Telehealth saves $55 million in the Basque Country

Faced with an aging population (18 percent over 65) and a failing Spanish economy, the Basque Country Health System is testing telehealth systems to keep its older population healthier and out of the hospital (23 percent are readmitted to hospital). The Accenture-developed TEKI is based on a Microsoft Kinect and connects to a heart rate monitor, pulse oximeter and a spirometer, using the Kinect to evaluate their mobility and provide prescribed exercise therapy as part of rehabilitation. TEKI is part of an Accenture-developed ‘Multi-channel Health Service Center’ that provides a variety of counseling and education services to the local older adult population. The Kinect is also used as a telemedicine platform to communicate with the patients in the study. Results achieved by the program:$55 million saving in Year 1 through eliminating 52,000 hospital visits, a 7 percent cost reduction per patient. CNBC/Philips feature, MedCityNews, video of Osakidetza Hospital staff using TEKI with respiratory patients, Accenture paper.

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    This is a multi-channel approach that expands on what we think Telehealth is, what we want it to be and what the public may see it as.

    TV, internet, telephone, apps, messaging, prompts, reminders all wrapped up in a nice package that can be personalised as to the actual needs of the user. Not kit bought from one supplier and then distributed to all and for them to fit to it.

    I would like to see a breakdown of the figures which I cannot seem to find anywhere. It does appear however that the telephone appears to be the biggest numbers being trumpeted so I think that is where the savings are probably being calculated from.

    Here in the UK we may already be doing this but it is so fragmented across various providers that we are unable to calculate and compare the actual Telehealth provision – Telehealth , NHS Direct, 111, NHS Choices, Telecoaching, Telephysio etc.

  2. Donna Cusano

    I do find it interesting that the publicity on it (versus the Accenture paper) is so non-comprehensive–that it focuses on the whiz-bang tech versus the system it fits into. This approach is so 2005-6, and is a definite impediment towards the package you’ve well outlined, UNATTR.

  3. I think that everyone will be disappointed by a paper that reports such an amazing level of savings without providing any context, the inclusion characteristics of participants, their level of education, their social capital etc etc. They might well have cherry-picked their patients and avoided those who are not computer literate, or who have a cognitive impairment or no family living within 500 km.
    When the industry is struggling to demonstrate both appropriateness and cost-effectiveness after the 3 Million Lives fiasco, I don’t believe that this type of report does anyone any good. My guess is that TEKI works really well for some people, and that other elements of service delivery (perhaps equivalent to NHS Direct, alarm telecare, activity monitoring or telecoaching) may work for others. The evaluations that I expect to see in the future should explain clearly how better profiling will help to identify which form of telecare is appropriate, how this leads to individual service provision (using a range of technologies), and targeted response protocols. Ultimately, the success (and savings potential) of telecare will be determined by the quality of service provision rather than by a single item of technology even if it does encourage a multi-channel approach. I believe that both healthcare professionals and potential service users need to be made aware of ALL the available technology options. That is surely a campaign that can unite governments, equipment manufacturers and distributors, service providers, commissioners and service users and their families.