interviews

Seizing the opportunity

Trevor Single, CEO of the Telecare Services Association (TSA), is adamant that mobile technology will “revolutionise” the way telecare and telehealth are delivered.

Detailed academic analysis of the results of the Whole System Demonstrator Programme are not yet available, but the headline findings are clearly very promising.

The Department of Health’s release of the initial results says: “The early indications show that if used correctly telehealth can deliver a 15% reduction in A&E visits, a 20% reduction in emergency admissions, a 14% reduction in elective admissions, a 14% reduction in bed days and an 8% reduction in tariff costs. More strikingly they also demonstrate a 45% reduction in mortality rates.”

Care services minister Paul Burstow has called those figures “staggering and quite unexpected” – though there has also been much debate over the complexity of the WSD programme, difficulties in comparing the data gathered, and the sheer number of variables involved in attempting scientific studies into the costs and benefits of telehealth and telecare.

The results of the telecare elements of the WSD are still awaited, and the Department of Health has said the detailed academic studies into the results will be released over the coming “months and years”.

But throughout the NHS, pilots have been taking place using new telecare technologies, with their own results – including mobile telecare, as explained 46-47.

Trevor Single, CEO of the Telecare Services Association (TSA), is an advocate of any new technology that improves the prospects for telemedicine for patients and commissioners, and mobile technology is no exception.

He told NHE: “At the moment, services are very dependent on fixed line into the home for the patient or user, but mobile technology and mobile applications have the means of moving beyond the physical home of the user, and allowing greater interaction and freedom. The whole point about telecare in particular is about enabling increased independence and addressing the risks and needs of that individual, as well as managing long-term health conditions.

“Anything that enhances their quality of life is very much something we’d be keen to see prosper within the market.”

Not just at home

There have been concerns raised in the past with telemedicine solutions that technology in the home can actually increase social isolation, as people have fewer reasons to get out and about. But Single said mobile telemedicine is a definite boost for quality of life.

He said: “Interestingly, the Whole System Demonstrator has said there is no net negative impact in terms of people’s quality of life. So the ability of people to be able to use technology to promote their independence and to enable that is something we should be encouraging as far as possible.”

Another concern raised by some patients has been a feeling that telehealth and telecare are ultimately about saving public money, whether or not it’s in the patient’s interest.

But Single said: “I don’t agree with that at all. What the results have indicated, and if you do speak to patients and users, many of them are incredibly positive about the impact it has on their life and them being able to manage their conditions.

“It has always been the view that technology is not appropriate for everybody, and that’s come out in terms of the Stan Newman approach, which is why ‘3millionlives’ was formed. It is all about addressing the three million people for whom this can have a significant positive impact, not looking at all the 15 millionplus people with long-term conditions. Not all of those cases are going to be suitable for technology, either because of the individual – their preference might be face-to-face rather than using this – but that technology is an enabler for very many patients and users.

“We should seize the opportunities it provides.”

The TSA is one of four trade associations that provided seed funding for 3millionlives, which has recently had financial resources committed by 15 companies (see side panel).

Dignity

Burstow has suggested that the new approach could save the NHS up to £1.2bn over five years: but insisted that the technology is ultimately about letting people live independent lives and control their own care.

This was one of his key messages at the International Congress on Telehealth and Telecare 2012 in March, organised by The King’s Fund and the University Medical Center Utrecht.

He said: “This new approach is not about the technology, it is about a revolution in personalised healthcare that can improve the lives of three million people, increase their independence and dignity as well as reduce the time they spend in hospital.” Single praised Burstow on this point, saying: “Precisely. The technology is the enabler, and should very much be in the background. What we’re talking about is how we can promote greater independence: patients being able to take greater control, and get more information on their health and wellbeing.”

He admitted the potential downside to mobile telecare is having to ensure network coverage, particularly in an emergency, but noted that fixed line telephones don’t have 100% coverage or reliability either.

He said: “As long as people are aware – and they are, in terms of their mobiles – of the scope of the coverage and networks, this is an enhancement to their life, not a detriment. But you have to be aware that there are some potential downsides.”

Intelligent customers

He said that promoting mobile telecare should be done in the same way as the broader push for telemedicine solutions: not relying just on Government or industry or commissioners, but forming effective partnership.

He told NHE: “There is no one body or sector that is responsible for taking this forward. It has to be a partnership approach.

“Certainly, that’s the message we’ve been promoting through ‘3millionlives’; there is the partnership between the Department of Health and industry, but it’s also recognised that we need to get commissioners on board, and get GPs and clinicians on board.

“They’ve got to be intelligent customers of the services and technologies available to them. Part of that is very much about industry bringing them case studies and raising awareness of what the technologies are and how they can address particular issues and requirements.”

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