Telecare benefits rural residents
It is not often that a new public service looks destined to help rather than hinder people living in rural areas. But the introduction of telecare spells good news for rural residents – offering benefits to patients as well as their carers, and healthcare professionals as well as their budgets.
What do we mean by telecare, telehealth and telemedicine?
Telecare describes services that use computer and other technology to deliver health and social care directly to a patient – ie they involve moving the information as opposed to the patient/clinician.
It may be as simple as an alarm system with back up telephone support. Or detectors that monitor for old people’s falls, and trigger warnings to a response centre.
Rural Services Network – June 2009
Telehealth is just one type of telecare – although the two are sometimes, incorrectly, used interchangeably. Telehelath involves the remote monitoring of a patient’s vital signs, such as their blood pressure, weight and glucose level.
Telemedicine relates to clinical consultations, which are usually done by video conferencing.
Preventive Technology Grants
Although telecare has been taking place for over 50 years, the real impetus for it came in 2006, when the government set up Preventative Technology Grants to enable social service departments to set up telecare projects.
The aim of the grants – which resulted in 84,000 new telecare users in 2006/07 – is to help people to live at home with safety and security, and to reduce the number of avoidable admissions to hospitals and residential/nursing care.
In North Yorkshire a pilot project was deemed so successful that telecare has now been mainstreamed throughout the county – available for all users and all ages.
“Telecare is the most radical change to the way vulnerable and older people receive support … it will allow record numbers receiving care to keep their independence,” says one of their councillors, Chris Metcalfe.
The provision of telecare in extra care housing schemes means “residential care will become a thing of the past within 20 years,” predicts the council’s corporate director of adult social care, Derek Law.
The progress of telehealth projects has been slower. But there is now “immense interest” from PCTs across the country, says Alison Rogan of Tunstall, a leading provider of telehealthcare technology.
These and other projects demonstrate four benefits of telecare:
Higher quality care – regular monitoring and more accurate information makes it easier for professionals to keep abreast of a patient’s condition. In some cases patients have also become more involved in their own care, eg adjusting controls on equipment.
Higher patient satisfaction – the Yorkshire and other projects have found over 80% of patents to be satisfied. Telecare has made them feel safer and able to stay in their own home, as well as giving them, their carers and relatives peace of mind.
Higher professional morale – it is not just patients who benefit from telecare. It is increasing job satisfaction in three ways: by reducing their mileage, providing access to more accurate information, and increasing their caseloads.
Substantial cost savings – research on pilot projects suggests, for example, savings of £4300 per patient (North Yorkshire), £2000 per hospital admission avoided (Sheffield PCT), and savings of £221,000 pa for 150 patients (Stockton).
But before telecare is rolled out nationally, the government is undertaking a more detailed evaluation, called ‘whole system demonstrators.’
One fear, however, is that telehealthcare might increase people’s isolation in rural areas.
But this did not happen in Kent, says Hazel Price, delivery manager for the county council’s pilot projects. Far from it, she says, patients got more involved in their care, and got involved in service-user groups and other health administration as well.
Nevertheless, it can present challenges.
The technology must be easy to use. And even if it is, it may not suit everyone – indeed, for some people it may increase their anxiety.
And technology does not remove the need for back up. Patients have to be supported, to make sure they understand and know how to use their equipment. Otherwise it results in more demand on GPs’ time rather than less.
With telehealthcare new to most councils and Primary Care Trusts, Kent describes their experience of finding the right patients, nursing skills and medical support as a process of ‘trial and error.’
But Price is confident of its potential: “I think there is great potential in rural communities,” she says. “We hope to prove the case for the technology and it will then become a policy and be driven forward.”
© Robert Bullard. Not for reproduction without prior permission