Scaling-up telecare and telehealth investment is the main challenge for the Whole System Demonstrator Action Network’s (WSDAN) programme. Plans for expanded use are not yet developed, and the WSDAN are looking for local proposals and contributions. The scale-up challenge is a consistent theme in projects across Europe and with the EC’s own planned investment. Most of these seem to face an unmet challenge of switching from pilots to mainstream.
WSDAN is relying on the findings of the randomised clinical evaluations of the three sites at Cornwall, Kent and Newham for diabetes, congestive heart failure and COPD. The plan is to link these to a return on investment (ROI) model, which is not as helpful as socio-economic impact (SEI) models such as the cost benefit methodologies in the Treasury’s Green Book. An example is that ROI models and evaluations omit the impact on informal carers. Valuable clinical data is already available from telehealth projects in Italy that have been operational for many years.
The aim of the WSDAN’s first regional event in London on 22 January (speaker and other details here) was to disseminate learning from three demonstrator projects, the WSDAN network of twelve sites and leading service organisations that integrate health and social care using advanced telecare and telehealth technologies.
Eight aims, an ambitious number, were set for the event. In summary:
- Report progress at three demonstrator sites and introduce twelve WSDAN sites
- Show how the WSD Programme randomised controlled trial differs from mainstreaming approaches for telecare and telehealth and identify learning points, tools and techniques for local service implementation and evaluation
- Identify big issues for systems, health records, predictive modelling, integrated working, stakeholder engagement, leadership and change management that impact on scaling telecare and telehealth programmes
- Understand national and local priorities, strategies and programmes across health, housing and social care, in particular the importance of World Class Commissioning, the Joint Strategic Needs Assessment and Local Area Agreements
- Contribute to standards for health records and vital signs data from telehealth devices, the options for procurement at scale and the future of the NHS PASA National Framework Agreement from 2010
- Report on the work of the Technology Strategy Board in particular the Assisted Living Innovation Platform and look at the benefits of partnership working in driving forwards innovation
- Summarise the two years of progress on the Preventative Technology Grant
- Contribute information on local progress and share learning through networking
On the first aim, a brief review of Newham was part of the programme. More about the experience of all three sites would have been valuable. More about the other twelve sites would have been valuable.
An intriguing goal of Connecting for Health (CfH) is to be the first in the world to find an interoperable solution to transfer data from telecare and telehealth systems into GP electronic patient records. CfH may find that some suppliers have already achieved this.
Topics and information that were not included in the presentations included:
- Costs, benefits, net benefits, timescales needed for successful investment, especially from a selection of sites outside the three clinical trials
- Steps for benefits realisation, especially the changing clinical, working and team working practices
- Interdependencies needed for net benefits
- Opportunity costs
- Overcoming the technical skill shortages that prevail in all European countries
- Plans to develop tariffs for telecare and telehealth as part of world class commissioning initiative – a requirement that can take years to complete and is a brake on scale-up
These are all critical for a successful business case for telecare and telehealth.
Slides from the event will be available on the WSDAN website in due course.