Among healthcare professionals, 89 per cent agree that better integrated care can improve the health of the UK’s population, and 77 per cent believe it would reduce costs.
This is according to the Future Health Index, an international report commissioned by Philips that examines how “connected care” could help address the global health challenge.
“The NHS today is constrained in the resources it has,” says Rupert Hipwell, Philips director of population health management services in the UK. “That’s not a situation that is going to change any time soon, so we need to come up with ways of working that enable us to do more with less.”
Telehealth is a term often used to describe technologies that deliver virtual healthcare services to patients in hospital and at home. It’s already helping to provide additional care to people in the UK living with long-term health problems. In a number of trials throughout the UK, conditions such as chronic pulmonary disease, heart failure and diabetes have benefited significantly in areas where telehealth is available.
The key to success is giving patients and clinicians choice. “Some clinicians will use video calling, while others will use SMS messaging,” explains Mr Hipwell. “A patient with a condition that needs regular monitoring might prefer to use a smartphone or tablet to receive some educational material to track their health. Another patient that doesn’t require such active monitoring might be more comfortable interacting through the television, and self-managing their condition by keeping an electronic health diary.”
Telehealth in intensive care
Banner Health, one of the largest non-profit healthcare systems in the US, was one of the first to apply telehealth technology in its intensive care units. It recognised that 5pc of its patients accounted for 50pc of its total expenditure, so it partnered with Philips to come up with solutions to improve patient outcomes, reduce hospital readmissions and emergency room visits, and increase hospital efficiency.
Deb Dahl, vice president of patient care innovation at Banner Health, believes strongly that telehealth can have a substantial impact on the healthcare system, in the hospital and at home. Since telehealth was introduced, Banner Health has seen a significant reduction in mortality within its intensive care units while greatly reducing costs.
“We have 29 facilities in seven different states, some of which have 153 beds, so it is very costly to put an intensive care specialist by each bedside,” says Ms Dahl. “So we looked at telehealth as a way to provide access to those physicians in all of the Banner sites – in effect, a critical care intensivist doc at your fingertips. There’s a button at the side of the bed in an ICU unit, with two-way cameras. If a patient or family member has a question at 2am, they can just press the button on the wall. It can also be used by the clinician at the bedside and a nurse, practitioner or intensivist will then pop up on the camera and they can have a two-way conversation. It’s a great way of reaching many ICUs with just a few physicians”.
Banner has now expanded on the adoption of telehealth-based care models in hospital, successfully applying them to its pilot programme for patients with multiple chronic conditions. Its at-home intensive ambulatory care (IAC) programme, which combines remote home monitoring, early intervention, educational services and engagement strategies, provides patients with near-instant access to caregivers, including social workers, pharmacists, and health coaches. An analysis of the results of each patient’s first six months demonstrated that the programme achieved a 45 per cent reduction in hospitalisations and a 27 per cent reduction in cost of care.1
Telehealth in the community
Today, telehealth is principally used in the UK to help patients with those long-term conditions that place the greatest burden on the healthcare system. For example, in a three-year study conducted by NHS Liverpool Clinical Commissioning Group in partnership with Philips, telehealth was shown to reduce emergency admissions by 22 to 32 per cent for patients with above-average risk. More than 90 per cent of patients also reported feeling more in control of their condition. As well as having a tangible impact on individual patients, telehealth has now become a part of routine care for the Liverpool group.2
The start of something new
So how will telehealth begin to transform the NHS? In the UK, patients with long-term health conditions will most likely be proactively approached and offered some form of telehealth support as a means of self-managing their health in between appointments.
“This is likely to be triggered by factors such as if they have multiple long-term conditions, or they’ve had a recent exacerbation or have had a number of admissions to hospital the previous year,” says Mr Hipwell. “These kinds of factors will trigger healthcare specialists, in areas where telehealth is up and running, to actively reach out.”
Additionally, patients can speak to their GP and ask about the availability of telehealth solutions in their local area and how these new models of care may help in the management of their own long-term condition while helping to safeguard a sustainable healthcare system for the future.
For more information on telehealth services in the UK, visit philips.co.uk/healthcare/solutions/enterprise-telehealth
1. Dahl, D., Khurana MD, H. (2015). Impact of an intensive ambulatory program on both financial and clinical outcomes in Banner Health. Unpublished internal study
2. Evidence for Supported Self-Care at Scale, report March 2016, Philips and NHS Liverpool Clinical Commissioning Group