In the UK, the Department of Health launched the Whole System Demonstrator program to build a body of evidence for the integration of health and social care provision through telehealth and telecare. The results show that by leveraging technology the health system was able to achieve a 20 percent reduction in emergency admissions, a 14 percent reduction in elective admissions and a 45 percent reduction in mortality rates. According to Lord Crisp, former NHS CEO and Honorary Professor at the London School of Hygiene and Tropical Medicine, "Telemedicine, rightly in my view, is seen as central to the improvement of health and life in developing countries."
The combination of electronic health records, mobile health devices, virtual teamwork and electronically enabled disease and knowledge management has also emerged as a platform for catalyzing the transformation of healthcare, particularly in the developing world. In China, for example, the government is engaged in a program to drive universal access to health services by developing the technologies and infrastructure required for a national eHealth program. In one fell swoop, the Chinese government expects to extend access to care to more than 1.3 billion people. The government also plans to build 30,000 hospitals16 across the country which – if built within sustainable guidelines – will provide substantial dividends to the health of a large portion of the world's population.
But both eHealth and telehealth require a significant investment in technology and infrastructure, as well as a supportive policy environment to ensure change is sustainable and effective. And, again, the participation of the private sector will be critical, particularly in building the basic infrastructure to support these emerging technologies.
Case study: Changing the model of care to enhance patient outcomes
Having undertaken a series of clinical trials, small pilots and meta-data reviews, the UK's Department of Health recognized that – while the case for telehealth was strengthening – the evidence lacked scale, statistical significance and robust cost-savings data.
As a result, the Department of Health launched the Whole System Demonstrator (WSD) program in May 2008. Preliminary findings from this, the largest randomized control trial of its kind in the world, prove how eHealth delivers on its promise to be truly transformational.
WSD sought to build the evidence for a new way of providing patient care through integrated health and social care provision, supported by advanced assistive technologies such as telehealth and telecare. It involved more than 6,000 participants across three locations.
The program selected five main themes upon which to evaluate the system:
- The impact upon service utilization and costs across health and social care.
- The impact upon the lives of participants and caregivers.
- The cost and cost-effectiveness of the service.
- The views and experiences of users, caregivers and professionals involved in the program.
- The impact of change, collaborative working and large-scale programs on the organization and individual.
"What we have seen in preliminary results is that telehealth and telecare – when applied to chronic disease areas such as diabetes, COPD and heart conditions – can provide a valuable alternative to the current model of patient care in the UK," noted Andrew Hine, a partner with KPMG in the UK. "And by treating patients outside of the emergency or ambulatory wards, the program has effectively changed the model of care that is provided to some of the most frequent users of health services."
The WSD "Headline Findings – December 2011" released by the Department of Health1 reveals the significant benefits of telehealth. If used correctly, telehealth can deliver a 15 percent reduction in A&E visits, a 20 percent reduction in emergency admissions, a 14 percent reduction in elective admissions, a 14 percent reduction in bed days and an 8 percent reduction in tariff costs. More strikingly the program also demonstrated a 45 percent reduction in mortality rates.