Will GPs take telehealth into the mainstream?

The Government has linked medical technologies such as telehealth with the potential to improve quality and efficiency in the NHS. But can it truly provide GP clinical commissioning groups with the means to improve outcomes and achieve vital cash savings? MARK AYTON , managing director of Honeywell HomMed UK, evaluates the potential opportunities

The high demand for NHS services, coupled with the news that people in the UK are continuing to live longer has led many primary care trusts and other NHS healthcare providers to investigate new ways of delivering care.

Realising the potential benefits - particularly for treating sufferers of long-term conditions (LTCs) - many NHS trusts have now pioneered investment in telehealth technology, which has continued to achieve a rapidly-growing user base and has proven, in many cases, to successfully reduce the cost of patient care and clinician time in patient management.

As commissioning responsibilities move to clinical commissioning groups, it is clear that telehealth could have massive potential, not only to improve patient outcomes but also to achieve crucial financial savings

The Government too seems to be convinced about the continuing immediate and future potential for telehealth. Speaking at the recent HC2011informatics Conference in Birmingham, Health Secretary Andrew Lansley spoke of his belief that ICT-driven techniques, including telehealth, mobile computing and access to data, will enable the NHS to improve its record on quality and efficiency.

Now, as commissioning responsibilities move to clinical commissioning groups, it is clear that telehealth could have massive potential, not only to improve patient outcomes but also to achieve crucial financial savings.

The rural programme

Telehealth has the potential to offer GPs a practical solution to meeting the needs of rural patients and improving their clinical outcomes

Experience shows that the key to success for telehealth is collaboration, making it essential to secure the support of all clinicians and patients involved. One such service, now underway in western Cheshire, began with the joint involvement of family doctors working in rural areas, specialist nurses, community matrons and patients. The primary goals of the pilot scheme are to reduce avoidable hospital admissions as well as improve patient outcomes.

Plans are also now underway to run a second scheme involving three rural practices serving people in a wide geographical area. Lancashire-based firm, SeniorLink Eldercare, is to install up to 25 HomMed monitors, which will be used by patients with long-term conditions such as heart failure and chronic obstructive pulmonary disease (COPD) to identify early signs of deterioration in the patient's condition and offer additional clinical support.

Telehealth schemes are about looking after people in their own homes and better enabling them to look after themselves

"Funding for the monitors in the scheme was approved by the Health and Well Being Board, with the main goal of improving the quality of life for patients with long-term conditions," says Charlotte Walton, commissioning manager for adult social care and health at Cheshire West and Chester Council. "Our current focus is to identify how and where telehealth can support pathway redesign. To date, patient feedback has been extremely positive."

Dr Steve Pomfret, chairman of the West Cheshire Rural Locality Group involved in the pilot scheme spoke of the further potential advantage of delivering care in the domestic environment: He said: "Telehealth has the potential to offer GPs a practical solution to meeting the needs of rural patients and improving their clinical outcomes. This pilot will be an opportunity to test this in rural practices that stand to benefit most from this technology."

Solid experience

Statistical data gathered in a variety of trials and established schemes supports not only the patient gains, but also the financial savings that can be achieved through successful telehealth application. Birmingham-based OwnHealth, a joint venture between NHS Direct, Pfizer Health Solutions and NHS Birmingham East and North, is a sound example of the achievable financial savings.

The NHS has to look for new ways to care for people as it does not have infinite resources to manage people. This is what the future of the NHS looks like

Before the telehealth monitors were installed, the 74 patients involved in the scheme who had used telehealth for more than one year had, in total, 175 admissions and spent 1,353 days in hospital, at a cost of £348,000. After the implementation of the technology, the group collectively amassed 24 admissions, and 291 days in hospital, at a cost of just £72,000.

Gill Stewart, director of operations at NHS Direct, is among the many in the industry who believe that telehealth should become more prevalent in the future - for the sake of both patients and the NHS. She said: "Telehealth schemes are about looking after people in their own homes and better enabling them to look after themselves. As a result, they typically do not have to go to A&E or see their GPs as frequently. The NHS has to look for new ways to care for people as it does not have infinite resources to manage people. This is what the future of the NHS looks like."

The GP Agenda

There is no doubt that, as telehealth providers and commissioners of the future, GPs will play a crucial part in mainstreaming telehealth. Yet there is still some way to go before the financial and patient benefits associated with the technology are accepted by the UK's broad GP community.

At a time when GPs are being obliged to shoulder greater responsibility than ever before for patient care, it’s clear that ignoring the potential benefits that telehealth has to offer could prove to be an even greater gamble than exploring the potential opportunities that the technology may bring

Family doctors have every reason to explore and engage in telehealth – not least for the sake of their own budgets. The remote aspect of home monitoring provides vital information and early-warning signs while also reducing the need for costly GP call-outs at weekends and hospitalisation. For GP consortia facing the prospect of managing caseloads of patients with LTCs, the potential return on investment is considerable.

Community-based care

Significantly, however, it is patients who have the potential to benefit the most from telehealth. The reassurance that being monitored remotely on a regular basis brings can be significant in reducing health service costs such as emergency admissions and re-admissions. And, through the early identification of an impending uplift in a patient’s parameters, a clinician can decide the right course of action, from changing medication through to admission to hospital.

Family doctors have every reason to explore and engage in telehealth – not least for the sake of their own budgets

In the medical sphere just as any other, technology has an important role to play in changing the future. Now, at a time when GPs are being obliged to shoulder greater responsibility than ever before for patient care, it’s clear that ignoring the potential benefits that telehealth has to offer could prove to be an even greater gamble than exploring the potential opportunities that the technology may bring.