Anonymous commentator applies some concepts from the technology adoption life cycle to consider progress – or not – in the UK’s telehealth market.
Being a market leader has one key responsibility: to grow the overall market. The market leader cannot make significant growth by focusing on taking business from its smaller competitors as there is not sufficient business to be gained. Market growth is achieved by promoting and proving the value to be had from innovative products and by the innovation of the applications, mainstream and niche, for which their products can be used.
So let’s look at what has happened in telehealth in the UK…
In my opinion Tunstall have done an average job of promoting their Genesis system over the past few years. They have used their marketing muscle to promote telehealth primarily to their sales agents, the community alarm centres, who have attempted to sell a telehealthcare story to the PCTs. This has had a poor impact because only a small percentage of the products sold are actually supporting patients; most are still on shelves waiting for implementation. (Birmingham / Pfizer; 200 systems and about 25 in use after 18 months!) These sales agents may be experts in telecare but their understanding of clinical applications of telehealth lacks the necessary consultative approach.
Bearing in mind that the market leader has now moved onto a new product, the question arises as to who now has the responsibility to support the implementation of these dormant Genesis systems? The market leader has no incentive and the customers have limited future growth paths for this 1st generation product.
With little product in use and the substance behind their case studies limited, how will the early adopters of telehealth be able to justify the financial return and the mainstreaming of telehealth? It’s not the Genesis system that will be regarded as less than effective but the whole of telehealth.
After many pilots why are the majority of early adopters not mainstreaming in view of the fact that a successful implementation will give an ROI in about 4 to 6 months? And will the budget holders give yet more money to unproven projects and to teams that have failed in the effective execution of telehealth?
The telehealth industry has been done a disservice – the use of telehealth should be far more pervasive by now.
A few early adopters are experiencing the levels of service provided by the non-dominant telehealth providers and they are acting as references for today’s first time buyers. As awareness of the alternatives spread it makes it increasingly difficult for the market leader to continue to sell by implying that security and future value depends on going with the market leader.
However, the opportunity still exists for Tunstall to move away from its sales target fixated agenda and behave like a market leader should – to put in sustained investment over several years and take the responsibility to grow the whole market.
Sour grapes…
OK so the UK doesn’t have a perfect market leader but surely we don’t have a situation where all responsibility falls at the providers door? Shouldn’t the buyers be held more accountable?
If it is true that >80% of systems sold are redundant I think the wider market will benefit greatly knowing this. @Steve Hards: Why don’t you ask for the facts under the Freedom of Information Act???
[Ah, if only Telecare Aware had the resources to go on such a large scale fishing expedition! If readers know people from NHS Trusts and PCTs who have bought telehealth equipment but not implemented it, perhaps they will encourage them to use the comment facility to tell us their experiences. Steve]
Moral high ground
Are there any business that don’t operate around making a profit? From the small telecare/telehealth manufacturers to the largest I very much doubt it!
Intel and Honeywell Hommed are larger than Tunstall, maybe they can afford to take the moral high ground?
For Telecare Aware to be unbiased maybe they should not target an individual company but all of them?
Unless Steve you have proof of other companies that are moral and run a reduced profit margin to ensure customer satisfaction?
The more important question is why all the councils/PCTs etc that buy equipment from any of the suppliers aren’t making sure most of it is used.
Tunstall not immoral because it makes a profit
I think the question of why councils and PCTs are not making sure most of it is used is an important, but different angle.
However, and this is important, I don’t think there is anything in the item that suggests Tunstall is in any way immoral because it makes a profit.
As I read it, the key phrase is surely ‘The telehealth industry has been done a disservice’ and, as I understand it, the author argues that this has arisen because of Tunstall’s focus on ‘taking business from its smaller competitors’ rather than ‘growing the whole market’. He or she says, it seems to me, that this is best done by making sure that its customers get their act together.
I suppose the further question is whether or not suppliers have a responsibility to do that when they are introducing novel technology and its associated new ways of working into a conservative market.
Redundant equipment
It is not unusual for 1st generation technological equipment to be lying around unused, especially when pump-priming funds are provided from Government, which encourages early purchase. The issue now for the providers is to convince customers that the newer equipment is cheaper and better, and that it has a long-term future. Currently, I suspect that many potential buyers are “waiting to see”.
Typical for government
The NHS, nay, make that the whole of government, is littered with IT failures. I don’t think Telehealth should be singled out.
The way government goes about both procurement and implementation is the root cause of failure. As suppliers it is near impossible to get over the first hurdle (procurement) but when you do, you still face the problem of the actual implementation since internal public sector doctrine leads to division and confusion on areas of responsibility.
Just waiting for somebody to say PRINCE-2 now. The standard “get out of jail free card” used by all failed public sector project management teams. “Well we followed government guidelines on the implementation of projects according to PRINCE-2 blah blah blah”
Telecare – who leads who?
Many local authorities went into the spend it or lose thinking mode when the PTG grant became available and perhaps panicked into spending on equipment before they had produced a plan to use it. I have found this often resulted in equipment sitting on dusty shelves being wasted and warranties expiring. Often there was no clear direction or strategy for Telecare/Telehealth or understanding of the practical application of Telecare and how it can be integratated as part of a whole care package system.
Many of the original project managers were on temporary secondments without real understanding or experience of applying Telecare and hence there was often a turnover of staff without handover, direction or momentum. Even now many local authorities have not budgeted or planned for the longer term, evidenced by the numerous temporary contracts for Telecare staff and funding only being allocated on an annual basis. How can you make long-term plans on this basis?
Where Telecare has been successful and mainstreamed (as was the original intention), is where a Telecare champion at a high management level is found who can drive it forward and incorporate into the overall adult care commissioning strategy. The good examples are of course authorities like Kent and Newham and I am sure there are others. Having dedicated knowledable teams within local authorities and health can be the drivers in this industry, after all they and their clients (the end users) are the customers and so can influence suppliers and manufacturers. There are alternatives if they do not listen to what the market wants or do not offer the service.
We have seen Intel react to POTS. No supplier in the long term can afford to act without the interest of the customer or end client (this includes any so called market leader), as Social Care and Health become more attuned to this technology, especially so as more manufacturers recognise this expanding market and wish to enter, thereby increasing choice. Manufacturers would be well advised to closely engage with services in a co-operative way to understand how the changing care demands and strains on financial and human resources may change the way local services approach managing long term care.