Telecare Soapbox: Credit Crunch and Telehealth

Andrew Hall, a Telehealth Entrepreneur in the UK, reflects on the potential effect of the financial crisis on the future of the market for remote patient monitoring telehealth.

Even when the cash flowed, investment in this technology has been startlingly low and ineffective. It is difficult to see how the new financial environment will improve that track record...

The immediate drivers for using more technology to improve social and health care are in demographics and higher cost per unit of care. As we enter the crucial period until 2050, we have all expected serious investment to release the potential of technology. However, our best laid plans have now been dented (smashed??) by the huge national debt we in the UK are suddenly facing. This debt is higher than after World War II. All political parties are slowly but surely becoming more open about the depth of service cuts that we face as a result.

Telecare Aware and its readers have often espoused integration of technology into mainstream service delivery and even more crucially, service planning. Undoubtedly, this is correct. My fear and expectation is that the situation will have to get a lot worse before any meaningful action is taken. Scotland is facing the reality of the cost of providing free social care. This is just the beginning for all of us.

However, this does seem to be the Western way of doing things: wait until the situation is desperate and then have a BIG solution. How many companies have ongoing efficiency programmes in times of growth? Most wait until a downturn, and then slash lots of jobs. How many of us do our tax returns at the last possible date, not months before? How many of us repair a roof before it leaks? Perhaps we should not be surprised that we are holding off using technology in healthcare.

There ARE places where continuous improvement and a positive appetite for change exist. In Japan, continuous improvement is generally expected. In parts of the automotive industry it is built into the way of working. In consumer marketing, it is the lifeblood of success.

The best way of accelerating the timetable for technology adoption in care is for whole services to be contracted out, and to embed mechanisms to ensure continuous improvement. These can be achieved by open book accounting (by both contracting parties), or contractual annual price reductions for example. Everyone wins: patient, service user, supplier and purchaser. Technology need not be specified in the contract, just the desired financial and care outcomes.

What services will you personally need in the next 40 years? Do you think they they will be provided in a way you would like? How, as a nation, do we have any chance of paying for those services given that we are now so deep in debt?

Given that we know the status quo cannot deliver meaningful change, we need to enlist new processes that can.

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