Why Telehealthcare Requires Your Engineers to Learn to Remove Their Shoes

March 6, 2012 – 1:47 am

Andrew Parton, Joint Managing Director, Hugo Technology

Andrew Parton, Hugo Technology

Guest blogger Andrew Parton, Joint Managing Director, Hugo Technology (Bromsgrove, UK), writes:

We’ve only seen the tip of the iceberg in terms of the changes that the web will bring to healthcare. Until now, it’s been mostly telecare innovations—remote monitoring of patients with long-term conditions. This is now rapidly moving towards telehealthcare, which we define as clinicians remotely treating patients’ long-term conditions while they remain at home. That revolution has only just begun. It has been made economically possible by the Internet, because it allows masses of information to be sent back to the clinician and for actions to be disseminated in an integrated way thereafter. There are several drivers behind telehealthcare:

  • early warnings allow clinicians to prevent conditions from escalating
  • treatment programmes can be adapted to respond to shifting symptoms
  • stress is reduced in the patient population
  • there is less risk of cross-infection because patients are treated in the comfort of their own homes.

The biggest driver, however, is cost savings. We all need to do more with less. Telehealthcare offers tremendous savings compared with current practices, and they go well beyond savings in patient transport costs.It doesn’t take a lot to cost-justify a monitoring system for someone suffering from chronic obstructive pulmonary disease. There is a three-day window during which worsening symptoms can be identified before the patient will need to be hospitalised. A £2500 investment in telehealthcare could prevent a £10,000 stay in a hospital (using NHS benchmarks).

Clinicians will need to learn to consult at a distance, but OEMs face an equal challenge. Their engineers have been used to visiting hospitals and servicing several machines; now, they will need to visit many homes. That means they will regularly come face to face with patients, so they must be checked with the Criminal Records Bureau. What’s more, they will need to be versed in common courtesies such as offering to remove their shoes before they enter a patient’s home.

These engineers also must understand medtech implicitly because it works to much tighter tolerances than many other disciplines. A monitor that is out by 1% could be life threatening. Take Nutricia’s enteral feeding pumps, which we’ve serviced, repaired and calibrated at our workshop for the last eight years. Patients on special diets use these at home, but they still have to go to their doctor to have the dosage altered. Now, that may all change. Clinicians are able to consult with patients through an Internet-enabled interface. For us, it means we soon may be able to remotely determine why a unit is failing. That is a massive time and financial saving when you consider that, eight times out of 10, unit failure is caused by user error.

As the telehealthcare trend grows, be prepared to see medtech OEMs radically adapt their service teams to respond to this seismic shift. They’ll either invest in bigger teams or, in the case of the cost-wise ones, outsource it to those who already are running an army that works to their ISO 13485 standards.

Whichever way the OEMs react, the winners will be those who manage to yoke telehealthcare to high levels of patient service.  As science erodes the distance between patient and clinician, the medtech guardians must ensure that distance is not inserted between us and the highest standards of care.

Andrew Parton, Hugo Technology

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  1. 3 Responses to “Why Telehealthcare Requires Your Engineers to Learn to Remove Their Shoes”

  2. Definitions are important and as a child I was often told to “say what you mean and mean what you say” so this sentence particularly caught my eye: “which we define as clinicians remotely treating patients’ long-term conditions while they remain at home” … it gives the impression that the clinicians are home working, whereas in fact it is the patients who are able to remain in their own home.

    Whilst agreeing with the gist of Andrew’s blog that many service deliveries that will need to be adapted around increasing use of technology in individual’s homes – the definitions used are misleading. If we wish to win hearts and minds to the benefits of technology in care then we need to be clear and consistent in the messages we share:

    Telecare is remote monitoring but not specifically for patients with long term conditions. Telecare is a broad term, literally care at distance, and ranges from simple personal alarms through to sophisticated Smart Homes. Telecare is aimed at alerts for risk (including but not exclusively, falls, fire, reducing use of kitchen/bathroom, wandering, bogus callers) and also prompting activities including taking medication. The alert generates an appropriate response to the situation; allowing an individual to live more independently, and confidently, in their own home for longer.

    Telehealth on the other hand is remote monitoring of a patients vital signs and is most usually benefiting patients with long term conditions, although not exclusively. It is, as Andrew indicates, intended to raise awareness of changes in health requiring potential acute admission and it often supports the patient in being more aware of their own health and contributing to management of it as well as.

    If treatment is being delivered remotely as well as vital signs being monitored then we are merging into telemedicine. Increasingly telehealth equipment is including some telecare (prompting) and some telemedicine (video conferencing).

    By Cathy on Mar 16, 2012

  3. Excellent points there from Cathy to which I can only remotely (as in away from my office) concur with. Hmmmmm!

    Another thing Andrew needs to be very very very careful with is cost savings. Cost savings such as the one Andrew has suggested were the kind of cost saving expectations that has led to a complete mistrust of all that is Telehealth. Similar such amazing savings were banded about 7 or 8 years ago when Telecare was starting its meteoric rise. Those cost savings were soon put to one side after closer inspection.

    A closer inspection is what is coming out in the Whole Systems Demonstrator findings (to be published sometime before 2015 – I have this under good authority!!!!). You may find there is a ‘cost redistribution’ or a ‘cost reallocation’ that arises as opposed to a saving.

    When a patient dies they no longer cost the NHS, or the Local Authority, any money whereas when we extend patient’s lives through closer monitoring in the home we continue to incur a cost. What we save in an acute admission avoided is lost in an extra 4 months of that person’s life being extended and the care provion from health and social care that continues.

    What may be seen is that there needs to be a shift from acute care to more timely interventions that this Tele(whatever) can provide. This is more of a cultural and traditional change as opposed to one specifically based on cost benefits.

    One thing that will definitely gradually disappear (as has done in the Telecare/Community alarm arena) is the personal touch. Through a screen is great but as we all know a hand hold and a nice cup of tea gets more out of a patient/service user/customer than doing your business online even when there is a face at each end. The one thing I totally agree with Andrew about is medtechs being much much more. Potentially they could be the only healthcare professional that person sees in the flesh so they will need to have their best set of teeth in as well as the ability to talk and listen; not just instruct.
    The end.

    By Mike@tech on Mar 19, 2012

  4. This non-intrusive and cost effective telecare service promotes self-care and supports people in maintaining their independence; it allows you to be actively involved in caring for your loved ones and whether you live close by or some distance away it is reassuring to know that you will be contacted if they do not answer their call.

    By telecare on May 20, 2012

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