IfG.CC -
Institute for eGovernment

Making judgments about telehealth soon after its luanch is like saying that Gareth Malone's choirs were hopeless after their first rehearsal, says Dick Vinegar.

This time last year, telehealth was riding high. On the back of the initial favourable report of the "Whole Systems Demonstrator" in Kent, Cornwall and West Ham, which tracked the progress of about 3,000 patients monitored by telehealth, the Department of Health launched its 3millionlives initiative.

Although few have heard of 'telehealth' and 'telecare', ministers are keen to increase use of these technologies, allow people with long term conditions like heart disease, diabetes and chronic obstructive pulmonary disorder (COPD) to manage their illness largely from home.

'Telehealth' systems enable patients to submit vital signs like blood pressure and glucose levels, and view treatment plans, to be interpreted remotely by doctors, meaning individuals do not have to constantly attend hospital appointments.

The announcement comes after early results of the world’s first RCT of the technologies suggested they could cut mortality by 45% and lead to a 21% fall in emergency admissions.

Telecare is the service which provides support to the elderly and vulnerable to live independent lives by providing home telephone monitors and buzzers which enable them to call for help in the case of an emergency.

Users pay a flat charge for use of the various monitors, ranging from £2.99 to £7.99 a week.

"It is like having my doctor sitting on my sofa," said the 64-year-old from Stoke-on-Trent in central England, explaining how her temperature, oxygen levels and sputum colour - a barometer for infection - are now checked daily from home.

She sends her readings by text message and gets a reply within minutes, removing the need for regular trips to the doctor.

The money – some £9.5m – has been earmarked to fund a new ‘Health Technology and Telehealth Fund,′ which the Welsh government hopes will build on other investment made in the region through the Health Technology Fund and Rural Health Innovation Fund.

The Telecare system allows vulnerable and sick residents to receive health advice and check-ups through a television or phone and can submit temperature, heart rate, blood pressure and other readings remotely.

By replacing routine home visits it was expected to save at least £7 million from the council’s care bill this year, as well as allowing older residents to live more independently.

Believed to be the largest city-wide deployment of telecare systems in the UK, the project is expected to help 25,000 patients through technology that allows people with long-term conditions to be remotely monitored from their home.

The Telehealth hub offers medical help via a high-quality secure video link. It is staffed by specialist nurses, who can assess patients as well as support the nursing home staff to provide any additional care.

The Counsel and Care guide explains the support that older people, their families and carers can get from the technology. It also gives information abut how choosing the best solution and how to get the technology.

The use of Telecare is on the rise with more than 160,000 using it in the last year. Telecare is available from local authorities and offers personalised solutions to suit people’s individual circumstances.

Surely, young doctors, like everybody else under the age of 25, are digital natives, and must be fed up with the clunky systems on offer in most hospitals. They must be longing to get hold of medical apps, to use on their iPods or iPads – which I am sure all of them have. They should be beating down their consultants' doors to persuade them to give them the technology they need to make their lives, and hopefully the lives of their patients, easier. But they don't seem to do this, or if they do, they are not very effective.

Last week, I expressed my disappointment with the King's Fund's International Telehealth and Telecare Conference. I am so upset that I am returning to the subject again.

For starters, I was amazed that there were only three GPs present. I found this strange, as telecare is likely to change the way GPs treat patients for ever. Or do GPs consider telehealth as just another irritating technology, like electronic patient records and email, which will go away if you ignore them long enough?

Telehealth has the potential to reduce hospitalisations and save lives. It also has an important role to play in caring for people against a challenging economic backdrop.

A report from the King's Fund (Transforming the Delivery of Health and Social Care) recently stated that the health and social care delivery system has failed to keep pace with the needs of an aging population, the changing burdens of disease and rising patient and public expectations.

Take, for instance, Haris Patel, 54, from Folkestone whose health conditions include problems caused by hardening of the arteries.

He said: “Before I had telehealth, I used to spend 10 months of each year in hospital. Since I got it, I have been in for two weeks in the last three years, and that was planned. Telehealth gives me peace of mind.”

A target of delivering between £15bn and £20bn in efficiency savings over the next four years has been set by the new operating framework for the NHS.

The announcement of the Whole System Demonstrator (WSD) results in early December 2011 highlighted that telehealth provides a unique opportunity to make significant financial savings when implemented for patients suffering with long-term conditions.

The high demand for NHS services, coupled with the news that people in the UK are continuing to live longer has led many primary care trusts and other NHS healthcare providers to investigate new ways of delivering care.

elehealth faces its moment of truth over the next few years. Championed by the English government, but questioned by critics over a perceived lack of evidence, it has become a divisive issue at a time of strangled budgets and pressured services.

As CCGs across England begin rolling out telehealth services, will the national drive be remembered as an essential innovation for a modern health service, or a flop like the National Programme for IT?

Eighteen homes will be linked up to the system on a trial basis in a bid to reduce hospital admissions and people using A&E. Calderdale and Huddersfield NHS Foundation Trust funded the installation.

The telehealth hub, run by Airedale NHS Foundation Trust’s specialist nurses, offers round-the-clock medical help via a secure video link.

Sutton Lodge residential home, in Sutton-in-Craven, Keighley, is the latest to be provided with the telemedicine service which has slashed hospital visits by the elderly and infirm.

The home is part of the Orchard Care Homes Group and is linked to a 24-hour service, provided seven days a week by the Telehealth Hub, based at the hospital.

Funding is being given on a trial basis for the next year by the Bradford City and Bradford District Clinical Commissioning Groups.

Gold Line – launched across Airedale, Wharfedale and Craven last November – provides round-the-clock help and advice to patients and their carers.