In a recent article from ehi ehealth insider (http://www.ehi.co.uk/news/EHI/8728/telehealth-doesn%27t-improve-self-care) a “Whole System Demonstrator” programme revealed that telehealth doesn’t improve patients’ self-care behavior. The randomized control trial by the Department of Health was attempting to find evidence to support the use of telehealth and telecare technologies.
A major finding was that the patient outcome pathway was rarely discussed when talking about telehealth. The article goes on to say that “behavior change is the only way to deliver telehealth. We need a new telehealth delivery model to achieve sustained improvement”.
Whilst there is some conflicting research about the cost effectiveness of telehealth, and the improvements in the quality of life for patients, I would suggest that further research is warranted to better define telehealth and determine it’s true effectiveness at delivering positive patient and fiscal outcomes.
There is no doubt that there are many barriers to the adoption of telehealth and telecare. As this article suggests, most of the barriers are to do with integration. In my view, the following activities need to be undertaken to reduce these barriers:
- Definition of a clear scope of what telehealth is and isn’t. Rather than have a broad high level definition of telehealth, develop an accurate and detailed picture of the processes and technology involved in delivering telehealth.
- Service delivery models need to be developed that support the process change for telehealth. Telehealth should not be provisioned just because we think that e-health is the way to go.
- Telehealth needs to be thoroughly considered and tested from a client, safety, financial, benefit, and process perspective.
- Telehealth needs to be carefully planned to ensure the service delivery models, processes and practices are in place to support the change in service delivery. Staff buy-in is paramount, particularly as it relates to the change to the way care is delivered.
- The client needs to be involved in the telehealth journey, to facilitate input, feedback, buy-in, etc
- Organisations need to understand the integration challenges in telehealth. This is from a technology perspective as well as a service delivery model perspective. Integration in relation to data, systems and infrastructure is as important as the integration in relation to service delivery, processes and change. Addressing one component without the other will result in poor outcomes.
The article goes on to say that “there’s no literature about the difficulties of integrating telehealth and telecare and no evidence that there is an awareness of this issue at policy level”. This is somewhat concerning given the push to implement telehealth (and many other ehealth initiatives) in the interest of improved client outcomes, care provision and financial efficiencies.
Ben Ward 