This document discusses lessons learned from trials of telehealth and remote care in the UK. It notes that while the concept of remote care has existed for over 100 years and numerous trials have shown benefits, adoption into mainstream care has been slow. It estimates the potential market for remote care in the UK could be over 1 million people but current usage is only around 350,000. Key challenges to wider adoption are organizational factors, needing strong leadership, project management and champions, as well as developing robust evidence and business cases. The Whole System Demonstrator trial highlighted these issues and more work is still needed to understand how to scale remote care solutions.
Hooked on Telehealth for Occupational TherapyDona Anderson
This document discusses using telehealth technologies like telemedicine and telerehabilitation to promote health and community reintegration for people living with spinal cord injuries and other disabilities. It highlights how broadband internet access and technologies can help overcome isolation through virtual support groups, education, and remote rehabilitation services. The document presents examples of using videoconferencing for remote occupational therapy evaluations and treatment in clients' homes. It also raises questions about how Rancho Los Amigos National Rehabilitation Center can promote digital literacy and internet access to better utilize eHealth technologies for their patients.
The document discusses how living labs in Europe foster innovation through collaboration and diversity. It provides an overview of the European Network of Living Labs (ENoLL) which connects various living lab organizations across different countries and domains to drive open innovation. The virtuous innovation circle model is presented as emphasizing reconciliation of realities, enrichment through interaction, and generating energy through complementary collaboration between diverse actors.
Xavier Chitnis: the effects of telehealth on service use Nuffield Trust
This document summarizes a study evaluating the impact of a large telehealth deployment program in North Yorkshire, England. The study will assess the effect of telehealth and telemonitoring alerts on rates of healthcare service use such as emergency admissions, mortality, and primary and secondary care usage. The study also aims to develop methods for routinely evaluating community-based interventions. Over 750 patients with conditions like heart failure, COPD, and diabetes who were enrolled in the telehealth program between 2009-2013 will be compared to retrospectively selected local and national controls.
Judith Smith: Commissioning for long-term conditionsNuffield Trust
1) The study explored how NHS commissioning can assure high quality care for people with long-term conditions through ethnographic research in three commissioning communities over two years.
2) The research found that commissioning in practice is messier than assumed, involves coordination and facilitation beyond a neat annual cycle, and commissioners play roles in implementation support.
3) The implications are that commissioning long-term conditions requires extensive relational work that may not align with the commissioning cycle and that there are critical enablers like skilled managers and clinicians that support effective commissioning practices.
Remote care has been discussed and piloted for decades but has not become mainstream. Three key barriers to mainstreaming remote care are organizational integration challenges, lack of obvious business models, and limited evidence of benefits. Simulation modeling can provide insights into remote care's potential impacts, like reduced hospital admissions, but real-world evidence is still limited. More data is needed on users, costs, and outcomes to build robust evidence that convinces stakeholders and supports widespread adoption.
This document summarizes a presentation on assessing and enhancing the public value of telehealthcare. It begins by discussing the various terms used in telehealth, including telehealthcare, telemedicine, telecare, telemonitoring, and eHealth. It then reviews definitions of telemedicine from Cochrane reviews, the European Commission, and other sources. The presentation notes the potential benefits of telehealthcare, such as reduced hospital and care home days, but also discusses challenges to adoption like a lack of clarity around cost savings and reluctance from physicians.
ILC-UK, New Dynamics of Ageing and the Actuarial Profession debate: Improving...ILC- UK
Telecare and telemedicine can improve health outcomes and save money, argued the Prime Minister late last year. The Whole System Demonstrator (WSD) programme was set up by the Department of Health to attempt to, amongst other things, explore the evidence base as to the effectiveness and cost-effectiveness of these technologies.
The findings were striking. “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” argued the DH.
The randomised control trial of over 6,000 patients found that if delivered properly, telehealth can deliver:
45% reduction in mortality rates
20% reduction in emergency admissions
15% reduction in A&E visits
14% reduction in elective admissions
14% reduction in bed days
8% reduction in tariff costs
Yet whilst claims about the potential of technology have been made for many years, embedding such technologies into people’s homes and lives has proved difficult.
The usability and accessibility of new technologies, the digital divide, a lack of funding for prevention, and a lack of trust and knowledge among healthcare professionals are among the many reasons why new technologies have sometimes failed to meet their potential.
At this event, Leela Damodaran, discussed how research into new technologies can help us age well and provide an overview of NDA research findings. She also highlight how we can most effectively deliver new technology.
Speakers presented the current evidence base in relation to the cost effectiveness of healthcare technologies.
ILC-UK presented findings of new work, supported by Nominet Trust, which will explore whether we can nudge people online.
