Building capacity and capability in telehealthcare
There are many opportunities to redesign care processes to incorporate telecare and telehealth in a way that delivers higher-quality support and care for vulnerable people and their carers, increased self-management, and more personalised services. The emergent evidence base on delivering efficiencies is increasingly robust. Patients, their carers, and clinicians are provided with additional information, insight and data in context. Care can be systematic rather than episodic, proactive rather than crisis-driven, and intelligent rather than partially informed. This reduces the likelihood of exacerbations of pre-existing conditions and provides individuals with the information and tools they need to better self-manage their health and wellbeing. It enables professionals in new service models to intelligently match their capacity to support the most vulnerable patients in need priority order. The contribution of telehealth can be seen in the broader context of:
- increasing collaboration between patients and clinicians in the management of their conditions, reflected in common goal-setting and shared decision-making
- increasing partnership working between health and social care professionals and between roles in acute, community and primary care
- increasing collaboration between clinicians to manage work flows more efficiently, with expertise delivered where it’s needed, and when it’s needed.
The NHS in Yorkshire and the Humber has been at the forefront of this experimentation, and a significant number of new care processes are being introduced that target patients with chronic obstructive pulmonary disease (COPD), heart failure, diabetes, stroke, and chronic kidney disease, which incorporate either telecoaching, telemonitoring or teleconsultation, or elements of each. In addition, local authorities have introduced telecare technologies in home and multi-user residential settings, helping individuals to live independently for longer. Carers too have a much higher level of confidence, as the technology produces alerts in response to environmental risks (such as fire, flooding, etc) and ensures that immediate help can be obtained where a vulnerable person requires it (eg, pendant alarms).
While there is increasing momentum for introducing new service models using telehealth because of its potential benefits in terms of quality of care, efficiency, and improved patient experience, there continues to be limited sharing of the resource its pioneers have created to support the introduction of new care pathways. Recognising the need to collate and disseminate this learning, linked to resources from telehealth implementations across the UK and further afield, the Health Innovation and Education Cluster (HIEC) in Yorkshire and the Humber has produced a toolkit, Introducing Telehealth at Scale and Pace: A development resource for telehealth pioneers, which can be downloaded from: www.yhhiec.org.uk/yhtoolkit This resource combines a set of newly commissioned ‘warts and all’ video case studies produced in local health economies with key operational documents from local implementations and a core toolkit that systematically collates the existing evidence base.
A companion resource, an e-learning module entitled ‘An introduction to telecare and telehealth’, recognises the need to increase basic awareness among the clinical and care workforce of the role telehealth can play in innovative service models, re-skilling professionals as their roles and relationships with patients develop going forward. The e-learning module is available at: www.telesolutionsea.co.uk/yorkshire
All enquiries related to these resources should be addressed to:
Paul Rice is Regional Telehealth Lead, Health Innovation and Education Cluster, Yorkshire and the Humber