IfG.CC -
Institute for eGovernment

Telehealth isn't new, it's been around since a doctor first carried out a telephone consultation with a patient, because the definition is simply the use of telecommunication technologies to provide health care services.

A report published by the institute today said some district nursing teams had already made significant changes to their practice as a result of new technology but others lagged behind.

It acknowledged that this variation in uptake existed because some nurses were worried that devices allowing remote consultations or measurements could damage their relationships with patients, or increase their isolation.

Patients who suffer long-term conditions make up 31% of the population, but approximately 69% of all primary and acute care budgets in England are spent on them. 5% of patients who have one or more long-term conditions account for 49% of all inpatient bed days. Managing the long-term health care needs of patients with long-term conditions in the context of an NHS facing efficiency targets will be particularly challenging. One method that is being considered and trialled is the introduction of telehealth programmes across the UK – a process that began in 2006 following a Department of Health paper that proposed telehealth within a whole system redesign of health and social care for people with long-term needs.

We hired what we call ‘primary care liaison officers', local people, often volunteers, from the community who we paid to befriend the patient, be their advocate and help them use the telehealth technology. This meant patients had a single point of contact and weren't isolated.

NHS Somerset has begun rolling out telehealth equipment to thousands of its patients as part of a scheme that will allow them to monitor long-term health conditions from home.

As part of a three-year, £1.2m contract, 4,000 NHS patients with chronic obstructive pulmonary disease (COPD), heart disease and diabetes will be able to monitor their health and vital signs remotely.

The pilot program debuted this week with its first clinic in Stornoway, and is slated to run another six months, officials told the Stornoway Gazette. Patients who participate in the virtual visits will later be seen on the mainland, re-evaluated, and the results compared to determine the telehealth options' efficacy.

Telehealth was thrown into the spotlight yesterday at the Health and Care Innovation Expo, where a panel of experts discussed its potential and asked the question - has it been too focused on technology?

The survey which was sent out to patients across 80 GP practices in Gloucestershire, asked each patient a series of questions about the impact of telehealth on the management of their health condition.

An increasing number of telehealth and telecare devices and facilities have become available over the last few years and there have been many well publicised success stories. The Department for Health was slow to show an interest but in 2008 it launched the world’s largest randomised control trial involving 6191 participants and 238 GP practices across three locations in Cornwall, Kent and Newham.

I can foresee an increased role for telehealth with the vision for merging health and social care.

Many patients who use telehealth systems feel that they are receiving a greater level of care from someone they can call on if needed.

Telehealth technology seems to be quite useful for patients and especially elderly people. If one uses this scheme then he does not need to step out of his house and get vital health checkups done through electronic equipments at home and its results would be sent electronically to respective GPs.

Introduced by the Prime Minister, the government's new Life Sciences Prospectus aimed to develop a "world-leading system in technology adoption". It said that the government was committed to removing barriers to technology adoption and diffusion in the health service and that telehealth systems would be widely rolled out.

The findings follow a BMJ study published last month showing that telehealth does not improve quality of life for patients with long term conditions.

Telehealth uses technology to help people with health problems live more independently at home. For example, blood pressure or blood glucose levels can be measured at home and electronically transmitted to a health professional, reducing the need for hospital visits.

An international team led by researchers at the Nuffield Trust have pored over the data generated from the 2009-10 trials at three sites in Cornwall, Kent and the London Borough of Newham to assess the impact of telehealth on hospital use for 3,230 patients with long term conditions (diabetes, chronic obstructive pulmonary disease or heart failure).

In the survey of 316 GPs, 61% said telehealth did not have the potential to improve the care they gave to patients, with a further 17% unsure.

Only 22% said they believed the technologies can enhance patient care.

Few people working in the highly charged world of healthcare will be surprised – or sad – to learn that the 3millionlives group has been disbanded. Since its inception in 2011, despite its original claim that three million people could benefit from the informed and appropriate use of telehealth, the widely held view is that any significant added value and health improvement has not yet been achieved.

Despite the academic rubbishing of Telehealth by the negative reports on the Telehealth Whole Systems Demonstrator, there are a number of small scale telehealth initiatives which announce spectacular successes like 45% drops in hospital admissions, 30% reductions in length-of-stay and 60% fewer bed days.

Every year, more than 200 infants are born in Northern Ireland with heart disease. I work at the Royal Belfast hospital for sick children and as specialists in paediatric cardiology, we deal with a majority of these cases. For the past few years we've been supplementing our traditional care with a telemedicine scheme that offers patients, parents and our colleagues a new way to interact.

Like thousands of hospital departments across the UK, we deal with resourcing difficulties. Not only do we cope with our current patient load but our expertise is also in high demand with colleagues at other hospitals.

The findings come as the Department of Health confirmed the full results of their Whole Systems Demonstrator Project will be published shortly in the BMJ, after criticism that it had not published the full results.

The study is a further blow to ambitious DH plans to increase the use of telemedicine in the NHS to save the health service up to £1.2bn over five years.

What is telemedicine?

Telehealth care enables patients to monitor their conditions using mobile technology. According to health minister Andrew Lansley, around 80% of face-to-face interactions with the NHS are unnecessary. Moving just 1% of those meetings online would save the health service around £250m a year, claims the minister for health.