Telehealth or telecare in health may soon allow people with long term conditions like heart disease, diabetes and chronic obstructive pulmonary disorder (COPD) to manage their illness largely from home feel authorities.
The 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. Telecare equipment enable vulnerable people to live at home longer, for example personal pendant alarms they can activate if in trouble.
In December the Prime Minister said he wanted such technology rolled out on an “industrial scale”, after a Department of Health study of 6,000 patients showed it cut accident and emergency visits by 15 per cent, emergency admissions by 20 per cent, and mortality rates by 45 per cent.
Paul Burstow, the care services minister, has indicated that he would like to see telehealth and telecare services provided to the NHS without the need for up-front capital payments. Yesterday Mr. Burstow described those findings as “staggering”. He said, “By keeping people out of hospital, by reducing the time they’re there when they have to be and 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 projected saving is based on extrapolating the trial's results to cover the three million people that officials believe could benefit.
Speaking at a conference on the subject at The King's Fund, a think-tank, he noted that seven in 10 hospital beds were filled by people with long-term conditions. About 15 million people currently have such a condition, a number that is rising fast as the population ages.
Burstow said a community nurse supervisor should be able to pay for a blood pressure monitor through a monthly contract, in a similar way to that in which people pay for iPhones or Blackberrys.
Mr Burstow the focus is to be on helping “local providers” get the equipment they think they need. Mr Burstow conceded there were “some substantial initial costs”. Hospitals, local health authorities and GPs' groups might well think twice about buying into such technology, in such hard times.
Such a strategy is already used in Gloucestershire, where the NHS is working with provider Tunstall. The company covers the up-front costs, such as clinical engagement, pathway redesign and training, and supplies NHS Gloucestershire on a per patient per month basis. “NHS Gloucester avoids the need for large scale up-front costs, and it enables the supplier to build relationships with patients and customers that it otherwise would not have,” the minister said.
Burstow also predicted that in time the cost of the telehealth and telecare technologies will start to fall. “Costs in the UK are significantly higher than they are in the US, and it is no wonder because in the current situation we have only 6,000 users, compared to 10 times that number in the veterans' association in the US,” said Burstow. “That is why we are looking at promoting our campaign, “3millionlives”, why we want to grow this rapidly.”
One of the principal challenges to the large scale take up of telehealth and telecare is broadband capacity, said Burstow, particularly because many of those who stand to benefit from the technologies live in rural areas where broadband provision is worst, although the government has earmarked £530m of funding to improve the situation.
There are also issues, according to Burstow, with NHS and social carestaff not having sufficient skills and understanding about telehealth and telecare. There are also fears the drive could marginalize elderly people - either because they do not want to use it; or because they do, but end up losing out on face-to-face contact with medical staff.
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