A database of telehealth and telecare services and projects in Scotland has been developed and made available as a public resource. For any given project included in the database it gives the organizations behind the project, a brief description, the type of users targetted and the technology used.
Developed by the Scottish Centre for Telehealth and Telecare (SCTT) the database can be searched online, say, to pick up all diabetes related projects in the database. One purpose of the database is to help the SCTT to review the uptake of technology used to deliver care.
SCTT is a part of NHS 24, which was established by the Scottish Government in 2001. NHS 24 is responsible for the delivery of clinical assessment and triage, health advice and information by telephone and online means in Scotland 24 hours a day all year round.
The database can be accessed here and further information on NHS 24 can be obtained here.
The video-link/ videoconferencing system used by Airedale NHS Foundation Trust in Yorkshire, England, to provide remote medical assistance is being rolled out to additoinal care home sites. The service is staffed by a specialist nurse at Airedale General Hospital who uses the system, known as the Telehealth Hub, to assess patients and support staff at the homes.
According to the Keighley News the service was installed in a Bradford nursing home with the first use on New Year’s Eve. Staff at Ashville Care Home are quoted as saying that the service allows their residents to receive medical care without having to call a GP out or take them into hospital. A hospital visit would mean having to get extra cover as a member of staff needs to go as well.
Meanwhile the Telegraph & Argus reports (more…)
With the Government’s Care Bill currently working its way through the UK parliament, a discussion paper has been published showing that over the past five years the Councils have reduced the number of people with “moderate needs” receiving Council funded care by one third. The paper, produced by the Personal Social Services Research Unit at the University of Kent and the London School of Economics, paints a dire picture of how budget cuts have squeezed Councils into cutting the number of people eligible for care.
Fair Access to Care Services guidelines were introduced in the UK in 2003 in an attempt to provide a common framework for eligibility for state funded care services (more…)
It is usually the large scale telehealth and telecare projects that hit the news, be it for their successes or, indeed, failures. So as the new year starts, let’s celebrate a couple of smaller scale projects which have made progress recently.
From Coldwater, Michigan, we have a student telehealth scheme opening this month. With significant funding from the Michigan Department of Community Health, clinics will be opened in two schools in Branch County to provide primary healthcare services from a central Adolescent and Pediatric Center which has four physicians and a nurse practioner. A school based nurse provides physical assessment of students in need and, if appropriate, links via video to the Center to consult a physician or the nurse practitioner. Diagnostic equipment at the schools are also networked so the Center staff have access to these in real time. Prescriptions, if needed are sent direct to a convenient pharmacy. The state funding provides the majority of costs for equipment, a nurse at each school and operation for 3 years. See Branch County CHC website for more details.
From the other side of the Atlantic, in Doncaster, England, the local council’s telecare service reported that it has reached its 1,000th user. Doncaster’s service povides access to a comprehensive range of sensors from simple fall detectors to other sensors placed discreetly around the home on ceilings, doors, walls, beds and chairs. The 24-hour monitoring service attracts a weekly charge under £4 and there is no charge for the equipment. The benefit to the user is obvious and the Council benefits too, as it has an obligation to provide care services to residents who are unable to live at home.
A very interesting article in The Guardian (UK) on Monday (16 December) that argues for small scale telehealth implementations. Dick Vinegar (aka the Patient from Hell) reports in the article from a telehealth conference organised by the Health Service Journal last month where some examples of successful small scale implementations were (more…)
Five months after pulling out of the telehealth market in the UK, Spain’s Telefonica has struck a partnership to develop eHealth solutions. In a recent press release
Telefonica announced a “global partnership agreement” with Capita “to deploy innovative communications and telehealth technologies”. According to the release Telefonica is set to enhance its portfolio of eHealth services with clinical content.
One of the three criteria for choosing Capita as its partner is stated as Capita’s NHS Direct website for the UK Department of Health. However, the same NHS Direct service was said by a Department of Health spokesman earlier this year to have “struggled to meet the standards required” (more…)
Maximising independence, managing costs: reablement and telecare in the evolving public health landscape is a conference taking place in London on 13th November 2013. The conference is organised by Pavilion Publishing and Media. Speakers from local government, academia and private sector have been announced. Further details from the Pavilion Publishing website here.
