It has been argued by government, hospital trailblazers and charitable organisations that remote care will play a key role in the hospital of the future. But I would argue that it's time to stop waiting for the future: remote care has an important role to play right now. The mounting pressure on our health system must be addressed imminently.
In fact I believe that a confluence of factors could make 2013 a watershed year in the move to transform and future-proof the NHS.
Joined up care delivery
The Health and Social Care Act 2012 is the most extensive reorganisation of the structure of the NHS in England to date. It is believed that clinical commissioning groups (CCGs) will be better placed than their predecessors (primary care trusts) to plan for patients' needs, in part because commissioning will be led by GPs rather than managers.
Telehealth is particularly well suited to providing quality care in this environment. It equips patients with the tools they need to learn how to self-care, and enables co-ordinated care to be delivered through a team of professionals, including the GP, community nurse, dietician and physiotherapist directly into the home.
The first report from the Whole System Demonstrator project showed how telehealth can improve efficiency and outcomes; as did the community matrons' experience of using telehealth to monitor patients with chronic obstructive pulmonary disease (COPD) at central Lancashire trust. For the patients who received the Intel-GE Care Innovations™ Guide, the trust recorded a 21% reduction in hospital readmissions and patients reported a reduction in anxiety levels.
Stimulating home care
But how do we move from sporadic trials to widespread deployment? In part, by recognising that the NHS, like any other employer, has a finite amount of money and needs to balance its books.
The new year of care tariff (YOC) will encourage healthcare providers to deliver whole care requirements for a year. Its introduction essentially encourages a new commissioning process, where the CCGs can contract with one or many organisations to ensure the health risks of a population are managed within a contained budget or tariff.
Adjusting payment based on outcome and prevention, rather than the number of hospital admissions for example, should serve as a cogent incentive for innovation in the form of telehealth.
The right incentives should encourage providers to seek out the best means of treating patients and monitoring conditions before they are allowed to deteriorate.
By taking an integrated approach, all patient needs, including their social and mental care requirements, will be better considered. This should lend itself to the spread of telehealth by encouraging new provider services to co-ordinate care delivery across primary and secondary care, in the community, while helping patients take a more active role in their own health – thereby fulfilling the YOC tariff's pledge to pave the way for a more complete patient experience.
The move to telehealth also has a greater chance of moving from theory to practice with the establishment of the academic health science networks (AHSNs) – a new tier of organisations committed to improving the identification, adoption and spread of innovation in the NHS.
The reasons why telehealth's potential is finally coming to the fore can be attributed to a number of factors. With an aging population beset with long-term illnesses the need to ease the burden on the NHS is being keenly felt. Fortunately the technology is now advanced and ready to deliver manifold benefits, including uninterrupted care in the home. Since the drivers for change have only recently formed, including new organisations in control of the purse strings, only time will tell whether this is the age of telehealth – but the conditions are certainly ripe and ready.