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DH keen to press ahead with telehealth, says adviser

Exclusive GPs are set for a ‘significant change' in the way they manage patients with long-term conditions, according to the lead investigator of a Department of Health trial of telemedicine in primary care.

In order to provide more evidence for the benefits of telehealth, the Department of Health has commissioned the Whole System Demonstrator pilot, the largest randomised controlled trial in the world, ‘to find out how technology can help people manage their own health while maintaining their independence.'

The trial has already been running for two years in more than 6,000 patients - in 238 GP practices in Cornwall, Kent and Newham - given either usual care or telecare or telehealth for 12 months.

Telecare provides devices such as electronic medication reminders to patients with physical disabilities, the elderly or those suffering from dementia or epilepsy. Telehealth services are aimed at patients with long term conditions – diabetes, heart failure or COPD – and provide devices such as blood sugar monitors to patients with diabetes that can alert a GP if the readings become dangerously high.

A review of the evidence for telehealth by the RCGP and Royal College of Physicians in 2010 - led by then deputy RCGP chair Dr Clare Gerada - found patients did tend to prefer being dealt with outside hospital, but that there was an ‘enormous gap' in the evidence for clinical benefit or cheapness of delivery.

Speaking exclusively to Pulse, Professor Stanton Newman, principal investigator for the Whole System Demonstrator pilot, said the results, due to be submitted to the DH in October ahead of publication in November, could ‘significantly change how GPs interact with their patients' – but warned it could pose medico-legal challenges.

He said: ‘It could potentially change the way healthcare is delivered quite significantly. It could change how GPs behave and interact with some of their patients and the way they manage patients with long term conditions in future.'

‘There will be evidence about how people responded to having the devices as well as quantitative data on outcomes. Patient-reported outcome measures are also being assessed, as well as the impact on GP consultations.'

‘It's going to potentially decrease hospitalisations and admissions, and if effective, it could have an immediate impact on how we deliver services.'

Professor Stanton told Pulse ministers were keen that the findings were quickly integrated into primary care. ‘One of the enduring difficulties in healthcare is how to translate research into practice. But clearly having commissioned the research the DH would want to see the evidence and there is likely to be a willingness on their part to implement what is shown to be evidence-based.'

‘There's a question about telemonitoring and clinical responsibility and governance and I suspect there will need to be discussions around that and the provision of a regulatory framework once the pilot results are published.'

It came as health secretary Andrew Lansley launched a call for new ideas and submissions for smartphone apps that help improve patient outcomes and manage their condition, and improve care and support for people with long term conditions.