The July Telecare LIN newsletter has been published and is available for download here. This month Mike has two short items on the Kings Fund congress earlier in the month and the transfer of 3ML from DH to NHS England plus the usual monthly round up of news with the top item being O2’s pull out from telecare and telehealth.
Diabetes in pregnant women, known as gestational diabetes, is said to have significantly increased over the past 20 years and affects 1 in 20 pregnant women in the UK. This is probably caused by an excess intake of carbohydrates, says Dr Lucy Mackillop of John Radcliffe Hospital, in an interview in Inside Health on BBC Radio 4, broadcast on 23 July 2013.
A foetus growing in a high sugar environment can lead to an overweight baby resulting in birth difficulties. Such babies may also develop problems such as diabetes in later life. Gestational diabetes also carries all the usual dangers of diabetes for mother.
If a pregnant woman has one of 5 risk factors she will be fully tested for diabetes and if she is diabetic, she will be monitored during preganancy. Monitoring typically may be a fortnightly hospital visit, but at the John Radcliffe there is a trial of 50 mothers who have been given special blood sugar meters which connect to smart phones via Bluetooth.
A daily blood sugar test result is transmitted to the hospital where software picks out patients that may need attention by a midwife, and changes to the treatment regime can be implemented if necessary. This saves many unnecessary hospital visits while giving a much more frequent review of the state of the patients.
Download the full programme from the BBC Radio 4 podcast page.
Out now, the February edition of the Telecare LIN newsletter. It, together with the separate supplement, contains “over 1200 news and events links over the last month” and a reminder that if you have not registered for the ALIP showcase event in Liverpool on 5/6 March or the Healthcare Innovation Expo on 13/14 March you need to act quickly. The newsletter has more details. PDF newsletter. Links supplement. NHS reforms supplement.
The British Medical Association’s (BMA) General Practitioners Committee (GPC) has written to the Department of Health (DH) with an analysis of the results of a consultation exercise and the surveying it has done to assess GPs’ views on the effect the forthcoming changes to their contract will have on their services. The relevant points for people who wish to promote telehealth remote monitoring are paragraphs 47 – 55, starting on page 13 of the BMA’s letter to DH. (PDF) Basically they are saying ‘It’s too difficult; we don’t believe it helps ease our work or that patients like it; so we can’t be bothered and please re-think making us do it.”
However, this reaction has to be seen in the context of the response as a whole. The BMA (as the doctors’ ‘union’), has a particular need to spin the results in the most negative way and the survey was undertaken at a time when GPs’ morale has been low and, on page 1, the BMA summarises the complete findings as:
“An overwhelming 88% of GPs responding to our survey with some awareness of the proposed contract imposition agreed with the statement that they personally will be less able to offer good quality care to their patients as a result of this imposition. Of the 58% of GPs who said they were prepared to take action and who expected to make changes as a result of the imposition:
54% said they expected their practice to have to reduce access to patients.
– 91% of these said that GPs would not be able to see patients for routine appointments as quickly as they currently do
– 72% thought they would have to reduce the number of consultations offered to free up time for the new workload
– 75% expected to reduce the range of services offered to patients.
82% expected to have to make changes to staff working hours or employment
52% expected to reduce their use of locums
Heads-up thanks to Mike Burton.
This important report was published last Friday. Like this editor, readers will surely thank the authors for making such a disparate mixture of elements readable and for picking their way through the implications for the 3ML campaign as well as the many clinical commissioning groups (CCGs) which will take over the reins (or should that be pick up the pieces?) of the NHS across England and Wales in April.
