Dr Julian Neal is a GP in Portsmouth (UK) and clinical adviser to Telehealth Solutions. In this article he picks his way through the Whole Systems Demonstrator (WSD) trial results published in the BMJ and looks forward to a more positive future – if telehealth (as in remote vital signs monitoring) is given the right conditions.

Following some frankly over-optimistic headline findings published by the UK Government in December 2011, there has been a great deal of publicity about telehealth during the last few months. Much has been cautious and some openly negative. Even the BMJ has got in on the act, publishing last month the first of five detailed papers from the WSD trial to assess the effect of telehealth on the use of secondary care and mortality. A total of 3,154 patients were recruited into this trial, approximately half of whom were provided with a variety of telehealth interventions and studied for a year. This was followed up by a thoughtful BMJ editorial a few weeks later by amongst others, Josip Car from Imperial College, London, the main thrust of which was combining caution with a need for more observational analysis.

The main findings from the first publication in the BMJ are interesting… (more…)

Despite Tunstall’s stream of eye-glazing ‘look-at-us-the-market-leader’ press releases one has to admire the genius of its directors for maintaining the company in that position.

Being a market leader has both advantages and dangers. Strengths and weaknesses are two sides of the coin. Generally, some of the sources of failure for market leaders include… (more…)

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.” (more…)

Jacques von Speyer, CEO of US Tele-Medicine reflects on his recent experience of talking to industry leaders at the ATA conference.

I was at the ATA conference a couple of weeks ago and found a certain commonality; no one is making money right now in telemedicine. Of all the device vendors, both the new ones from Korea, Taiwan, China, Israel, France and Switzerland, to the branded names like Intel, GE, AT&T, Bosch, Honeywell and the others, not one of them has produced an important single flow of income.

The entire industry seems to be waiting for some payor or another to step forward and be the first to implement a national system of sufficient proportions to kick start telemedicine in the USA. One difficulty to achieving that is the fact that US industries and governments are in abeyance until the election, and the prospect of redefining how someone approaches healthcare and its delivery, based on an uncertain economic indicators, is difficult. Entities are comfortable with the status-quo and after all, eventually, everyone seems to be receiving healthcare irrespective of cost or time involved. So where is the incentive to change? It appears that not even the inherent savings appropriated in most telemedicine programs is enough of a motivator to push telemedicine along in the USA.

Basically we are all waiting for the ‘eventuality’ to take place, and it will. The challenge for most, however, is to stick around long enough to benefit from it.

Jacques von Speyer
US Tele-Medicine

Independent consultant cardiologist Dr Lance Forbat, whose work using telehealth monitoring Telecare Aware has reported a number of times, responds to the recent headline on the Mayo Clinic study that telehealth monitoring appeared to treble death rates and points out that in comparing monitoring people at home with and without telehealth monitoring they were not comparing like-for-like.

If I do a twice daily ward round on my patients and look at the physiological signs recorded by the nurse and take a history, possibly pick up on unnoticed issues that my years of experience detect, I would like to think I make an impact on the outcome of patients’ illnesses as well as their sense of well being… (more…)