Among hundreds of debates on NHS reform, underpinning them all is the agreed concern of revolutionising the way healthcare is delivered. Technology can kickstart the revolution, but it requires change at every level – from the patient to the most senior decision makers, says Microsoft sales director John Gobron.
To trigger real change in the NHS we need to enable patients to take their place at the heart of the health system as an informed decision maker and active participant in their wellness. Technology has the potential to act as the trigger and many in the industry are acknowledging that telehealth can be part of the solution for healthcare reform.
Despite the rise in demand for new delivery models, web-based healthcare tools have lagged behind other industries, such as retail and travel. Telehealth is one of the most notable areas of technological development which has been held out as a potential answer to many of the current problems of the healthcare industry. This view is supported by health secretary Andrew Lansley. At the recent HC2011 informatics conference in Birmingham, Lansley said ICT-driven techniques; including telehealth, mobile computing and access to data, will enable the NHS to improve its record on quality and efficiency.
Telehealth spans a myriad of technologies, but at its most basic allows the delivery of health-related services and information via telecommunications technologies. Within one generation, telecommunications have changed almost every dimension of our lives, and telehealth is its application in healthcare. In order for it to take hold, telehealth must finally deliver the positive transformation that has accompanied the move of other consumer activities online.
Dr Richard Pope, a consultant diabetologist and former medical director at Airedale Trust in West Yorkshire, has experienced first-hand how advanced technologies in healthcare can allow health professionals to work differently, as it narrows the gap between patient and doctor.
Speaking at a recent health conference in Manchester, Dr Pope discussed the work they’ve done over the past six years for the prison service, where they are now delivering secondary care advice – both in an urgent (A&E) and outpatient context. From their work in prisons, two thirds of the cases they were being asked to see for outpatient opinions were dealt with remotely and, in the A&E context – a much more acute problem – approximately 50 per cent of cases were dealt with remotely.
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To be able to actually see the patient, as opposed to only data, makes a real different. The visual element of delivering remote care is incredibly important; as not only does it give a doctor an accurate picture of an individual’s medical condition or state, it also allows them to monitor the patient’s environment and level of comfort and allows them to make more confident decisions. These circumstantial factors play an important part in the diagnoses and treatment of patients.
While telehealth technologies are not the right solution for every scenario, for most specialities it’s a very effective way of delivering a consultant opinion to somebody at a remote location. And in doing so, it shortens the pathway, taking costs out of the system. Telehealth also reduces the high number of avoidable admissions in hospitals, nursing homes and other health organisations; as well as plays a crucial role in pre and post op checks, early support discharge and reducing cost for both the patient and the hospital.
While the UK healthcare sector is playing catch-up to other industries when it comes to technological advancements, it is not – and does not need to be – a difficult process. Hospitals can deliver virtual consultations through both a telemedicine route and care planning as a different style of consultation.
We have already seen proof of telehealth’s cost effectiveness from deployments of HealthVault in the US. One project involved physicians managing patients with diabetes, heart failure and hypertension. Clinic patients used blood pressure monitors, glucometers and heart rate monitors at home, each of which uploaded data to the patients’ HealthVault personal health records that connected to their electronic health records at the clinic. The project found that patients’ control of their conditions improved, resulting in a reduced average number of days between patients’ visits to physicians.
However, telehealth should not be seen as a replacement for the relationship between a patient and doctor, but is ideal for a defined scope of medical care. It needs to be portrayed clearly as such to remove ambiguity and unrealistic expectations.
Patient engagement with care providers will always remain a critical part of the health environment and, even with its increasingly high-definition audiovisual capabilities, telehealth does not replace a hands-on examination. It thus requires physicians to exercise different clinical judgement on the care they render.
But telehealth can enable seamless care coordination across a range of specialty providers where many gaps are present today. They can allow a team of care providers to collaborate – in real time – on a patient’s behalf to improve care, remove potential communication gaps and drive down costs.
Significant time and attention is being directed towards developing the future of healthcare. People are ready for this. Health organisations are ready for this; and the technology has long been ready and available. This is an opportunity for the NHS to adapt to much needed change quickly, to ultimately deliver real benefits to patients and the UK health sector as a whole.