As well as the debate, there were a number of Technology Showcases: Mappmal: hospitalfoodie; SomnIA; Design for Ageing Well; TACT3; Envision to envisage; Making the Kitchen Easier; NANA; Keeping Older People Connected; Safety on Stairs
Agenda from the event
15.00 – 16.30
Technology Showcases
16.30 – 16.35
Baroness Sally Greengross – Chief Executive, International Longevity Centre – UK
16.35 – 16.40
Alan Walker - Professor of Social Policy and Social Gerontology, Director of the New Dynamics
16.40 – 17.00
Mark Hawley – Professor of Health Service Research, University of Sheffield
17.00 – 17.10
Dr Nick Goodwin – Senior Fellow, Health Policy, The King’s Fund
17.10 – 17.25
Leela Damodaran – Professor of Participative Design and Change Management, Loughborough University
17.25 – 17.35
David Sinclair – Assistant Director, Research and Strategy, International Longevity Centre – UK
17.35 – 18.25
Discussion and Debate
18.25 – 18.30
Close - Baroness Sally Greengross – Chief Executive, International Longevity Centre – UK
18:30
Refreshments/Networki
This document provides an overview of telehealth initiatives in the Yorkshire and Humber region of England. It discusses the population trends that are increasing demand for health services, such as an aging population and rise in long-term conditions. It then summarizes some of the early telehealth pilots and a regional telehealth hub that was established. Finally, it discusses national initiatives like 3millionlives and Digital First that aim to accelerate the adoption of telehealth, and how the region is aligning local efforts with these strategies.
Hooked on Telehealth for Occupational TherapyDona Anderson
This document discusses using telehealth technologies like telemedicine and telerehabilitation to promote health and community reintegration for people living with spinal cord injuries and other disabilities. It highlights how broadband internet access and technologies can help overcome isolation through virtual support groups, education, and remote rehabilitation services. The document presents examples of using videoconferencing for remote occupational therapy evaluations and treatment in clients' homes. It also raises questions about how Rancho Los Amigos National Rehabilitation Center can promote digital literacy and internet access to better utilize eHealth technologies for their patients.
The document discusses how living labs in Europe foster innovation through collaboration and diversity. It provides an overview of the European Network of Living Labs (ENoLL) which connects various living lab organizations across different countries and domains to drive open innovation. The virtuous innovation circle model is presented as emphasizing reconciliation of realities, enrichment through interaction, and generating energy through complementary collaboration between diverse actors.
Xavier Chitnis: the effects of telehealth on service use Nuffield Trust
This document summarizes a study evaluating the impact of a large telehealth deployment program in North Yorkshire, England. The study will assess the effect of telehealth and telemonitoring alerts on rates of healthcare service use such as emergency admissions, mortality, and primary and secondary care usage. The study also aims to develop methods for routinely evaluating community-based interventions. Over 750 patients with conditions like heart failure, COPD, and diabetes who were enrolled in the telehealth program between 2009-2013 will be compared to retrospectively selected local and national controls.
Judith Smith: Commissioning for long-term conditionsNuffield Trust
1) The study explored how NHS commissioning can assure high quality care for people with long-term conditions through ethnographic research in three commissioning communities over two years.
2) The research found that commissioning in practice is messier than assumed, involves coordination and facilitation beyond a neat annual cycle, and commissioners play roles in implementation support.
3) The implications are that commissioning long-term conditions requires extensive relational work that may not align with the commissioning cycle and that there are critical enablers like skilled managers and clinicians that support effective commissioning practices.
Remote care has been discussed and piloted for decades but has not become mainstream. Three key barriers to mainstreaming remote care are organizational integration challenges, lack of obvious business models, and limited evidence of benefits. Simulation modeling can provide insights into remote care's potential impacts, like reduced hospital admissions, but real-world evidence is still limited. More data is needed on users, costs, and outcomes to build robust evidence that convinces stakeholders and supports widespread adoption.
This document summarizes a presentation on assessing and enhancing the public value of telehealthcare. It begins by discussing the various terms used in telehealth, including telehealthcare, telemedicine, telecare, telemonitoring, and eHealth. It then reviews definitions of telemedicine from Cochrane reviews, the European Commission, and other sources. The presentation notes the potential benefits of telehealthcare, such as reduced hospital and care home days, but also discusses challenges to adoption like a lack of clarity around cost savings and reluctance from physicians.
ILC-UK, New Dynamics of Ageing and the Actuarial Profession debate: Improving...ILC- UK
Telecare and telemedicine can improve health outcomes and save money, argued the Prime Minister late last year. The Whole System Demonstrator (WSD) programme was set up by the Department of Health to attempt to, amongst other things, explore the evidence base as to the effectiveness and cost-effectiveness of these technologies.
The findings were striking. “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” argued the DH.
