Telehealth: a viable solution to NHS burdens?
Telehealth – or mobile monitoring – has been on the radar recently, and it’s perhaps little surprise given the growing pressures on the NHS to deliver from ever-tighter wallets.
By allowing patients to connect with healthcare specialists using video, email, text or phone conversations, the general premise is that Telehealth could reduce hospital admissions and help people to manage long-term conditions, while potentially cutting overall costs in the process. According to Safe Patient Systems, a quarter of people with long-term conditions account for 70% of NHS health and care costs each year; if they can be managed remotely, that could all change.
It’s already been trialled in several instances in the UK; under the DAWN project – launched in 2011 by the Health Foundation’s Shine programme – diabetic patients in Newham were offered Skype consultations in place of face-to-face appointments, and it produced positive results; almost two thirds signed up in the first ten months, and it saved time, with Skype appointments shown to be six minutes shorter than face-to-face meetings. It didn’t completely replace the need for in-person consultations, which were shown to be important for building trust, but researchers concluded that a combination of the two provided an effective service.
Meanwhile, text messaging service Flo has shown promising signs. Funded by the Health Foundation, the service is designed to help people manage their health by sending reminders to patients, and relaying their data back to the person in charge of their healthcare. It’s been introduced at over 70 health and social care organisations in the UK since it launched at NHS Stoke on Trent in 2010, reaching more than 30,000 people and spreading overseas too.
Other successful projects have seen follow-up text services being provided for recovering alcoholics (trialled at NHS Bolton in 2011) and remote telephone care for end-of-life patients wanting to stay in their own home (Airedale NHS Trust). ACT Now! – a series of web-based modules designed to lower levels of anxiety in depression in diabetic patients – was also shown to have positive results.
While all of this is encouraging, there are still barriers to overcome before it can have a wider impact, as Sophie Castle-Clarke, Health Policy Fellow at the Nuffield Trust, recognises. “In many places in the UK, patient uptake of remote consultations is low,” she says. “Patients and professionals are often also concerned about privacy – although some evidence suggests patients are willing to trade-off concerns about privacy and security for ease of access.”
There’s also the fact that some patients just aren’t willing to put all their trust in remote communication. And according to Sophie, Telehealth has been found to increase demand in certain instances, without actually impacting on in-person appointments.
But perhaps the only way of defeating these demons is by making Telehealth more of a norm – rolling it out across a greater number of health centres so that patients eventually come to trust it, and to use it as a proper alternative to face-to-face meetings. Telehealth might not be able to completely replace those meetings, but if it’s used in the right way, it could at least help stave off some of the avoidable admissions – and benefit both patients and the economy in the process.