Concern as research reveals use of telehealth technologies does not reduce reliance on primary care services
The long-term success of telehealth services depends on the NHS redesigning the way it delivers care, a new study warns.
Analysis of the Government-backed Whole Systems Demonstrator (WSD) study by the Nuffield Trust shows no change in the number of times patients using telehealth systems contact healthcare professionals.
The findings appear go some way to allaying fears that assistive technologies could increase demands on primary care, but they also fail to support the Government’s claim that the widespread rollout of systems will lead to a significant cut in GPs’ workloads.
Remote monitoring technology alone is unlikely to transform care and service utilisation. However, the appropriate use of technology in a well-understood and researched patient pathway can make a huge difference
However, the authors of the research, which was published in Biomedcentral Health Services Research, did note that telehealth could have a different effect on workload if current systems were designed differently.
They said the findings showed \'fears that the widespread increase in the use of this technology may increase the burden on primary care are unfounded’. But they added: “Conversely, we did not find evidence that telehealth led to a significant reduction in GP workload.”
The study looked at data from 179 practices and found no change in contact frequency between patients being remotely monitored through telehealth technologies and those receiving standard care.
Graeme Duncan, group director of strategy and marketing for Healthcare at Home, said the findings tell ‘only tell half a story’. He added: “I am not surprised that some observations show that technology alone seems to make no demonstrable difference to service utilisation. Remote monitoring technology alone is unlikely to transform care and service utilisation. However, the appropriate use of technology in a well-understood and researched patient pathway can make a huge difference.”
This supports the authors’ view that the Government’s telehealth mission will only succeed if NHS pathways change dramatically.
For example, during the research period the frequency with which clinical measurements such as weight and blood oxygen were taken by GP practice staff remained unchanged between the study and control groups. This was despite the fact patients in the telehealth group were recording their own similar measurements up to five times a week.
“This may indicate scope to improve the integration of information systems and care between the telehealth intervention and general practice and thus reduce some of the workload,” the researchers said.
When the results of the WSD were published in 2011, they claimed that, if used properly, teleheallth can deliver reductions of 20% in emergency hospital admissions, 8% in tariff costs and 45% in mortality rates.
However, since those findings follow-up research has thrown doubt on the true impact this sort of technology can have.
This may indicate scope to improve the integration of information systems and care between the telehealth intervention and general practice and thus reduce some of the workload
In March this year, a report by Stanton Newman and colleagues published in the British Medical Journal found that those assigned telehealth had similar outcomes after 12 months to those assigned to usual care when comparing depression and anxiety symptoms. And, in January, analyst, Tola Sargeant, warned that barriers to adoption would prevent the Government’s plan to roll out technology to three million patients suffering from long-term medical conditions. These barriers included a lack of central funding and a lack of evidence and conflicting evidence of efficacy.
Commenting on the latest research, Firas Sarhan, director of the Centre of Excellence for Telehealth and Assisted Living, said that patients being more aware of changes in their health would ultimately impact on their need to access services, adding: “Telehealth will help to early identify changes in individuals’ health and wellbeing, which leads to early intervention, preventing complications and reducing access to healthcare, either general practice or hospital acute services.
“It will also help patients to be more involved in their healthcare and become aware of changes which could warrant appropriate use of health services, leading to a more-effective use of time.”
And the Department of Health remains confident in the potential of telehealth, continuing to support the mass rollout of systems across the country by 2017.