The randomised control trial of over 6,000 patients found that if delivered properly, telehealth can deliver:
45% reduction in mortality rates
20% reduction in emergency admissions
15% reduction in A&E visits
14% reduction in elective admissions
14% reduction in bed days
8% reduction in tariff costs
Yet whilst claims about the potential of technology have been made for many years, embedding such technologies into people’s homes and lives has proved difficult.
The usability and accessibility of new technologies, the digital divide, a lack of funding for prevention, and a lack of trust and knowledge among healthcare professionals are among the many reasons why new technologies have sometimes failed to meet their potential.
At this event, Leela Damodaran, discussed how research into new technologies can help us age well and provide an overview of NDA research findings. She also highlight how we can most effectively deliver new technology.
Speakers presented the current evidence base in relation to the cost effectiveness of healthcare technologies.
ILC-UK presented findings of new work, supported by Nominet Trust, which will explore whether we can nudge people online.
As well as the debate, there were a number of Technology Showcases: Mappmal: hospitalfoodie; SomnIA; Design for Ageing Well; TACT3; Envision to envisage; Making the Kitchen Easier; NANA; Keeping Older People Connected; Safety on Stairs
Agenda from the event
15.00 – 16.30
Technology Showcases
16.30 – 16.35
Baroness Sally Greengross – Chief Executive, International Longevity Centre – UK
16.35 – 16.40
Alan Walker - Professor of Social Policy and Social Gerontology, Director of the New Dynamics
16.40 – 17.00
Mark Hawley – Professor of Health Service Research, University of Sheffield
17.00 – 17.10
Dr Nick Goodwin – Senior Fellow, Health Policy, The King’s Fund
17.10 – 17.25
Leela Damodaran – Professor of Participative Design and Change Management, Loughborough University
17.25 – 17.35
David Sinclair – Assistant Director, Research and Strategy, International Longevity Centre – UK
17.35 – 18.25
Discussion and Debate
18.25 – 18.30
Close - Baroness Sally Greengross – Chief Executive, International Longevity Centre – UK
18:30
Refreshments/Networki
This document provides an overview of telehealth initiatives in the Yorkshire and Humber region of England. It discusses the population trends that are increasing demand for health services, such as an aging population and rise in long-term conditions. It then summarizes some of the early telehealth pilots and a regional telehealth hub that was established. Finally, it discusses national initiatives like 3millionlives and Digital First that aim to accelerate the adoption of telehealth, and how the region is aligning local efforts with these strategies.
Telemedicina i pacients crònics / Telemedicine in chronic patientsAntoni Parada
Telemedicina i pacients crònics. Conferència impartida pel Professor canadenc Denis Protti Health Information Science - Victoria University. Barcelona, 2 de febrer de 2012. Organitzada per la Fundació TicSalut i l’Agència d’Informació, Avaluació i Qualitat en Salut.
Telemedicine is defined as using telecommunications to provide healthcare remotely by sharing medical information and expertise over distances. It involves transferring various medical data like images, sounds, and patient records via internet, intranet, computers, and telephone lines. Some key applications of telemedicine include teleconsultation, telemonitoring of patients, telediagnosis, and tele-education of medical practitioners. While telemedicine provides benefits like improved access to care and cost savings, its adoption faces challenges due to issues around technology infrastructure, licensing, and patient acceptance of remote healthcare.
Telemedicine (Information Technology) - Mathankumar.S - VMKVECMathankumar S
The document discusses various medical imaging techniques including their principles, applications, advantages, and disadvantages. It covers X-rays, CT, MRI, PET, ultrasound, mammography, and angiography. CT is described as producing 3D images from 2D X-ray projections taken around the body. MRI uses magnetic fields and radio waves to generate detailed anatomical images without X-rays. PET involves detecting gamma rays emitted from radiotracers to produce functional images. Ultrasound uses sound waves to image tissues based on acoustic impedance.
INFORMATION TECHNOLOGY IN HEALTHCARE - MATHANKUMAR.S - VMKVECMathankumar S
The document discusses the potential of various emerging technologies in healthcare, such as virtual reality, cyber surgery, and 3D imaging. It notes that while telemedicine and e-healthcare could greatly benefit patients, several preconditions must be met first, such as improved internet access and standardization of protocols. India is seen as well-positioned to experiment with e-healthcare solutions due to its skilled workforce and growing healthcare sector. The document also provides examples of various medical imaging techniques such as X-rays, CT scans, MRI, ultrasound and their applications in diagnosis.
NZ Commerce Commission - Issues paper 2 e-health and e-education - january 2012Silvia Zanini
The Commerce Commission released the second of three issues papers relating to the uptake of high speed broadband ahead of a public conference in February 2012. The paper is in two parts and examines the potential demand for high speed broadband from the education and health sectors.
The paper was prepared by Ernie Newman, former Chief Executive of the Telecommunications Users Association of New Zealand.
This document discusses the use of tele-ophthalmology and telemedicine in rural areas to improve access to eye care. It describes how tele-ophthalmology works by connecting doctors at urban hospitals to patients in rural vision centers using videoconferencing and image sharing technology. The benefits discussed include increased access to specialty care for rural populations in a more cost-effective manner by reducing travel costs and time. Challenges like infrastructure and connectivity issues are also mentioned. Overall, the document argues that tele-ophthalmology can help deliver quality eye care services to rural communities.
The document discusses the growth of telemedicine and its potential to revolutionize healthcare delivery. Telemedicine uses technology to allow medical professionals to diagnose and consult with patients remotely, increasing access to care. Several examples are provided of telemedicine applications like teledermatology that have reduced costs and wait times while improving health outcomes.
Stephen Johnson: Can assistive technology support people with LTCs?Nuffield Trust
The document discusses how assistive technology can support people with long term conditions (LTCs). It notes that over 15 million people in England have a LTC, and treatment accounts for 70% of health spending. The UK strategy for LTCs uses a three-tier model, with different levels of support. Telehealth aims to help the majority who are in Tier 1 and manage their conditions through self-care. The Whole System Demonstrator trial showed promising early results for telehealth in improving outcomes and reducing costs. Barriers to adoption include lack of a strong evidence base, upfront technology costs, and workforce training needs.
Tim Straughan: The NHS Information RevolutionThe King's Fund
Tim Straughan discusses Health informatics - driving integration and efficiencies across primary, secondary and community care at The King's Fund's NHS Information Revolution conference.
This document provides an overview of the design and implementation of a wireless IP telephony system for telemedicine services in Bangladesh. It discusses:
1. The history and components of telemedicine and how IP telephony works.
2. The proposed design of a prototype wireless IP telephony system for telemedicine, which would enable integrated voice and data transmission for flexible medical services.
3. Some of the technical problems and economic aspects of implementing such a wireless IP telemedicine system, as well as the benefits to patients, practitioners, and telemedicine services.
In short there is a missing piece in the innovation process …where can technology companies conduct large scale trials/PoCs with real customer feedback? The pace of worldwide innovation now requires a scalable live production lab where technology, products and services can be tested prior to global expansion. JT Labs is offering a solution to solve this major innovation dilemma; JT is the only tier-one quad-play carrier in the world that is offing it’s networks and customer base for companies to trial their technology, products and services before launching worldwide.
JT Lab is in the island nation of Jersey, located in the English Channel; 100,000 person population, 42,000 households, 4000 businesses and Government offices, Island size 9 miles x 5 miles. Jersey is a self-governing, British Crown Dependency, English speaking & uses Jersey Pound Sterling currency, yet is outside the EU & UK. Sixth highest GDP per capita in the world and broadest demographic spread in Europe. Highly educated tech-savvy population with 80+% smartphone penetration and connected to some of the fastest networks in the world (Wireless, 1Gps FTTP, VoIP NGN Landline) all provided to them by JT Global.
We are offing technology companies and their strategic partners an opportunity to test and launch products and services on a REAL infrastructure, with REAL customers, in REAL time, with REAL customer feedback using JT Lab.
The document discusses predictions for IT spending in Western Europe in 2011, with total spending expected to reach 12.24 billion dollars. Spain is predicted to spend 523 million dollars (around 390 million euros depending on exchange rate), while the UK, France, Germany, Italy, and Netherlands are each predicted to spend over 500 million dollars. The document also outlines 10 ways that information technology and healthcare are expected to evolve in 2011 and beyond, such as increased use of mobile health, electronic prescribing, clinical decision support systems, and new architectures to handle growing clinical data.
At Modern Health Talk, we see the future of mHealth as less about Mobile health and more about MODERN healthcare that includes all sorts of solutions for addressing demographic shift of retiring baby boomers and the resulting doctor shortage.
These solutions include mobile technologies (smartphones & tablets) and big broadband support of high-def video calls with medical imaging, as well as new delivery options such as retail clinics and insurance-funded home care (and home modifications), remote sensor monitoring, healthcare robots, Watson-like cloud services, new laws & regulations, support of family caregivers, and more.
The slides hint at the topics I cover as a public speaker but lack the discussion and delivery. To schedule a speaking engagement for your organization, contact me at waynecaswell AT mhealthtalk DOT com.
Telemedicina i pacients crònics / Telemedicine in chronic patientsAntoni Parada
Telemedicina i pacients crònics. Conferència impartida pel Professor canadenc Denis Protti Health Information Science - Victoria University. Barcelona, 2 de febrer de 2012. Organitzada per la Fundació TicSalut i l’Agència d’Informació, Avaluació i Qualitat en Salut.
Telemedicine is defined as using telecommunications to provide healthcare remotely by sharing medical information and expertise over distances. It involves transferring various medical data like images, sounds, and patient records via internet, intranet, computers, and telephone lines. Some key applications of telemedicine include teleconsultation, telemonitoring of patients, telediagnosis, and tele-education of medical practitioners. While telemedicine provides benefits like improved access to care and cost savings, its adoption faces challenges due to issues around technology infrastructure, licensing, and patient acceptance of remote healthcare.
Telemedicine (Information Technology) - Mathankumar.S - VMKVECMathankumar S
The document discusses various medical imaging techniques including their principles, applications, advantages, and disadvantages. It covers X-rays, CT, MRI, PET, ultrasound, mammography, and angiography. CT is described as producing 3D images from 2D X-ray projections taken around the body. MRI uses magnetic fields and radio waves to generate detailed anatomical images without X-rays. PET involves detecting gamma rays emitted from radiotracers to produce functional images. Ultrasound uses sound waves to image tissues based on acoustic impedance.
INFORMATION TECHNOLOGY IN HEALTHCARE - MATHANKUMAR.S - VMKVECMathankumar S
The document discusses the potential of various emerging technologies in healthcare, such as virtual reality, cyber surgery, and 3D imaging. It notes that while telemedicine and e-healthcare could greatly benefit patients, several preconditions must be met first, such as improved internet access and standardization of protocols. India is seen as well-positioned to experiment with e-healthcare solutions due to its skilled workforce and growing healthcare sector. The document also provides examples of various medical imaging techniques such as X-rays, CT scans, MRI, ultrasound and their applications in diagnosis.
NZ Commerce Commission - Issues paper 2 e-health and e-education - january 2012Silvia Zanini
The Commerce Commission released the second of three issues papers relating to the uptake of high speed broadband ahead of a public conference in February 2012. The paper is in two parts and examines the potential demand for high speed broadband from the education and health sectors.
The paper was prepared by Ernie Newman, former Chief Executive of the Telecommunications Users Association of New Zealand.
This document discusses the use of tele-ophthalmology and telemedicine in rural areas to improve access to eye care. It describes how tele-ophthalmology works by connecting doctors at urban hospitals to patients in rural vision centers using videoconferencing and image sharing technology. The benefits discussed include increased access to specialty care for rural populations in a more cost-effective manner by reducing travel costs and time. Challenges like infrastructure and connectivity issues are also mentioned. Overall, the document argues that tele-ophthalmology can help deliver quality eye care services to rural communities.
The document discusses the growth of telemedicine and its potential to revolutionize healthcare delivery. Telemedicine uses technology to allow medical professionals to diagnose and consult with patients remotely, increasing access to care. Several examples are provided of telemedicine applications like teledermatology that have reduced costs and wait times while improving health outcomes.
Stephen Johnson: Can assistive technology support people with LTCs?Nuffield Trust
The document discusses how assistive technology can support people with long term conditions (LTCs). It notes that over 15 million people in England have a LTC, and treatment accounts for 70% of health spending. The UK strategy for LTCs uses a three-tier model, with different levels of support. Telehealth aims to help the majority who are in Tier 1 and manage their conditions through self-care. The Whole System Demonstrator trial showed promising early results for telehealth in improving outcomes and reducing costs. Barriers to adoption include lack of a strong evidence base, upfront technology costs, and workforce training needs.
Tim Straughan: The NHS Information RevolutionThe King's Fund
Tim Straughan discusses Health informatics - driving integration and efficiencies across primary, secondary and community care at The King's Fund's NHS Information Revolution conference.
This document provides an overview of the design and implementation of a wireless IP telephony system for telemedicine services in Bangladesh. It discusses:
1. The history and components of telemedicine and how IP telephony works.
2. The proposed design of a prototype wireless IP telephony system for telemedicine, which would enable integrated voice and data transmission for flexible medical services.
3. Some of the technical problems and economic aspects of implementing such a wireless IP telemedicine system, as well as the benefits to patients, practitioners, and telemedicine services.
In short there is a missing piece in the innovation process …where can technology companies conduct large scale trials/PoCs with real customer feedback? The pace of worldwide innovation now requires a scalable live production lab where technology, products and services can be tested prior to global expansion. JT Labs is offering a solution to solve this major innovation dilemma; JT is the only tier-one quad-play carrier in the world that is offing it’s networks and customer base for companies to trial their technology, products and services before launching worldwide.
JT Lab is in the island nation of Jersey, located in the English Channel; 100,000 person population, 42,000 households, 4000 businesses and Government offices, Island size 9 miles x 5 miles. Jersey is a self-governing, British Crown Dependency, English speaking & uses Jersey Pound Sterling currency, yet is outside the EU & UK. Sixth highest GDP per capita in the world and broadest demographic spread in Europe. Highly educated tech-savvy population with 80+% smartphone penetration and connected to some of the fastest networks in the world (Wireless, 1Gps FTTP, VoIP NGN Landline) all provided to them by JT Global.
We are offing technology companies and their strategic partners an opportunity to test and launch products and services on a REAL infrastructure, with REAL customers, in REAL time, with REAL customer feedback using JT Lab.
The document discusses predictions for IT spending in Western Europe in 2011, with total spending expected to reach 12.24 billion dollars. Spain is predicted to spend 523 million dollars (around 390 million euros depending on exchange rate), while the UK, France, Germany, Italy, and Netherlands are each predicted to spend over 500 million dollars. The document also outlines 10 ways that information technology and healthcare are expected to evolve in 2011 and beyond, such as increased use of mobile health, electronic prescribing, clinical decision support systems, and new architectures to handle growing clinical data.
At Modern Health Talk, we see the future of mHealth as less about Mobile health and more about MODERN healthcare that includes all sorts of solutions for addressing demographic shift of retiring baby boomers and the resulting doctor shortage.
These solutions include mobile technologies (smartphones & tablets) and big broadband support of high-def video calls with medical imaging, as well as new delivery options such as retail clinics and insurance-funded home care (and home modifications), remote sensor monitoring, healthcare robots, Watson-like cloud services, new laws & regulations, support of family caregivers, and more.
The slides hint at the topics I cover as a public speaker but lack the discussion and delivery. To schedule a speaking engagement for your organization, contact me at waynecaswell AT mhealthtalk DOT com.
Similar to James Barlow - unanswered questions in telehealth 121002 (20)
This document discusses the potential impacts of automation on healthcare employment and discusses alternative views beyond job loss. It notes that automation may lead to reconfiguring of healthcare work rather than outright job loss. Examples of existing technologies that have automated tasks in healthcare like pharmacy automation and emerging technologies like decision support systems and personal health tracking are provided. The document advocates that automation could lead to a virtuous cycle in healthcare if it allows workers to focus on tasks that require human skills and judgment.
Evaluation of the Integrated Care and Support Pioneers ProgrammeNuffield Trust
This document summarizes the findings of evaluations of the Integrated Care and Support Pioneers Programme in the UK. The evaluations found that while Pioneers aspired to comprehensive system change, their activities focused more narrowly on initiatives like risk stratification and care coordination teams. Progress was difficult to measure against indicators and Pioneers faced challenges from financial pressures and competing priorities. The evaluations concluded that further integration will be challenging under increasing demands on the health system.
The document discusses lessons learned from the Southwark and Lambeth Integrated Care (SLIC) program in London. Key points:
- SLIC aimed to reduce hospital admissions and care home placements for older adults through risk stratification, holistic assessments, and care management.
- Success required agreement on the problem, dedicated teams, funding shifts to support community care, and leadership development.
- Future programs need a strong business case, co-design with citizens, and a dedicated "engine room" team to drive local transformation.
Effectiveness of the current dominant approach to integrated care in the NHSNuffield Trust
Jonathan Stokes of the Greater Manchester Primary Care Patient Safety Translational Research Centre presents a systematic review of case management in integrated care.
Providing actionable healthcare analytics at scale: Understanding improvement...Nuffield Trust
This document discusses measurement for quality improvement. It explains that measurement in improvement aims to provide a basis for action to improve processes and outcomes, rather than just estimating parameters. Improvement measures should be simple, specific, and available in real-time. Statistical process control methods are important to separate normal variation from changes resulting from interventions. Examples are provided of run charts measuring improvements in recording BMI for mental health patients and compliance with care bundles. The document advocates making the theories behind improvement efforts more explicit.
Ramani Moonesinghe, Associate National Clinical Director for Elective Care at NHS England, discusses the use of data for monitoring care quality at various levels within the system.
This document discusses using statistical process control (CUSUM) charts to monitor mortality rates at the level of individual general practitioners and health authorities. It describes how CUSUM charts could potentially have detected Harold Shipman, a GP who murdered over 200 patients, by spotting outliers in the routine mortality data. The document also discusses challenges in risk adjusting outcomes to account for differences in patient characteristics and casemix between providers. Accurately adjusting for factors like age, comorbidities, and emergency status is important for fair comparisons but difficult using only administrative data.
Martin Utley, Director of the Clinical Operational Research Unit at University College London, reflects upon his involvement in the launch of specific tools to monitor care quality for paediatric cardiac surgery.
Evaluating new models of care: Improvement Analytics UnitNuffield Trust
Martin Caunt, Improvement Analytics Unit Project Director and NHS England and Adam Steventon, Director of Data Analytics at The Health Foundation share insights into how they have approached evaluating new models of care.
