Telehealth: Clash of the COPs claims a casualty (UK)

here (PDF).

In short, the two positions seem to reflect top-down versus bottom-up approaches:

  • The TSA’s integrated code is an extension of the current matrix approach and will require its standards to be measured against performance indicators (KPI). For telehealth, these will focus on vital signs monitoring, clinical pathways and risk stratification.
  • The European code is characterised as having a broader focus, covering health training, lifestyles and self-management as well as social alarms, telecare and vital signs monitoring and a flexible approach in relation to the introduction of ‘new’ technologies. Compliance with the TeleScoPe code would be based on an element of judgement rather than KPIs.

In the absence of the protagonists’ up-to-date slides from the Telehealth and Telecare event held at Heriot Watt University, Edinburgh last week, here are some presented in April at Med-e-Tel. (PDFs)

History and Current Developments of the Telecare Code of Practice in the UK – Trevor Single

Developing European Standards and Guidelines for Telehealth Services – Malcolm Fisk

Perhaps the rift reflects something deeper, such as the problem Telecare Aware has frequently observed in the variations in the use of the term ‘telehealth’ and lack of an internationally agreed definition of it.

It is a great pity that, despite all the work on the codes of practice and heartache that such a resignation brings to all parties, one has to ask ‘What is the point of having COPs at all?’ It has become clear recently [see comments on this TA Soapbox] that accreditation against them has no teeth in service procurements and that non-accreditation is proof only of ‘not belonging to the club’ and not evidence that a non-accredited service is inferior.

2 thoughts on “Telehealth: Clash of the COPs claims a casualty (UK)

  1. Taking up your point regarding the use of the term ‘telehealth’ and specifically in relation to COP development. Given TSA’s background and experience they seem to assume that telehealth is simply an adjunct to telecare consisting of A to B monitoring of vital signs and other quantifiable data. The future of telehealth is not A to B monitoring, but about self management via sensor devices, mobile phone and tablet based technologies etc. linked to sophisticated automated algorithmic based monitors. I question whether the TSA has fully analysed the telehealth space during the years it has taken to develop their code. And one final thought – are these codes validated and tested prior to market launch and if so where is the evidence?

  2. Jane is absolutely right that the TSA has restricted its old telecare code and its new integrated code to simple alarms and once-a-day vital signs monitoring (from the home of the vulnerable person). This might represent nearly 100% of last year’s telemonitoring needs but most people would agree that this is NOT the future.
    I suggest that the TSA will be seen as buried in the past if they don’t embrace web-based telecare (including video consultations) and the use of smart phones and tablets for a much broader range of telehealth applications. Perhaps this is the difference between the old-fashioned TSA matrix and the more flexible and dynamic European approach of Malcolm Fisk and his partners.
    It sounds as if the TSA is going to support (in a minimalist sort of way)the European research project until the end of March but then park the draft code somewhere dark and difficult to find, rather than help develop auditable features that could support regulation. That sounds like a formula to waste the hundreds of thousands of Euros spent on this. Worse than this is the potential for the UK to be relegated to the slow lane of the ehealthcare superhighway.
    No wonder Malcolm Fisk has resigned. I hope that both the telehealth and telecare industries in the UK and across Europe support him in taking his version of the code further. Competition must be good for everyone.

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