Since the publication of the Whole System Demonstrator (WSD) results and the finding that the cost per QALY of the technology used is off the scale, the cost of systems has become a hot topic.
There are a number of suppliers that are considerably less expensive. One that has been making progress in terms of acquiring new customers – as their latest press release (PDF download) states – is Safe Patient Systems, with its ‘Safe Mobile Care’. The company is an offshoot of Heart of England NHS Foundation Trust. Unfortunately, as is often the way with youngish companies, their website is rather full of aspiration and light on hard information.
Editor Steve will be happy to add to this item links to other companies who claim cheaper-than-WSD telehealth monitoring systems.
Firstly its great to see SPS making inroads into the telehealth market which if nothing else, increases choice and awareness of what is possible.
On the general matter of the costs and ROI there two key points, both highlighted by the Department of Health QIPP Long Term Conditions programme that need to be factored into any discussion regarding return on investment.
Firstly when we talk of costs, some as per the press release refer to the costs of kit and suppliers services, but do not cover the Total Cost of Ownership (TCO) including clinical time and additional activity that reactive triage based “supported care” systems inevitably cause.
Secondly and probably the biggest cost-influencing factor with the Community Team deployments of Telehealth for COPD/CHF is the choice of patient. The WSD results factored in “regression to the mean”, hence the low number of avoided admissions reported and high QALY. Therefore unless this type of deployment is based on “Combined Model Risk Stratification” it is highly unlikely to produce a return on investment at all given that the telehealth kit will be given to many patients who may have previously been admitted to hospital but have a low risk of re-admittance.
Finally in reply to your invitation to list telehealth services “claiming cheaper than WSD”, I am not aware of any telehealth system costing as much as the numbers quoted in the WSD. However taking WSD numbers into account and assuming you need a return on the investment I believe you would be looking at a TCO ( including risk stratification ) of less than £300 per year for that group of patients.
There are many solutions that fall into this low cost category. However it depends on what you are trying to achieve with the telehealth solution as to the type of system you need because one size does not fit all.
WSD should have set the challenge to the providers to get cost low enough to be cost effective.
As you mention, some are considerably less expensive but also just as (if not more) effective.
Our service is very low cost at £2 per week and is being used to support low/medium risk patients, thus created a tiered service where technology can support those at all levels. We have a good relationship with SPS & believe that our values are aligned.
I would also suggest other services like Florence as they are the low cost and simple enough to scale; if you can support the majority with things like Florence and our service, then support the high risk patients and the less compliant users with more advanced services.
All this has to be supported by education though, which is why I like Know Your Own Health!
US – http://www.telecaretechnology.com
SPS – http://www.safepatientsystems.com
Florence – http://www.getflorence.co.uk
KYOH – http://www.kyoh.org
@ Phil – Thanks for your wise words!
@ Jamie – Apart from the shameless plug for your own service which, as I understand it, does not do telehealth monitoring, thanks for the links.
I agree with Phil’s comment that ‘one size does not fit all.’ Whzan Telehealth have linked with Florence and Simple, and combined services so as to offer a greater range to the tiered system, covering patients from low risk through to high risk, including short term illnesses or monitoring. These systems have to be user friendly for both the Clinician and the patient, as well as affordable. A number of Telehealth systems now run on a mobile phone platform, reducing costs considerably as systems do not have to be wired in and taken out of patients homes.