Does telemedicine deserve the green light?
BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e4622 (Published 10 July 2012) Cite this as: BMJ 2012;345:e4622
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We read with great interest the article by Jonathan Gornall on the usefulness of telemedicine in primary care[1]. Although the improvement in morbidity and mortality in patients admitted to secondary care was only modest, this is at least a step in the right direction. In a health system that is increasingly primary care-centred, it is understandable that doctors perceive the need to implement technological advances to improve patient care in the community. The advent of portable devices and the wider connectivity between patients and doctors has meant that oxygen saturation, blood glucose levels and body weight in patients with heart failure can be closely monitored and managed from a distance.
Such initiatives invite the question: how can we make hospital medicine more efficient with technology[2]? A recent study by Patel et al. showed such a trend with the use of mobile tablet computers. These not only improved subjective measures, such as increased patient contact and time spent at educational meetings, but also objective measures regarding tests ordered since patient admission and significant events such as ward rounds and meetings. At a time when services are being compressed and the demand for improved patient care is increasing, these are ways by which investing in the right technology can produce significant results. We remain optimistic about the technological future of our health service and encourage others to vigorously pursue this promising research area.
1. Gornall, J. Does telemedicine deserve the green light? BMJ. 2012 Jul 10;345.
2. Patel BK, Chapman CG, Luo N, Woodruff JN, Arora VM. Impact of mobile tablet computers on internal medicine resident efficiency. Arch Intern Med. 2012 Mar 12;172(5):436-8.
Competing interests: No competing interests
Does telehealth include the direct access to a known named healthcare professional by telephone? Since the pilots were introduced other related services have become widely available. Community matrons, community heart failure nurses and respiratory nurses. Patients now can ring them directly and speak to people they know rather than having to try to get through to their GP and the potential barriers that this causes.Heart failure nurses can ask weight without electonic transmission . Anecdoteally this availability is stopping a 999 response when the surgery telephone lines are all engaged or percieved that they will be or patients own doctor not available . It would be great if we do have a methodd here that prevents un-needed admissions. It will only save money though, one of the aims and stated outcomes, if the unused beds are closed. We may have a better service but at increased cost not just with the machines but the extra community staff. This is at a time when there is no more money so what will go? It seems a shame that the government has again decided on its own plans without the evidence of what bits of telehealth work and which dont just when it proclaims local decision making should be the way ahead.
Competing interests: No competing interests
Sir,
I am convinced that it has the potential to revolutionise medical care.The important issue in my view is that it should involve exchange of information between professionals and provision of more expert care to areas which are under served.Direct interaction between patients and doctors can only have limited gains.
Regards,
Sandeep Saluja
Competing interests: No competing interests
Re: Does telemedicine deserve the green light?
Does telemedicine deserve the green light? It is my opinion that it does. However, one of the major shortcomings of the WSD report is that it has not given any areas of focus for the telehealth industry to work on.
The only way to make telehealth a commercially viable and successful service is to work with the clinicians on how to fix the issues and challenges the NHS faces. This way, we can see how telehealth can enhance the service the NHS offers and ultimately improve patient care and experience.
One of my biggest frustrations is that despite significant time and investment in the report, and all this data that proves that telehealth works; the findings then reveal that the technology is too expensive and it needs to be cheaper. Yes, of course it should be cheaper; and it can be cheaper.
But what we need to identify as an industry, working with the NHS, is where telehealth works best. Where does it add the most value? I believe one of the major reasons behind some of these findings is that the players involved are not answering these questions. More than that, the diagnostic businesses need to become more involved.
It is a question of making telehealth work for the NHS, not the NHS making telehealth work for the companies offering the technology.
Competing interests: No competing interests