Abstract

Telecare is characterised by continuous, automatic and remote monitoring to manage the risks associated with independent living. Examples include sensors that can detect movement, falls, and bed occupancy. Telehealth is the remote exchange of data between an individual and a health care professional, and aims to assist in the diagnosis and management of health care conditions. Examples include monitoring blood pressure and blood glucose levels for clinical review by a health professional using phone lines or wireless technology. Both telecare and telehealth have the potential to support a number of key policy objectives, for example around delivering care closer to home, preventing unnecessary hospital admissions, providing choice for people with long-term conditions and supporting independent living. The technology driving these developments has improved vastly with the introduction of broadband and secure webbased services for exchanging data between patients and clinicians.

Many studies have also shown the potential benefits of telecare/telehealth to users but there remains a lack of robust evidence, particularly related to cost-effectiveness. Telecare and telehealth has also not yet been implemented on a large scale. In the UK, over £30 million was allocated in 2007 to establish a 'Whole System Demonstrators Programme' seeking to demonstrate how telecare/telehealth innovations can help in the management of people with long-term care needs. This involved a large randomised control trial involving more than 6,000 patients. In July 2008, the Whole System Demonstrators Action Network (WSDAN) was established. Funded by the Department of Health, its aim was to develop an evidence database on the impact of telehealth and telecare and, in addition, undertake action research with 12 health economies across England to examine the issues and challenges to telecare and telehealth adoption.

This paper provides the following findings from the WSDAN work: 1. The results from a systematic review of the evidence for the impact of telehealth in the management of people with long-term care needs; and 2. An overview of the key lessons learned in deploying technology-assisted home care services successfully.

The paper concludes that the successful deployment of technology-assisted long-term care is far more than just a question of technology. The approach implies the need for fundamental redesign of services, strong collaboration across health and social care, the reshaping of professional roles and staff training, and a specific focus on supporting patients, users and carers to get the best out of technology when managing their needs.

Slides