Stewart Maxwell, Managing Director, Numera Health takes a look at the need to put the WSD results – when they are published – into an up-to-date context.
The GP trade magazines have been falling over themselves recently to report the concerns GPs have about telehealth and telecare and their call for the Department of Health to explain the £1.2bn savings figure widely quoted when the government launched the 3millionlives programme.
In one magazine Dr Paul Cundy, chair of the British Medical Association’s GP IT subcommittee, predicted that poor take-up by practices could force the Department of Health to “rethink the whole thing”. He said: “Your average GP needs substantial convincing that there is any benefit to telehealth.”
On top of this we have seen a rather lengthy delay in the publication of the results of the Whole System Demonstrator (WSD) pilots. Critics have read into this further bad news about the effectiveness of telehealth and telecare. This was not helped by the publication of some preliminary costing from the pilots which were reported to be “very disappointing”. Findings were presented at the King’s Fund and revealed the cost per quality adjusted life year (QALY), including direct costs, was in the region of £80,000. The QALY threshold used by the National Institute for Health and Clinical Excellence (NICE) to determine the cost effectiveness of treatments is between £20,000 and £30,000.
However, Health Minister Simon Burns said recently that the results of the Whole System Demonstrator pilot will answer these critics and show telehealth and telecare have a significant role to play in reducing unnecessary hospital admissions and improving quality of life.
With 6,000 participants the WSD programme was the largest randomised control trial of telecare and telehealth anywhere in the world and it is a complex piece of research. My concern is not with the findings but rather with the trial itself.
It is the combination of telehealth and telecare which I see as having the biggest impact on care for those people with long-term conditions. Yet the WSD pilots considered each in isolation: telecare or telehealth. Surely it is the combination of the two that has the potential to have the greatest impact.
So we should examine the WSD results carefully and GP commissioners need to pay particular attention to what the pilots were not able to investigate. They should also consider that the costs of telehealth services are falling and they do not have to invest in expensive kit – especially if it is on a pay-as-you-use basis. In addition, the technology is changing fast. Telehealth can now be combined with the latest social media applications which have been shown to engage patients in their treatment. It is also adaptable to local needs and that means large scale programmes can be rolled out quickly.
So I ask commissioners to give telehealth and telecare the opportunity to make a difference. Work with providers to prove its benefits and do not be swayed by the negative press. We have the chance to work in partnership to change the lives of millions of people who suffer from long-term conditions.
Managing Director, Numera Health