Is telehealth what we’ve all been waiting for?

by Leicestershire Health Informatics Service 29. September 2011 09:13

NHS health IT systems have been getting a bit of a bashing lately. They tend to feature in bad news stories in the media and the recent announcement by the Department of Health, that it is planning to breakup the National Programme for IT, hasn’t helped to improve their reputation. Which is why you may be surprised to hear that not all NHS health IT projects have been a disaster; in fact a number of them have significantly improved NHS services, including:

The Spine - a national database which provides hospitals with key health information about us in an emergency 

N3 - the NHS national broadband network which allows fast communications between hospitals, medical centres and GPs

NHS Mail - a secure email account for all NHS staff helping to keep our patient data safe

Choose and Book - the national electronic referral service gives patients a choice of place, date and time for their first outpatient appointment in a hospital

The Secondary Uses Services - provides access to anonymous patient-based data for healthcare planning

The Picture Archiving and Communications Service– which enables health professionals to acquire, store, retrieve, present and distribute medical images such as x-rays in a matter of minutes rather than days

The Electronic Prescription Service – the EPS is being rolled out right now and will enable GPs to send prescriptions electronically to a pharmacy of the patient's choice

Health IT can and does provide data, save costs, ensure information stays secure and improve services for patients - and those same qualities are what the latest health IT pioneers are looking for in their quest to move towards a greater use of telehealth in the NHS. Telehealth involves using technology to help people manage their health condition in their own home (as opposed to telecare which tends to be used to describe social care in the home provided by local authorities). 

NHS Yorkshire and the Humber is at the forefront of the UK’s latest advances in NHS telehealth provision. In their booklet Teleheath: leading innovation in healthcare they state that telehealth technologies can play a major role in delivering new models of care and enable patients to manage their health in their own home or community. Seen as a cost effective and innovative alternative to hospital and GP surgery attendance, telehealth is also being used in the north east in settings such as care homes and prisons. NHS Yorkshire and the Humber a running a range of different telehealth projects that are yet to be fully evaluated, but the results for one of them look very promising. Evaluation of the Hull Heart Failure Telehealth Project by the University of Hull suggests that by telemonitoring 140 patients with heart problems they are averting approximately 14 hospital admissions per month. This translates into substantial savings for the local NHS and massive improvements for patients who have not had to face the terrifying experience of being rushed to A&E with heart failure.

Interestingly more recent research into using telehealth to reduce hospitalization of patients with heart problems actually improves on the University of Hull data. The article Automated home telephone self-monitoring reduces hospitalization in patients with advanced heart failure, published in the Journal of Telemedicine and Telecare this month, compared hospitalisation form three groups of patients with advanced heart failure. One group of patients received usual care, another group received a multi-disciplinary team approach, and the group who were given home telephone self-monitoring had reduced levels hospitalization of around 50% when compared to both of the other groups.

But what we are all waiting for is the outcome of the largest randomised control trial of telecare and telehealth in the world to date. The results from the Whole System Demonstrator (WSD) Programme, a recent research project funded by the Department of Health, are under evaluation and expected to be published later this year. In the meanwhile you can read a quick intro to the project in their booklet, Whole Systems Demonstrators: An Overview of Telecare and Telehealth which details the equipment used in the telehealth trials including blood pressure monitors, weighing scales, pulse oximeters to measure blood oxygen levels and/or heart rate, blood glucometers to measure an individual’s blood sugar level and spirometers to measure the volume of air inhaled and exhaled by the lungs.

The WSD programme is a broad study exploring telehealth options for people with heart failure, diabetes and chronic obstructive pulmonary disease (COPD) – three of the common long-term conditions that affect millions of patients in the UK. People with long term conditions are the most frequent users of healthcare services. They account for 29 percent of the population, but use 50 percent of all GP appointments and 70 percent of all inpatient bed days. If telehealth can help them to manage their condition and reduce their need to visit their GP or be admitted to hospital, it could have a major impact on the NHS economy.

All in all, it’s starting to look more and more like telehealth could be exactly what patients and the NHS are looking for.  If the WSD programme results confirm the expected improvements in patient satisfaction, together with cost savings to the NHS, then expect to see telehealth coming to a living room near you soon! 

More telehealth links:

Telehealth stories

Telehealth story podcasts from patients and health professionals on the Patient Voices website

Mainstreaming telehealth to enable QIPP

A series of videos recorded at an NHS Confederation workshop in 2010 about how telehealth can help NHS organisations to meet their quality, innovation, productivity and prevention (QIPP) targets

 

6 of the best eHealth news sources

by Leicestershire Health Informatics Service 13. September 2011 15:50

There’s a lot going in ehealth these days and it’s not always easy to find the latest news, but the websites listed below can help. They are some of our favourite ehealth news sources – and we hope you find them useful too. But if you have any other ehealth websites or publications you’d like to recommend why not click on the comments link at the bottom of the blog post and tell us all about them…

British Journal of Healthcare Computing (BJHC)
The BJHC relaunched in January, with a brand new design, structure and focus. The new focus is on the medical benefits of information technology, presented through news, views and the practical experiences of the users of the technology. In March this year, the British Journal of Healthcare Computing joined so2say communications and the HealthTech Wire News Partner Network. This enables it to play a key role in presenting British news, views and experiences in healthcare IT across Europe′s largest online news network for health IT.

