Widespread remote GP consultations getting closer; no shortage of implementation advice

Following our previous item on the topic, on January 16th, Tim Kelsey made it very clear to this editor at a PICTFOR event that the £1b promised to GPs for premises improvement included a strong requirement that GPs also invest in electronic support, including remote consultation technology.

It is therefore particularly pleasing to see in yesterday’s Pulse Today, an item on a Skype trial in Central London that both patients and GPs seem to love. Some key quotes:

Almost all patients surveyed about their experience of the remote consultation service said they ‘would use it again’ (95%).

Although patients were warned that ‘the security of Skype isn’t 100%’, 83% also said they were happy with the safeguarding of their privacy

Two-thirds of patients joined the remote consultation from home but more than a quarter – 28% – skyped from their workplace.

Dr Alice Fraser, the lead GP at the pilot practice Cavendish Health Centre in Westminster, said: ‘…I found the use of Skype particularly helpful as I could carry out consultations with my patients from home without having to travel to London, which meant I was able to better balance my work and family commitments.

It does increasingly suggest that GP premises expansion should be made progressively harder to justify in the NHS to accelerate remote consultation becoming the norm.

Remote consultation is of course ideal for managing long term conditions as Airedale have proven (35% reduction in hospital admissions, 53% reduction in A&E visits) and for diagnosing diseases requiring specialist expertise as the Peek Vision project has proven, just two examples in (in the opinion of this editor) one of the best ever Kings Fund publications, out today “The Future is Now“. A real must read!

And if anyone is wondering how to implement telemedicine, just in the nick of time, here comes another ‘how to’ guide, this time from the results of a three-year study by the Momentum Consortium (“European Momentum for Mainstreaming Telemedicine Deployment in Daily Practice”). The original eHealthNews item is here and the full 37-page Blueprint is here. There is little to comment on in the document as it is both conventional wisdom, and strikingly similar to the UK’s telehealth readiness tool that we featured recently (indeed a wicked thought would be to wonder how it took three years to produce). This editor has not yet read it exhaustively, however he was struck that he could not find any definition of telemedicine or indeed what services are covered by the term. In addition, the phrase “average users – whether they are health professionals or patients” suggests perhaps too little recognition that one of the big challenges of implementing any system which has both patients and professionals as users is ensuring that it is a joy to use by both communities (particularly those closer to the budget holder, typically the professionals).

What looked like it was going to be a more helpful document, as it is NHS-specific, was the recently-produced Inside Commissioning report entitled “How CCGs can develop integrated care through implementation of TECS“. However this editor, though fully registered with the site, was unable to access it: if others have the same problem, this will be a shame for Simple Telehealth (aka Flo/Florence) because when he finally got in, he found that they had sponsored the report and indeed feature in every one of the eight case studies.

As ‘doing’ can be hard work, particularly when there is a queue of people telling you how to, those of a more cerebral bent may prefer to consider a conceptual model for telehealth intervention, design and evaluation. This paper, on BMJ Open, with lead author Chris Salisbury from Bristol University, describing the TECH model concludes:

A conceptual model has been developed based on multiple sources of evidence which articulates how telehealth may best provide benefits for patients with chronic health conditions. It can be used to structure the design and evaluation of telehealth programmes which aim to be acceptable to patients and providers, and cost-effective.

Undoubtedly the UK offers huge expertise in the digital health world, from concept to delivery, so it’s particularly cheering to see the DTI producing a very well designed export-oriented item on digital health subtitled “The UK: Your partner for healthcare solutions” Love the strapline “HEALTHCARE IS GREAT” with a Union Jack compressed alongside.

Hat tip to Mike Clark for much of the above.

Talking about going overseas, Prof Mike Short has just alerted us to a new start-up MedicineAfrica which looks to be a potential user of this remote healthcare provision advice. The BMJ has also very recently produced an excellent case study on mHealth in low & middle income countries.

Mike also alerted TTA to a lovely example of how mHealth can save lives, with an excellent video on how to tackle choking in babies and young children.


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