Why Telecare and Telehealth?
Telecare is a service that enables people, especially older and more vulnerable individuals, to live independently in their own home. 90% of people say that that is their wish and telecare allows it to happen. Equally it gives peace of mind to family, friends and carers, knowing that when they are unable to watch over their loved ones, telecare will.
Telecare is as much about the philosophy of dignity and independence as it is about technology and services. The service package, and choice of technology, is provided to support the individual in their home and is tailored to meet their needs. It can be as simple as the basic social alarm service, able to respond 24/7 in a given situation, it can include sensors and triggers such as motion or fall detectors and fire and gas alarms, that trigger a warning to a response centre staffed 24 hours a day, 365 days a year. It can also include location devices, that can be used to enable an individual to have security outside of their home.
As well as responding to an immediate need, telecare can work in a preventative mode, with services programmed to monitor an individual's health or well-being. Often known as lifestyle monitoring, this can provide early warning of deterioration, prompting a response from family or professionals.
Telehealth works by monitoring vital signs, such as blood pressure, and transmitting the data to a response centre or clinician's computer, where it is monitored against parameters set by the individual's clinician. Evidence that vital signs are outside of 'normal' parameters triggers a response. To be successful telehealth needs to be part of the care pathway for managing long term conditions.
Telecare and telehealth can be used on their own or in combination in order to best meet the needs of the individual and get the best fit with local services, including those provided by family and friends. The services need to balance technology with other forms of care and support and be reviewed in the same way as all other packages of health and social care.
The Whole System Demonstrator Programme
The Whole System Demonstrator (WSD) programme was the largest randomised control trial of telehealth and telecare in the world. The trial involved 6191 patients, 238 GP practices across three sites, Newham, Kent and Cornwall and was set up to look at cost effectiveness, clinical effectiveness, organisational issues, effect on carers and workforce issues. It focused on three conditions, diabetes, Chronic Obstructive Pulmonary Disease (COPD) and coronary heart disease.
The headline findings for the telehealth element of the trial were published in January 2012. These findings show that, if delivered properly, telehealth can substantially reduce mortality, reduce the need for admissions to hospital, lower the number of bed days spent in hospital and reduce the time spent in A&E: