1) The document discusses the past, present, and future of telehealth in a district general hospital serving a population of 217,000 people over 700 square miles. 2) In the past, the hospital had no telehealth services, but now offers telemonitoring, telecoaching, teleconsultations and other virtual care services for prisons, care homes, and patients at home to reduce travel burdens. 3) Current challenges include technical issues, scheduling, collaborative working between community teams and GPs, and culture change, but scale and positive results show telehealth can reduce costs and bed days used while improving access to specialist care.

1. Telehealth Hub Know How….
past, present and future
Rebecca Malin
Head of Business Development and Investment

2. • District General Hospital
• Population of 217,000 over 700 square miles
• £140m Turnover
• 7 Commissioners (CCGs), 5 x LA
Context

3. Introducing telehealth
• tele care
• tele coaching
• tele monitoring
teleconsultation
A1

4. Slajd 3
A1 Use for no. 2
AGH; 2013-05-17

5. Past….nothing is ever “new”

6. Past….nothing is ever “new”

7. Past….nothing is ever “new”

8. so less in
here…
We need to move to a system
designed for purpose

9. and more “near me”
“I didn’t
have
to
travel
to
clinic”
“I could get advice – now”
“….you could bring the specialist to me”

10. Exemplar...Prison
Teleconsultation
• Risks, Costs, Quality
• 2006 HMP Full Sutton
• ISDN lines
• Results….

11. Prison Teleconsultation
specialist opinion
nurse with patient
shared record
n = 20 prisons
up to 50% cases no
longer need transfer out
0
200
400
600
800
Number of Consultations
2011‐12
2012‐13

12. Teleconsultation –
2010 - Present
Care Homes
consultation in room
or central location
results……

13. 12 Month Results -
Care Homes

14. Patients at home
Long Term Conditions
SALT / Parkinson’s
Lee Silverman voice
treatment
1hr/day x 4days/week x
4weeks

15. Supporting people
at the end of life
supporting patients
(and carers) at home
supporting staff
delivering consultant
opinions to hospice
team
shared record

16. Results:
25 COPD patients at home
Bed Days used
0
50
100
150
200
250
300
Year pre post Year pre post
-29.5%
-36.5%

17. Other uses
handover to paramedics
use within the hospital
supporting clinical handover (HEE funding)

18. Current status…
20 prisons
30 care homes
+ 15 care homes
+ 50 care homes
60 @ home
1 hospice
e-learning
Customers, Partners….

19. What are the challenges?
 technical (care homes)
 tariff
 scheduling
 collaborative working
(community teams, GPs)
 culture change…STILL
(evidence?)
 the importance of scale
 noise in the system
 ED pressures

20. Final (obvious) thoughts
Redesign means deploying many new approaches
together
Focus on the right things – services not kit
Redesign means stopping something else
This is where the headroom comes from
Change in healthcare can be delivered

21. what are we waiting for?
•