Technology and demographics are increasingly making telehealthcare a reality for the insurance and long-term care industries. Simon Arnold looks to the near future.
Last December, David Cameron made a major commitment to telehealthcare, announcing an initiative aiming to improve the lives of 3 million people with long-term medical conditions by bringing telehealthcare technology into their homes.
By doing so, the Prime Minister estimates it could save costs of about £1.2bn over the next five years. In addition to saving money, telehealthcare is a revolution in enabling people to live independently at home. If telehealthcare goes mainstream, then it could have a significant impact on the health insurance market.
Firstly, we need to define briefly what is meant by telehealthcare, which incorporates both telecare and telehealth. While telecare uses technology to monitor a person's environment for risks and emergencies, telehealth monitors the individual's condition.
Proactive intervention by clinicians occurs when they are alerted via trended data. Telecare supports and facilitates independent living by monitoring 24/7 for conditions ranging from epilepsy to dementia. It has been around for many years and currently has 1.7 million users in the UK.
Diverse monitoring
The scope of medical, health and welfare conditions now monitored is diverse. This monitoring is achieved through a wide range of ‘peripherals', such as smoke or carbon monoxide alarms, bogus caller alerts, temperature extremes sensors and even epilepsy sensors. These alarms alert a carer or call centre that can then intervene.
Telehealth, on the other hand, is preventative healthcare and tracks the patient's vital signs, so a clinician can view trended data and intervene proactively, thereby avoiding the need for hospitalisation. It provides technology that remotely monitors a patient's health condition or co-morbidities.
This information is sent to a triage centre, which will then refer the patient immediately to a GP or clinical support should the information fall outside of clinically-specified acceptable levels.
Up until now, there has been a level of scepticism regarding the use of such home-based technology as part of a mainstream clinical pathway, due to a lack of independent evidence. Consequently, it is still only in its infancy, with just 5,000 users in the UK.
However, this issue is being resolved following the Department of Health's Whole System Demonstrator (WSD) randomised control trial. This was launched in 2008 to establish the true benefits, or otherwise, of telehealthcare - both clinically and financially - with the top-line results released at the end of 2011.
The WSD was the largest randomised control trial of telehealth and telecare in the world, involving 6,191 patients and 238 GP practices across three regions in the UK: Newham, Kent and Cornwall.
