Friday, 13 September 2013

Telehealth: let's hear from those who have used it

Telehealth: let's hear from those who have used it While we wait for the successor to the 3millionlives group, we should listen to those patients with experience of telehealth.

Few people working in the highly charged world of healthcare will be surprised – or sad – to learn that the 3millionlives group has been disbanded. Since its inception in 2011, despite its original claim that three million people could benefit from the informed and appropriate use of telehealth, the widely held view is that any significant added value and health improvement has not yet been achieved.
Perhaps the problem – and, therefore, the cause of lack of progress – is that its structure and focus was misguided, although it held the very best of intentions. It was made up entirely of people working in industry, which resulted in polarised views, rather than the action required to promote telehealth successfully.
We are now told that the 3millionlives group will be replaced by another structure with the grander title of Integrated care for 3millionlives stakeholder forum. Apparently, it is likely to include clinical leaders, representatives from healthcare provider organisations, the third sector and local government. There is, however, an obvious absence – the most important people of all: patients and carers.
Genuine and effective grass roots engagement and the development of integrated care pathways can only be achieved if all parts of the multi-disciplinary and multi-agency team work together with a common purpose – the proper use of telehealth technology. From day one, within this team, there must be the patients and carers who have the strong desire and motivation to transform their lives through the use of modern technology.
The 3millionlives campaign aimed to recruit patients to telehealth, yet, two years in a row, research commissioned by the Telehealth Forum revealed that 90% of people are unaware of what telehealth is, and what it can do in terms of individual health improvement. Among the over-55s, who are statistically more likely to have a long-term condition, 92% have no understanding of what telehealth is. We cannot expect people to use telehealth to help manage their long-term condition if they are completely unaware of the available technology, and therefore ignorant of its potential benefits.
It is important to understand that telehealth is not appropriate for all people who live with one or more long-term conditions, but it is essential for the people who could benefit from it to be identified and encouraged to use it. Patients and carers should be asked what they want the technology to do for them, what they like and dislike about it and exactly how they want it to enhance their quality of life. Telehealth services can easily be adapted and tailored to meet the individual preferences and needs of the people using it.
If telehealth is to achieve its potential, we must develop a network of patient advocates. Telehealth cynics are advised to listen to patients such as Terry, who offered a most compelling argument for the widespread use of this technology at an event in Newham in east London. He eloquently described using telehealth as "having angels in the house", and how since his epiphany, has recommended it to his friends whom he thought could benefit from it.
Terry has also taken on the role of teacher to those who have been persuaded to "have a go" at telehealth. Word of mouth and recommendations from an experienced friend or relative is the surest route to expanding its proper use.
The Department of Health needs to be ambitious in terms of telehealth becoming the norm, rather than the extraordinary, and understand that a change in culture can only happen if enthusiasts, such as Terry are given a public platform to extol its virtues. So, my plea is that we must hear more from the people using telehealth and maybe a little less from those who produce and sell it.
Lynn Young is a former district nurse and primary care adviser to the Royal College of Nursing. She is also a member of the Self Care Forum Guardian Professional.

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