Summary: Telehealth services are on the brink of taking off, with the UK and France leading the way. But can governments balance the moral and social benefits with the cost of technology? iTunes: cs.co/tnp - Listen to past episodes, subscribe or write a review. TRANSCRIPT for "Telecare's Rise in Europe" written by Joanne Taaffe: Streets of half-timbered houses with steeply sloping red-tiled roofs suggest change comes slowly to Colmar, the city at the heart of France’s Alsace wine region. But when it comes to providing healthcare its authorities are breaking with tradition. Since January residents of Colmar’s care homes for the elderly have been trialing an ambulatory video-conferencing service that links doctors via a high definition camera to patients under their care. Nurses wheel the video-conferencing unit, which is installed on a trolley, between patients and help them with the consultation. Alsace hopes the video-conferencing service will cut the time doctors spend traveling between eight nursing homes, thereby enabling them to see patients more regularly, and improve access to remote specialist care. Christine Lecomte is director of Alsace E-Santé, Alsace’s telehealth project. She says, quote: “It allows doctors to see patients more often and for shorter periods, which allows for better overall patient care. We’ll do an economic study…but cost will not necessarily be the most important aspect. We will also be looking at quality of care. Life expectancy decreases with each hospital admission.” End quote. During 2013, Alsace E-Santé will extend trials to five additional organizations, including prisons and care homes for the handicapped. Alsace E-Santé is one of several trials in France, and recent research suggests telehealth is finally on the brink of growth. According to InMedica, a division of IHS Research, in 2012 only 308,000 patients worldwide were monitored remotely for conditions including congestive heart failure, chronic obstructive pulmonary disease, diabetes, hypertension and mental health conditions. InMedica forecasts telehealth services will reach 1.8 million patients worldwide by 2017. Europe’s most ambitious program is in the UK. Unlike France, where private insurance pays for a percentage of an individual’s medical cost, the UK’s National Health Service acts as both the payer and provider of healthcare, giving it greater freedom to undertake trials that have unproven financial benefit. Theo Ahadome is senior analyst at InMedica, IHS. He says, quote: “Healthcare providers want to do it for the quality of care, but the financial side doesn’t always add up, so the insurance company doesn’t want to get involved. The UK can take a longer-term view.” In January 2012 the UK government announced the “3 million lives” project which aims to extend the uptake of telecare and telehealth services. Three million represents the number of people with long-term medical conditions and/or social care needs whom the government estimates can benefit from such services. The 3 million lives program grew out of the UK’s Whole System Demonstrator, a randomized set of telecare and telehealth trials involving 6,191 patients across 238 medical practices which began in May 2008. The trials showed a 20% reduction in emergency admissions, a 15% reduction in A&E visits, a 14% reduction in elective admissions, a 14% reduction in bed days and an 8% reduction in tariff costs, according to the UK government. Perhaps most strikingly of all, it claims the trials demonstrated a 45% reduction in mortality rates over the period. Ahadome says large scale trials are essential if the medical and financial benefits are to be proven. Paul Rice, Telehealth Lead at the Yorkshire and Humber HIEC, agrees. Quote, “Unless there is a robust evidence base for remote telemonitoring one would struggle with detractors.” Authorities in the Yorkshire and Humber region have run multiple telehealth trials and projects, which have involved between 1
