Health Secretary Jeremy Hunt has announced continued support for Telehealth, John Dyson chief executive of Telehealth Solutions, details how this will save the NHS money.
Despite the evidence from other countries, particularly the Veterans Administration (VA) in the US, there is little consensus in the UK regarding the effectiveness of telehealth in meeting the challenge of cost-savings required for the NHS while improving quality of care. Telehealth Solutions believe that we have found a route to success and are conducting a case study, at Portsdown Group Practice, based in Portsmouth, with the help of a respected health economist.
Portsdown have deployed Telehealth Solution’s fully managed service using a central nurse-led triage service. Telehealth is not an ‘add-on’ to day jobs, does not increase staff members’ workloads and does not require clinicians to undertake technical tasks. Additionally, the service can be easily scaled up. The study is recording clinical outcomes and early internal evaluation has shown impressive results: for the period June - November 2012, 696 bed days and £249,128 have been saved by a cohort that has now increased to over 100 patients.
To make telehealth services effective, there are several key elements. First, the patients must be quite poorly, with a long-term condition and be expected to have to go to hospital at least once in the next year. Second, those running the deployment have to focus on the desired outcomes: patients should be able to stay at home with reduced visits to hospital or GPs and require fewer visits from nurses. To achieve this, triaging nurses need to be disease experts, who can proactively advise patients on their treatment on a regular basis using data gathered from their HomePod. This focus on supporting the patient will also include referring back to the GP or to hospital if clinical judgment and agreed protocols indicate these as the appropriate course of treatment.
Over 50% of patients in hospital or visitors to GP surgeries are those with long-term conditions. The aim is not to eliminate this number, but to effect a reduction of 30%, a figure supported by the VA experience. There is a cost to providing an end-to-end telehealth service, typically, £1,200 per year; so it will only provide an economic benefit to the NHS when patient cost savings are more than that amount.
For telehealth to be scalable and effective to meet goals the Department of Health have set out with the 3millionlives initiative, it is necessary to carefully consider the role of the clinical triage team. This team is essential to establish a continuous focus on the outcomes and to give the patients the confidence that they are being properly cared for. With encouragement and support, patients are able to make their own decisions to use their rescue medication or visit their GP, based on the information that they can see for themselves.
Changed working methods, alongside new care pathways, and specialized technical and clinical triage will enable increased use of clinician time in resolving patient needs when appropriate.
As a consequence, it’s possible for patients, clinicians and the NHS to achieve their objectives at the same time. It can be a win-win-win proposal.