I’m not going to attempt to summarise the report. The four-page Executive Summary contains three tables of essential findings and is the place to start. Despite, or perhaps because of, the general failure of the Telehealth Hub to achieve wider adoption locally, some significant lessons have been learned. TTA readers will, no doubt, comment on those lessons as they see them. Perhaps we should regard the work done by the Hub as a precursor to that which will be done by the 3ML Pathfinder sites. Let’s hope that they are studying this report closely and take note of this key comment by one of the Hub partners:
“When I look at the aims expressed, what strikes me is the ‘tele’ not the condition. We would write these aims differently now – whether because of learning or the fact that the environment changes. The risk now is that local CCGs only think in terms of local pathways and not the wider patient needs.”
The 2020Health evaluation of the Yorkshire ‘Telehealth Hub’ project can be downloaded from the 2020health press release Telehealth does produce savings.
Oh, and for any non-UK readers who may be confused by ‘Yorkshire’ in the title, the area covered by the Hub does not include North Yorkshire and York (NYY) which has famously failed to scale up its telehealth project also, but at more than three times the cost.
These three items all happened to come in on the same day. Not telecare-related directly, but relevant to the main client group.
1. One third of older people in UK planning to live in one room in the winter. A survey by Help the Aged and British Gas.
2. Joan Bakewell (known in the 1960s as ‘the thinking man’s crumpet’) now 75, just appointed by the UK Government to represent the interests of older people. Her manifesto – get more of the little things right to make life easier. The Independent’s take on the story.
3. Moving account by a Canadian of a visit to Scandinavian care homes: “The ageism that is so much part of North American society didn’t really hit me until I saw the vitality and freedom of older people in Denmark and Sweden…” From the Toronto Star.
Nottingham PCT aims to monitor around 800 people each year with long-term conditions such as chronic obstructive pulmonary disease and congestive heart failure, using Tunstall equipment. Press release.
[Comment: This is the third press release in recent times to headline the word ‘mainstreaming’ in the context of a deployment that is bigger than the usual pilot study. Is ‘mainstream’ now becoming redefined to mean ‘large scale pilot’? Surely something isn’t mainstream until it is routinely offered to everyone who could benefit from it? I’ve flagged this item for the ‘Terminology’ category because perhaps the meaning of ‘mainstream’ should be part of the terminology debate.]
Here are two free reports you should consider downloading.
First, The Center for ConnectedHealth’s 2007 Progress Report. Good if you want a wide-ranging look at current remote health monitoring and care delivery trends in the US. [And in Second Life…I wonder if not being able to fly or grow a tail count as health problems in that virtual world?] Interesting stuff, and you can download it from this page on the Center’s website.
Second, there’s the S2S (Strategies to Solutions) discussion paper, called Technology to Support the Ageing Global Population 2007 to 2027. It is 25 pages of balanced, well written information that ranges over assistive technology [a term used in its broad sense – compare with this post] including health- and care-related AT, and highlights various issues for society and emerging technology. You have to join the S2S mailing list to get it, but don’t let that put you off. Get it here.
With a bit of editing and a slightly revamped commentary this video could become a useful introduction to telecare and telehealth for the public. However, people who know me will anticipate that I have a huge problem with Norfolk’s conflation of ‘assistive technology’ with telecare and telehealth, hence I’ve also categorised the video under ‘terminology’.
Let’s get this straight: ‘assistive technology’ is a very broad term for any equipment that helps compensate for some form of functional impairment. Or, as the Foundation for Assistive Technology (FAST) defines it, “Assistive Technology (AT) is any product or service designed to enable independence for disabled and older people.” A few shots at the beginning of the video imply that they understand this, but it soon slips into referring to the telecare and telehealth as AT. Although can be regarded as a subset of AT, there is no implication that AT has a remote component in any way, which is the key defining characteristic of telecare, telehealth, telemedicine, etc. When I was contracted to work at the Department of Health I frequently reminded civil servants and Ministers not to refer to telecare as ‘assistive technology’ and I thought that eventually the message did get through. At least by the time the Preventative Technology Grant conditions were published. And now it raises its head again…
OK, rant over! My thanks to Saneth Wijayaratna of Telemedcare Ltd for alerting me to the 7 minute video.