest diagnostic and treatment tools are available."

Telehealth combines new methods of patient care with technology in the home to help patients manage long-term conditions. It is part of a wider e-Health agenda aimed at harnessing information technology to improve health and deliver services more efficiently.

E-Health could revolutionise the way care is delivered. But many large-scale initiatives have collapsed under their own complexity.

"Many carers live in constant worry about the people they care for which can prevent them from sleeping, being able to get out of the house or stay in work," said Carers UK chief executive, Heléna Herklots. "Telecare and telehealth can play a transformative role in reducing carer stress and give them the peace of mind to take time for themselves, socialise or even enable them to work alongside caring. Yet a lack of advice, information and awareness about how to access telecare and telehealth mean that these potential benefits are not being realised for many."

The DH told GP it assumes at least two million telehealth users will save the NHS £70 to £543 each per year, mainly from fewer hospital admissions.

University of Hull telehealth expert David Barrett, who was shown the evidence, said rolling out enough telehealth devices to save this sum would be ‘exceptionally challenging’.

Patients using telehealth services visited their GP just as often as those receiving usual care, Nuffield Trust researchers found.

The findings suggest claims that telehealth can reduce demand on health services may only apply to secondary care.

Researchers writing in the BMJ said although telehealth reduced demands on NHS services, equipment costs outweighed savings and was not an effective use of NHS funds at current prices.

At 2009 equipment costs, the cost per quality-adjusted life year (QALY) was £92,000 - three times the level considered by NICE to be cost-effective.

The latest assessment of the Department of Health-funded “whole systems demonstrator” programme compared the cost effectiveness of patients using telehealth against a control group.

The paper, submitted to the British Medical Journal on March 22 by London School of Economics researchers, said: “Telehealth does not seem to be a cost effective addition to standard support and treatment.”

In a speech at a telecare conference yesterday, 'telehealth' and 'telecare' technologies, which aim to let people with long term conditions such as heart disease and diabetes to manage their illness largely from the premises of their homes, would benefit three million people by 2017.

Speaking at the King's Fund international congress on telehealth and telecare, Mr. Burstow said, "By keeping people out of hospital. by being far more targeted and efficient with the use of NHS resources, we estimate the widespread use of telecare and telehealth could save the NHS up to £1.2 billion over five years."

The findings come in spite of the national 3millionlives campaign by the Department of Health which aimed to increase knowledge of services which can help people manage their own conditions in a community setting.

The research, commissioned by the National Telehealth Forum - an independent body comprising patients, patient groups, commissioners, GPs, nurses, academics and industry bodies and charities - quizzed a representative sample of 2,066 adults in the UK and found 90 per cent had never heard of telehealth.

Telehealth has already helped to transform the way healthcare services are accessed and provided. For any healthcare organisation, patient care is the priority, and telehealth has proven to be a groundbreaking way of providing fast, high-quality and convenient care services.

Findings regarding the impact of telehealth technology used in a huge research programme called the “whole system demonstrator” were presented at the King’s Fund today. They revealed the cost per quality adjusted life year, including direct costs, was in the region of £80,000.

The QALY threshold used by the National Institute for Health and Clinical Excellence to determine the cost effectiveness of treatments is between £20,000 and £30,000.

Addressing the international congress for telehealth and telecare, health minister Paul Burstow said the NHS could save £1.2bn from the technology that would also help patients live more independently and control their own care.

David Cameron announced last year that three million people would benefit from an "industrial scale" rollout of NHS telehealth systems to homes across the country.

Around 100,000 people will be able to access telehealth services during 2013, health secretary Jeremy Hunt has announced in a speech to Age UK. The move is a part of an overall ambition to extend telehealth to three million people by 2017.

The project will be led in England by seven ‘pathfinders' - NHS and local authority organisations including clinical commissioning groups - which will agree contracts with industry suppliers:

• Worcestershire (3 CCGs and Worcestershire County Council)
• North Yorkshire & York and Humber PCT Cluster (will involved the CCGs as they develop)
• Kernow CCG and Cornwall & Isles of Scilly PCT
• NHS Kent & Medway (8 Kent CCGs, Kent Community Health Trust and Medway Unitary Authority)
• NHS Merseyside
• NHS South Yorkshire & Bassetlaw (Sheffield, Barnsley Rotherham Doncaster and Bassetlaw PCTs but will include CCGs as they develop)
• Camden CCG(with UCL Partners).

The roll out of telehealth technology, which the government said will support 3 million people with long term health conditions over the next five years, will be funded as part of the government's life sciences strategy.

Announcing the strategy, prime minister David Cameron said that the whole systems demonstrator (WSD) programme trial had been a big success and that the Department of Health would now implement the programme nationally. He highlighted the achievements of the technology in assisting patients such as diabetics in alerting themselves and doctors to changes in their vital signs.

Looking at data from 179 practices, researchers from the Nuffield Trust found no change in contact frequency between patients being remotely monitored and those receiving standard care.

This finding, published in Biomedcentral Health Services Research, flies in the face of fears that widespread use of such telehealth technologies could increase demands on primary care.

Research into the benefits that telehealth can bring has so far not fully convinced decision makers because the information is "still not absolutely clear", according to David Barrett, a lecturer in telehealth at the University of Hull.

The former nurse, who spoke at a recent telehealth conference held by the university, told Guardian Healthcare that better analysis is required if GPs, consultants and physicians are going to be persuaded to implement telehealth more widely.