Telehealth Soapbox: Standing firm on the argument for telehealth is vital

<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…)

Telehealth Soapbox: The questions (and answers) are out there

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…)

Telecare Soapbox: Regulation of the industry

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…)

Telecare Soapbox: Why using PIR detectors to check on residents’ well being is profoundly dangerous and misguided

In response to yesterday’s item that included a reference to Contour Housing using a Tunstall PIR system to give an ‘I’m OK’ service, James Batchelor, Chief Executive of Alertacall, sets out why he believes that such a development is a bad move. Just because he has a commercial interest to defend – his company provides well being checks – this does not invalidate his points. If Tunstall, or any other supplier, would like to come back with a response, it will be published.

If you use passive infrared detectors (PIRs) to check on residents’ well being, then be prepared for them to passively kill someone.

With cutbacks to Supporting People funding housing providers are finding themselves in the predicament that they have fewer staff hours available to look after the needs of their sheltered residents. This risks eroding the life-saving daily contact of the ‘traditional’ warden-based morning call, which is time consuming for both the housing provider and its residents.

For decades this daily contact was the backbone of sheltered accommodation, real people checking on other real people. It provided an insight into individual resident’s care needs as they developed.

However, you cannot blame housing providers for (more…)

Terminology: ‘telecare’ v ‘assistive technology’

If you know anyone who persists in using the generic term ‘assistive technology’ (AT) when they mean something as specific as ‘telecare’, then direct them to the following excellent list of examples of AT from the British Assistive Technology Association. It is interesting that they have adopted the US term ‘PERS’ for telecare alarms, but we can live with that! Further Information on What Assistive Technology Is. Heads-up thanks to Guy Dewsbury.

UPDATE Fri 17th: A reader has reminded me (Ed. Steve) that I did not put the above into the context of the Foundation For Assistive Technology’s (FAST) definition, as supported by the AT Alliance. As I was involved in the development of the FAST definition in 2001 I fully support the AT Alliance’s comment that “to define the term too closely using illustrative lists of equipment ran the risk that any associated legislation, funding or regulatory measures failed to cover emerging technologies not included in the listing.” However, there are still people who refer to ‘telecare’ as if it were the whole of, and not a subset of, ‘assistive technology’ and one wonders why the message still has not got through. That’s the reason why I liked the BATA page for giving so many examples.

Telehealth Soapbox: The NHS can simply not afford to continue to do more of the same

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…)

Telecare Soapbox: Telehealth and telecare need the opportunity to make a difference

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…)

Telecare Soapbox: When will telehealth companies start generating income?

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

Telecare Soapbox: Telehealth apples and pears

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…)

Telecare Soapbox: What should the role of the Telecare Services Association be? (UK)

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…)

Telecare Soapbox: Is mHealth/eHealth becoming a ‘Field of Dreams’?

Editor Donna muses on the link in the telecare chain where it can all fall down – the person who is expected to use the device.

“If you build it, they will come”–misattributed to the film Field of Dreams, 1989

We can get telehealth and mhealth into the home care or healthcare provider, payer, ‘app store’ or ‘ecosystem’ (the ‘push’), but you cannot force the client or patient to use it.

The buzz may be about how slick a system or app is, how to sell it to the C-suite or even the Four Big Questions, but have we forgotten someone? We assume that end users/clients/patients will be delighted to use our wonderful devices, in the way they should be used–consistently, correctly, continuously until they… expire. Step back and think about human behavior, however, and you realize…that cannot be true. (more…)

Telecare Soapbox: 3millionlives Plan D: Money from councils and the NHS

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…)

Telecare Soapbox: The security of telecare confidential information

Guy Dewsbury, Managing Director of gdewsbury, which is a freelance specialist technology writing service and consultancy, takes a thoughtful look at data security in telecare call centres and asks a few pertinent questions.

Let me state at the off that there are some really great call centres that I have been privileged to work with and some others I have become acquainted with that deserve high praise.

That said, when you pick up the phone and speak to your bank, you feel protected… (more…)

Telecare Soapbox: TSA2011 losing touch and losing relevance?

This Soapbox is published anonymously for someone who wished to express some observations and feedback for the conference organisers and the TSA membership without compromising his company. Please note Telecare Aware’s Anonymity Policy (Soapbox Section right sidebar).

Given the economic climate, TSA will undoubtedly report excellent results for its 2011 conference. And with so many corporate sponsors, it will certainly have been a great financial success. But careful analysis of the attendees listed reveals a concerning trend (more…)

Telecare Soapbox: Complicity between UK telehealth commissioners and providers

If ‘ignorance of the law is no excuse’ telehealth commissioners and providers have a responsibility to make sure that in matters of medical devices all regulations – many of them legal requirements – are being adhered to. Failure to do so on one side or the other implies a willingness to be complicit in their breaking and it unfairly tilts the market against those companies that abide by the rules.

This Soapbox item is timely given that there is due to be a big push for telehealth in the UK on the back of the WSD programme results. It is written by an experienced professional in the telehealth field who, because of his or her position cannot reveal his or her identity. It will also become obvious to readers why he or she cannot name the ‘guilty parties’. However, there are questions at the end which service commissioners should now use to identify whether they are dealing with a company that is breaking the regulations.

There is now no excuse for either the companies involved not to correct the situation or for commissioners to continue to put their investment of public money at risk.

Steve Hards, Editor

Readers who prefer to read this long item as a PDF can download it here.


 

While the world holds its breath waiting for the imminent final revelation of the Department of Health’s Whole System Demonstrators (WSD) results, the global mass of telecare and telehealth manufacturers, distributors, resellers and newcomers are revving up their trucks full of boxes and briefing their marketing departments – all believing that a ‘tsunami of sales’ are just around the corner!

Storm brewing… (more…)