E-Health Insider (EHI)
A website with NHS and healthcare IT news and a jobs board dedicated to the recruitment of IT professionals in the UK healthcare sector. Currently campaigning for the development of a new role - chief clinical information officer - to provide clear clinical leadership on IT projects and the use of information in NHS organisations, which it believes will significantly improve the way the NHS harnesses information technology and uses information.

eHealthNews.eu
European ehealth news (web-based) publication that covers the European ehealth industrial and research sectors, promoting awareness of the latest trends, achievements and technology in the field.

Guardian Healthcare Network / Informatics
Analysis, news, comment and data, covering informatics/ICT issues. The Guardian Healthcare Network builds on the success of SmartHealthcare.com, which has covered health and social care informatics and ICT for the past two years. That site's archive, along with ongoing coverage of this important topic, can be found on the informatics pages.

Journal of the American Medical Informatics Association (JAMIA)
Includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA's articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education. 

Public Technology.net
Highlights the transformational impact of technology on front-line service delivery and back office efficiency through best practice, while providing thought-leadership, expert commentary and practical guidance in key strategic areas, such as cloud computing, shared services and supplier relationship management. It is the only public sector ICT online community to recognise and reward best practice through the annual UK Public Sector Digital Awards, supported by the Cabinet Office.

Seen this summer: resourcing and crowd sourcing health IT

by Leicestershire Health Informatics Service 1. September 2011 14:35

Health IT continues to move on at a fast pace, with new ideas for sourcing and connecting surfacing over the summer. Read about the latest developments below and discover how the public sector are using IT to improve services...

IT in Use

This is the only magazine to focus solely on the use of IT within local government and other frontline service organisations in the UK. An interesting read and useful resource IT in Use has the latest public sector technology news with a focus on the use of technology to both improve public service quality and reduce service delivery costs across central government, local government, police, fire and health. Available free on the UKAuthorITY.com website

Innovation Hub

DotGovLabs' Innovation Hub is a recent crowd sourcing initiative that aims to nurture digital innovation from outside government from the people who know digital.  It is the part of the Cabinet Office skunkworks programme that looks to ask the external community to show government what it should be doing with digital

The Hub website lists a number of social challenges that we as a society face and asks members of to put forward solutions to those challenges. It then asks the community to work together to bring these solutions to life.  If you have a great digital solution to one or more of the challenges listed you can post a solution. If another member has posted a solution that you are interested in contributing to you can comment. You can also vote on a solution by giving it a thumbs up or thumbs down.

Maps and apps

In August Health Secretary Andrew Lansley launched a call for new ideas for health apps that would help patients make informed decisions about their care.

Everyone, including patients, doctors, nurses and other health professionals and app developers, is invited to submit new ideas of health apps and online maps they think would be useful. One leading example of an app that benefits patients is Choosing Well, developed by NHS Yorkshire & Humber for their local community, which allows people to search for their nearest NHS health services.

As part of this drive for ideas, Andrew Lansley has also asked people to come forward and name their favourite existing health applications.

Over the next few weeks, people can visit the website and suggest favourite apps, ideas for apps or health maps they would like to see, as well as vote for their favourite ideas submitted by others.

Internet of things competition

You can find almost anything online these days – including the vital statistics of cows. A Dutch company called Sparked has created a sensor implant that can measure a cow's vital signs, with the data transmitted to a server for access by farmers, who can instantly determine the health of the herd and respond when an animal is sick or pregnant. The animals' movements, eating habits and response to environmental factors can also be monitored.

It may sound like the stuff of science fiction but these cyber cows are at the forefront of the evolution of the internet. In future, almost anything could be connected to the web via a sensor, radio frequency identification tag or IP address, forming an "Internet of Things" (IoT) that will make today's online world seem archaic in comparison.

The Technology Strategy Board is inviting companies to submit proposals for preparatory studies to explore, from a business and user perspective, the case for moving towards an Internet of Things and to develop strategies and plans to get there. They will award contracts of up to £50k to cover the total project costs. Lead businesses and their partners can be from any sector including healthcare.

Open date: 11 October 2011

Registration close date: 09 November 2011

Close date: 16 November 2011

About the author

Rupal Patel, Communication and Marketing Officer, blogging for NHS Leicestershire Health Informatics Service, your one-stop-shop for information management and technology. Writing about some of the work we do, discussing IT issues, introducing some of our terriffic staff and generally shedding a little light on the world of health informatics. Visit our website at: www.leics-his.nhs.uk

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