To deliver better preventative care for an aging population, healthcare systems need to: focus initially on high intensity users of acute services; establish a flexible operational platform for other patient groups; and develop capability and capacity to impact the entire system.
Understanding the implications of the Telehealth 'Whole System Demonstrator' report
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The growing number of older people both in developed countries and in poorer nations where birth rates are slowing, is triggering a far-reaching debate about how best to meet their needs for medical care, nursing and social support.
One promising solution looks at re-orienting healthcare away from treatment and towards prevention. Telehealth technology has a key part to play in enabling this change by identifying and managing illnesses earlier, providing more effective care to those with chronic conditions and managing risk for vulnerable people to enable them to live independently for longer.
However, the large-scale implementation of telehealth is not happening rapidly enough to have a significant impact on the overall costs of providing care or to develop new capability and capacity. This is being exacerbated by the current economic climate which is making it even harder to secure funding for innovation.
Healthcare systems need to get three things right when looking to rise to the challenge of an aging population by delivering better preventative care.To have a meaningful impact across the entire system they need to:
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focus initially on dealing with patients who are, or are about to be, high intensity users of acute services;
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do this on a scale that truly drives the development of capability and capacity;
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establish an operational platform that has the flexibility to expand to reach out to other patient groups.
Focusing on the right patient group
This involves focusing on patients who are, or are about to be, high intensity users of acute services. The results achieved in the US Veterans’ Health Administrations Care Coordination Home Telehealth programme show what can be achieved: 25% reduction in numbers of bed days of care; 19% reduction in numbers of hospital admissions; significant savings in total cost of care; and high levels of patient satisfaction. Trials in the UK are now beginning to show similar results. These are true ‘quick wins’ for the patients, clinicians and payers. However, only addressing the most complex ‘downstream’ cases will not provide a sustainable solution. There is a need to consider how services can be developed and extended.
Achieving the right scale
This means ensuring that early implementations are truly able to drive the development of capability and capacity. A risk averse culture in healthcare often means that innovations end up as interesting topics for the research community and have limited impact on mainstream services. Careful risk assessment is clearly necessary to manage any impact on the health economy. Yet that should not hold back the integration of innovative services – involving teams and not isolated individuals - into mainstream care pathways and ensuring that they become part of the professional development curriculum of those involved. In England, this is beginning to happen, with the NHS looking to establish telehealth services that care for patients by the thousand rather than the handful. Already progress has been made in NHS North Yorkshire, West Midlands and with the mainstreaming of the Whole System Demonstrators in Kent and Cornwall.
Developing the right operational platform
This is about building in the flexibility to support what you want to be doing in 5 years time. A key reason why early adopters of innovation in connected health technologies in this area have failed to exploit their initial successes is that all too often they have not considered the question of ‘where next’. They then find as they expand into new patient groups and new groups of professionals, they have to meet very different expectations. Standards, both professional and technical, have a big part to play in providing the flexibility needed to adapt, and early investments in standards will pay dividends when it comes to reaching mainstream adoption.
If telehealth is to fulfil its potential, healthcare systems must focus initially on acute services, be flexible enough to adapt to different patient groups and be sufficiently scalable to have an impact across the entire healthcare system.
To find out more about PA’s innovative approaches to telehealth, please contact us now.