Lisa Annaly, Head of Provider Analytics at the Care Quality Commission, discusses lessons learned from the CQC as they have worked to monitor care quality over time.
- Real-time monitoring of healthcare services requires defining both a reporting window and data window to accurately capture demand, activity, and wait times.
- Using only a reporting window (e.g. a single month) to request data can result in invalid or misleading performance metrics, as it does not account for patients with long wait times.
- Defining a larger data window that includes all patients requested before the end of the reporting window and reported after the start avoids this problem, but requires a counterintuitive data request.
- Without properly defining both windows, real-time monitoring can provide an inaccurate picture of service performance and falsely suggest the need for more resources.
Monitoring quality of care: making the most of dataNuffield Trust
Chris Sherlaw-Johnson, Senior Research Analyst at the Nuffield Trust, introduced the Monitoring quality of care conference and gives an overview of some of the approaches that we've been using at the Trust to identify where care quality has been improving, especially for frail and older people.
Providing actionable healthcare analytics at scale: Insights from the Nationa...Nuffield Trust
Christopher Boulton, Falls and Fragility Fracture Audit Programme Manager at the Royal College of Physicians and Rob Wakeman, Clinical Lead for Orthopaedic Surgery at the National Hip Fracture Database talk about what they have learned by analysing the national hip fracture database.
Providing actionable healthcare analytics at scale: A perspective from stroke...Nuffield Trust
Benjamin Bray, Research Director and the Sentinel Stroke National Audit Programme, presents at the Monitoring quality of care conference about stroke care analytics.
New Models of General Practice: Practical and policy lessonsNuffield Trust
Nuffield Trust policy researchers Rebecca Rosen and Stephanie Kumpunen present findings from our upcoming report on large scale general practice models.
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
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Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
This presentation gives information on the pharmacology of Prostaglandins, Thromboxanes and Leukotrienes i.e. Eicosanoids. Eicosanoids are signaling molecules derived from polyunsaturated fatty acids like arachidonic acid. They are involved in complex control over inflammation, immunity, and the central nervous system. Eicosanoids are synthesized through the enzymatic oxidation of fatty acids by cyclooxygenase and lipoxygenase enzymes. They have short half-lives and act locally through autocrine and paracrine signaling.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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After getting it read you will definitely understand the topic.
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Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
James Barlow - unanswered questions in telehealth 121002
1. Unanswered questions in telehealth. The
lessons to be learnt from the WSD trial
Evaluating the impact of telehealth: where next for research beyond
the Whole System Demonstrator trial?
2 October 2012
Nuffield Trust, London
James Barlow
www.haciric.org
2. Outline
• Lesson 1. Taking stock. What progress has been made
in deploying remote care in the UK?
• Lesson 2. How big is the potential UK market for remote
care?
• Lesson 3. Crossing the brick wall – mainstreaming
remote care
• Lesson 4. Evaluation, evidence, policy and scaling up
• The questions we now need to address
4. The idea has been around a long time
Practice by Telephone
The Yankees are rapidly finding out the benefits of the telephone. A newly
made grandmamma, we are told, was recently awakened by the bell at midnight,
and told by her inexperienced daughter, "Baby has the croup. What shall I do
with it?" Grandmamma replied she would call the family doctor, and would be
there in a minute. Grandmamma woke the doctor, and told him the terrible
news. He in turn asked to be put in telephonic communication with the anxious
mamma. "Lift the child to the telephone, and let me hear it cough," he
commands. The child is lifted, and it coughs. "That's not the croup," he declares,
and declines to leave his house on such small matters. He advises grandmamma
also to stay in bed: and, all anxiety quieted, the trio settle down happy for the
night
The Lancet 29 Nov 1879, Page 819
5. There is political support
Successive UK governments have bought
into the remote care story
• Since 1998 at least twenty
government reports have
called for remote care
• Public finance (£200m+ since
2006)
• ‘3 Million Lives’ initiative
(2012 – 2017)
7. There have been many trials ...
Diffusion of telecare in Surrey 1998-2005
COPD Project
Brockhurst Dementia unit
LAA: Safe Thames Ward, Molesey Hospital
At Home
Columba MEWS Hospital Discharge project
NEECH videophone pilot
Leatherhead Hospital
Mid Surrey Falls Project Dormers SMART House
Guildford Falls Project
Dray Court Telecare flat Mid Surrey Wristcare pilot
Tandridge Telecare Flat
COPD at Home Project
Community Alarm Teams,
Elmbridge, Guildford, Mole Valley
7
& Runnymede
8. Even before WSD there was a
large evidence base
• Very large number of
studies around the world
(now 10,000+ published
reports?)
