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

 

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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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