Editor Steve Hards frets about a dilemma for telehealth and telecare service purchasers.

Imagine that you are ‘a commissioner’ in a position to influence plans for local NHS or council spending, or you could be in a position of influence within an NHS trust, or a council.

You are acutely aware of past, current and impending funding pressures. Positive messages about telehealth and telecare technologies and their potential to facilitate changes in the way services are provided – and possibly to ease some of those funding pressures – have somehow penetrated your noisy environment.

You are reasonably convinced that services locally should ‘do something’ about it. You start convincing others. You build enough momentum to get to the point of someone drawing up a commissioning specification.

What do you put in it? (more…)

Regular Telecare Aware readers will know our long-standing general concern about the market-distorting effect of the UK Government’s Telecare, Telehealth and Telecoaching Framework Agreement for procuring such services. John Guyatt, Director of Solutions4Health spells out what that means from the perspective of a relatively new company in the field.

I was recently preparing a bid for a telehealth service being commissioned in the next few months, when I realised that the exercise only allowed bids from companies already in the Government’s framework agreement.

We’ve been active with products in the telehealth business for the past 18 months, but we are excluded because we weren’t providing telehealth solutions when this framework agreement was first introduced about three years ago.

That’s several generations in the technology world and therefore raises a number of issues… (more…)

In this Soapbox, Peter Kruger, Managing Director of Steinkrug, looks backwards at the pressures that have shaped the NHS and forwards to a different kind of future for caring.

Twenty years ago the NHS underwent something of a revolution: one that went far beyond anything the former health secretary Andrew Lansley envisaged. Technology played a key role in what was perhaps one of the largest business re-engineering projects ever undertaken. The impact of this change is still being felt; not only by patients but also by their relatives who find themselves playing the role of carers. This is opening up opportunities for a number of organisations ranging from mobile health vendors to high street pharmacies.

The following 4 minute video clip shows how most people perceived the NHS before the 1990s – complete with some old fashioned social attitudes:

Only When I Laugh 1982. Watch the complete episode on YouTube

However, twenty years ago a wave of ageing baby boomers (the ones born during the 1920s, not those born in 1946) hit NHS hospital wards… (more…)

<em>Keith Nurcombe, Telefonica’s global director of healthcare, and managing director of O2 Health UK, makes a rallying call to all telehealth supporters.</em>

Telehealth significantly reduces mortality rates, emergency admissions, A&amp;E visits, elective admissions, bed days and costs. Yet despite the overwhelming evidence, there is growing worry about its implementation. We’re far from crisis point, but unless we continue to argue the case for telehealth and promote the evidence available we will allow detractors to win.

That’s why I read with worry last week that the Nuffield Trust’s Adam Steventon – one of the lead investigators behind the WSD – had claimed he doubted the safety of telehealth. As the <a target=”_blank” href=”http://www.telegraph.co.uk/health/healthnews/9509181/Doubts-raised-over-safety-of-doctor-by-broadband”>Telegraph reported</a>, he said… (more…)

Kishore Sankla, CEO of UK-based Solutions4Health, puts out a plea for proof of effectiveness through innovation and looks ahead to an era of consumer-driven services.

We in the industry are already fully convinced that telehealth works, and we have the satisfied customers to prove it.

The Whole System Demonstrator outcomes to date suggest that we have to focus in the right areas, aim for the right goals, and shout loud about our achievements in order to convince the payers of the enormous potential. Some really strong positive points have already emerged… (more…)

Following the TA item Scummy website starts to make the case for telecare/telehealth industry regulation, Editor Steve points out in this shortest-ever Soapbox that, while formal regulation may be on the distant horizon (it may need legislation, and then it has to be policed, which is another issue), there is something that the Telecare Services Association (TSA) could do in just a few months that may even make statutory regulation unnecessary… (more…)

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…)

Editor Steve Hards asks if it is time for a reconsideration of the role of the Telecare Services Association (TSA).

With yesterday’s news of the draft EU Telehealth Code of Practice (including telecare) some of the TSA’s members are wondering why it is about to spend up to £25,000 of their money developing one of its own to extend its existing Telecare Code of Practice.

But there is a deeper question that they and the TSA Board members should be considering… (more…)

After my (editor Steve’s) comment about ‘fairy dust’ (3millionlives: Plan B and Plan C) certain Telecare Aware readers asked where is my Plan D? It is not fully formed, but here’s the outline.

The key is to get the Department of Health (DH) to exert some monetary influence.

However, we know that in view of the savings the public sector is going to have to make over the next 5 years (£20 billion for the NHS alone) DH is not going to come up with any new funding…[read more] (more…)