UK doctors give thumbs down to ‘remote care monitoring’

February 25, 2013 | by | 1 Comment

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.

2020Health evaluation of the Yorkshire ‘Telehealth Hub’ project (UK)

February 22, 2013 | by | 1 Comment

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.

‘The big picture’, minus hype, of mobile in health

February 21, 2013 | by

Refreshingly free of hype, and in fact rather dry, is the commentary of  Deborah Estrin, professor of computer science at Cornell NYC Tech (soon to be your Editor’s neighbor), at the 2013 annual meeting of the American Association for the Advancement of Science in Boston chaired by Google’s Vint Cerf. Essentially any phone can be a data platform; her focus is on converting apps to data streams, gauging frequency of use and GPS data for movement. Sensibly, she advises ‘scaling down’ apps to make them useful to individual patients. Undoubtedly she’s read the statistics on abandoned apps, estimated at about 95%–and that most everyone uses the same old apps, Google, Facebook, YouTube, Gmail etc. for about the same time as in 2011. But then she goes into how mobile can keep track of ‘digital exhaust’ a/k/a pollution…. Mobile Devices Linked to Better Health (BioScienceTechnology.com)  App Usage Has Stalled As Smartphone Users Hit Burnout (Business Insider)

Revealed: Hospital EHRs lobbied for stimulus funding (US)

February 20, 2013 | by

Man Bites Dog! The New York Times just discovered that not only did large EHR companies lobby for the health records mandatories that were part of the 2009 Federal ‘stimulus’ bill–along with ‘Meaningful Use’ subsidies–but also they also won big in hospital sales. This article focuses on Cerner, Allscripts (which bought Eclipsys) and Epic, and the 60% + gain these companies have made in sales since. It touches on the sticking point of non-interoperability, but not at all on the chaos at the practice level where the Big Three (nor the unmentioned GE Centricity) largely do not play. Here is where 600-odd companies, many of them offshored IT outfits, also around 2005 started to peddle various EHRs which were first software, now cloud-based. It took off after 2009 as well, to primary care doctors worried about Federal regulations–or missing out on years of subsidies and MU payouts. (more…)

MMRGlobal IP infringement lawsuits, allegations continue

February 20, 2013 | by | 4 Comments

Personal Health Record (PHR) patent holder and penny-stock company MMRGlobal [TA 10 Feb] continues to keep law firms in the US, Australia and now Singapore very busy with various complaints of patent infringement, demanding monetary damages, a permanent injunction and presumably, a lucrative licensing deal. Last week, MMRG filed in US District Court, Central District of California against health giant WebMD for their online PHR, claiming that from meetings dating back to 2007, WebMD incorporated “features and functionality that are the subject of MMR’s patents”. Today’s MMRG press release now highlights the Singapore Ministry of Health (with associated health agencies), which MMRG alleges uses PHR vendors which violate various patents–which just happen to be owned by MMRG in Singapore.  (more…)

Policy on telehealth practice by ASHA (US)

April 7, 2008 | by

Janet Brown, for the American Speech Language Hearing Association made this comment about its policy on ‘telehealth’, posted on Google Video. It’s good to see that she shows a sensitivity to the uncertainties of the terminology.

What a great way to make policy announcements!

Nottingham telehealth monitoring (UK)

March 17, 2008 | by | 1 Comment

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.]

Two free reports

February 28, 2008 | by

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.

Telecare and telehealth coming together in Norfolk (UK)

February 21, 2008 | by | 2 Comments

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.

 

[youtube=http://www.youtube.com/watch?v=0ukJMscqLak]

 

Scotty Group equips Holland’s biggest telehealth project (+ video)

November 14, 2006 | by

According to this British Journal of Healthcare Computing article, Scotty Group plc made an initial delivery of equipment to Dutch telecoms provider KPN in October, as part of a €1.5m telehealth deal with KPN signed in July.

See a seven-and-a-half minute video of the Scotty Dutch project on the Home Telehealth Ltd. website. Navigate from the home page to videos and ‘CareStation – TV based homehealthcare’. There are also two other video clips of Scotty video telehealth solutions in operation. Peter Range, of Home Telehealth says ‘As one of Scotty’s largest telehealth partners in the UK, we would be pleased to assist any of your readers who may have an interest in this telecare/telehealth solution. Also for the record, Joop Wallenburg, presented this video last Wednesday at the TSA conference in Cardiff, but in Dutch, so any TSA delegates who now want to see it in English can now do so.’