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Telehealth looks good – but why does it work?

Our GP commissioner blogger, Dr Clive Henderson, is encourage by results he's seen for telehealth initiatives but wants to know why they worked.

Our PCT has 110 telehealth units which are just starting to be deployed at significant levels. It has taken a while to get off the ground for various reasons one of which is people actually asking a simple but important question – does telehealth work ?

Well, I asked our neighbours ,who have much more experience than our own, and Kerry Wheeler , assistant director of strategy North Yorks and York, was very helpful. They have deployed 400 units – roughly two thirds in COPD and the rest in Heart Failure ( HF ). On the face of it the results are impressive. Of the 55 patients utilising telehealth for more than six months, there was an 82 % reduction in admissions for those with HF and 31% for COPD : liberating £150,000 in secondary care costs. How much hassle was this for the clinicians – about 3 % ‘pressed the button' – my term, not theirs - for clinical help.

How does this equate with what is known nationally ? There have been numerous small scale reports and the trend is similarly positive, however there are a myriad of methodological problems. We will know a lot more shortly when the results of the Wholesystem Demonstrator trial is released. This is a DH two year trial on 6,000 patients, the largest randomised controlled trial in telehealth worldwide to date. Rumour is that is is showing good results.

What is less sure is why telehealth is effective. Is it the biometrical recording device or the extra personalised care and reassurance people feel because they are part of the service.

Jonathan Thorpe, the telehealth project manager for Hull University remarked at a recent meeting that he was a lot more likely to lose weight if a nurse told him than a castigating electronic icon on his Wii fit machine.

It looks like we going to find out shortly just how effective telehealth actually is. Why , and how best to perfect it and commission it, is going to take longer.

Dr Clive Henderson