• Clinical / QoL benefits
have been shown in trials
in a variety of
circumstances
• Robust economic Bulk of studies are
evidence is limited targeted at diabetes and
heart disease
Source: Barlow et al (2007)
13. Growth in remote care users in England
(with many assumptions) Source: Based on CQC returns, JIT
(Scotland) data, and authors’ research for
WAG.
Includes LA and other agency services.
Assumes 30% drop-out rate each year
350000
With Scotland &
300000 Wales
250000
200000
150000
100000
Assumes 15,000 remote care
50000 users (2005) and 5000 users
(2000)
0
15. Half a million, one million … or three million?
Assumptions:
• UK population aged 75+ is
c4.9m (2010)
• c85% of older people wish
Actual remote Potential remote care to remain at home as long
as possible
care market 2010 market 2010 • 1/3 needs remote care at
350,000 1,400,000 any given time
Source: based on CQC
returns, JIT (Scotland) data,
Potential and authors’ research for
telehealth WAG. Telehealth figures
Actual telehealth market
market 2010 from Minutes of the Strategic
2010 Intelligence Monitor on
450,000
22,500 Personal Health Systems
[SIMPHS] meeting,
Brussels, 17-18 November
2009.
16. We don’t know:
How many people could
benefit at a given
snapshot in time or over a
year (what is the rate of
“The Department of Health
‘churn’?) believes that at least three million
people with long term conditions
and/or social care needs could
Which population groups benefit from the use of telehealth
can benefit most? (top of and telecare services.”
http://3millionlives.co.uk/about-
the ‘pyramid’, next tier, 3ml#background
which conditions?)
18. All those pilot projects COPD Project
have told us LAA: Safe
At Home
Brockhurst Dementia unit
Thames Ward, Molesey Hospital
Columba MEWS Hospital Discharge project
something about the NEECH videophone pilot
Leatherhead Hospital
organisational and Guildford Falls Project
Dray Court Telecare flat
Mid Surrey Falls Project
Mid Surrey Wristcare pilot
Dormers SMART House
Tandridge Telecare Flat
economic factors COPD at Home Project
Community Alarm Teams, Elmbridge,
which influence Guildford, Mole Valley & Runnymede
implementation of
remote care
20. Financial support has helped stimulate
activity at a local level
Adoption Spread Mainstreaming
Level of
uptake
Enthusiasts
Pump priming
Grants
Time
21. We understand much about the organisational
factors that influence implementation
Adoption Spread Mainstreaming
Level of Leadership
uptake
Project management
Champions
Enthusiasts
Pump priming
Grants
Time
22. WSD has highlighted questions about the need for
evidence and a business case
Adoption Spread Mainstreaming
Business case
Evidence
Evaluation
Level of Leadership
uptake
Project management
Champions
Enthusiasts
Pump priming
Grants
Time
24. It is often hard to pin down healthcare
‘innovation’ … remote care is no different
An innovation with seemingly
straightforward objectives and
using relatively simple technology
can be:
• highly operationally complex
• with a large number of stakeholders and
• perverse economics
• often evolve through process of adoption
25. So evaluating the impact of telehealth
(and especially telecare) is very hard
and leads to ambiguous, context-
specific findings
26. Yet there is a perceived need for
very ‘robust’ evidence
• ‘Pilot-itis’ – lessons learnt from
projects are not disseminated
or accepted locally
• ‘The largest RCT of remote
care’ to date
• Background discourse on
‘evidence-based policy’
27. Is an obsession with
evidence beginning to stifle
experimentation and
innovation, and slow scaling-
up?
28. The future landscape is
apparently promising
• Government and
industry ambitions are
high – 3 Million Lives
• DH is encouraging –
adjust tariff, look at
incentives
• We know what the
organisational barriers
are and what to do
about them
30. Suppliers have been
searching for business
models for years:
• market segment, i.e. users to whom
the offering is useful and for what
purpose
• value chain required to create and
distribute the offering
• cost structure and profit potential
• position of supplier within the value
network
• competitive strategy to gain and
hold advantage over rivals
31. Finally, the questions we
now need to address
(apart from continuing to work on
the WSD data)
32. Do they have the capacity /
• How to engage with the expertise / inclination to plan and
coordinate the implementation of
part of the health system remote care?
that has the bulk of the
budget – CCGs
• What is the role of the Many would like to move from a
‘box provider’ to ‘service
supply side? provider’ role … but how to do
this?
• What financial and
contractual models for
What PPP arrangements work
remote care are the most and what do they embrace?
• infrastructure only
effective? • infrastructure + monitoring
• infrastructure + monitoring +
clinical care
33. WSD research team: James Barlow, Jane Hendy and
Theti Chrysanthaki
Based on several projects funded by EPSRC and Dept of Health