Feature Telehealth

Does telemedicine deserve the green light?

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e4622 (Published 10 July 2012) Cite this as: BMJ 2012;345:e4622
  1. Jonathan Gornall, freelance journalist
  1. 1London, UK
  1. jgornall{at}mac.com

The government is enthusiastically promoting telehealth as a way to cut NHS costs and improve care, but the evidence emerging from a large NHS trial seems much more equivocal. Jonathan Gornall reports

The Whole System Demonstrator programme, which spanned three and a half years and recruited more than 6000 patients and 230 general practices at a cost of £30m (€37m; $47m), is one of the most complex and ambitious trials ever conducted by the NHS and the biggest assessment of telehealth and telecare in the world.

Launched in May 2008, it was designed to answer one deceptively simple question for a health service hungry for innovative ways to manage the escalating costs of caring for an increasingly elderly population: does the use of technology as a remote intervention make a difference?

It was a good question. As Paul Burstow, the minister for care services, pointed out in March during his keynote speech at the King’s Fund’s international congress of telehealth and telecare, “Seven out of 10 inpatient beds are occupied by people with long term conditions; around 70p in every NHS pound is spent looking after them.”1

If the number of these admissions could be reduced by adopting technology that allowed patients to manage their conditions at home, it could lead to substantial savings. But, despite the impression given by the government, the answer to that question remains uncertain.

Such is the scale of the programme that evaluation of its results has been divided into five themes, each analysed by a different institution. Only the first strand results have so far been published, appearing in the BMJ online on 21 June.2 Yet the government, apparently determined to introduce telehealth throughout the NHS come what may, seems unwilling to wait for the full picture to emerge before committing itself …

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