There’s no question that telehealth is an area of technology which has an opportunity to generate real value in the NHS.
It’s a relatively mature area of IT – in more remote areas (the highlands and islands of Scotland, for example), trials and point solutions have been deployed for well over a decade now; and this should give some comfort to IT decisionmakers.
It can visibly cut costs (travel time), drive efficiencies (the number of patients a specialist can deal with), and reduce error (by allowing specialists to collaborate on individual cases, particularly when those specialists are dispersed). Indeed, as the reconfiguration of services will see centres of excellence in specific disciplines around the country, we can expect remote collaboration to become a must-have technology.
Finally, and it’s a patient-centric argument which rarely seems to be voiced, telehealth services are also a chance to redefine the way in which citizens see the role of technology in the provision of healthcare. Ask most patients today of their instinctive reaction to computers in surgeries, and they will say that their doctor spends too much time looking at a screen instead of their bodies; or that they are required to use kiosks instead of speaking to a receptionist. Yet give a patient the convenience of a stop-smoking programme, diabetes consultation or weight-loss service which they can use from the comfort of their sofa, and suddenly new vistas of engagement and patient satisfaction are opened up!
Andy Dunbar of Microsoft specialist healthcare Partner, Risual, has worked in this area for several years, and says there is currently a challenge of fragmentation. “We have lots of clients using basic telehealth solutions, and some have been doing it for a good while,” he says. “I work with one Trust which is large and geographically spread, who are looking at telehealth as way to drive engagement with patients, plus allowing them greater choice in consultants. In another use case, two top cardiothoracic specialists – one in the North of the UK and one in the South - for years have travelled weekly to one another’s campuses. Now they collaborate on cases in real-time, meaning no need for travel and ultimately also allowing them to see more patients.
“But these use cases are fragmented. There’s no shortage of ideas, but they are coming from clinical specialists and occasionally managers, looking to solve specific problems or try out neat, low-cost ideas. Partly because of the uncertainty left by the vacuum after NPfIT, the drive to localised IT, and the need for CCGs to bed down, we’re still only on the cusp of seeing the really good stuff.”
There are two factors which will allow Trusts to unlock greater value, breadth of deployment and consistency from their telehealth ambitions. The first is a disciplined strategic approach (and we will be examining this with Risual’s Andy Dunbar in a post next month, with some advice which will be applicable for much IT activity to be undertaken by CCGs as they emerge blinking into the daylight).
Secondly, says Dunbar, “Where I see real value is the integration and federation of unified communications platforms like Microsoft Lync, with consumer programs like Skype. Lync is the sort of enterprise-grade ‘anytime, any medium’ communications tools which Trusts are beginning to use, because it has a full audit trail, complete scalability, and integration with other management and delivery tools like SharePoint.” Skype, meanwhile, is the world’s most popular video calling service, and it’s used by citizens of all ages and demographics, from kids making video calls on their smartphones to grandparents on PCs keeping in touch with their families across continents. When these two trends collide, the result is a genuine driver for mass-market takeup of telehealth.
And collide they will. Skype is now owned by Microsoft, and federation – the automatic integration of login identities – between Lync and Skype will be complete in a matter of weeks. The same Microsoft Live IDs which millions of Britons signed up for in the past decade to use services like Instant Messenger or Hotmail will also serve as their Skype logins; and will similarly be the identities which can seamlessly be used to connect to GPs, clinicians or consultants in telehealth contexts.
Says Dunbar, “Ten years ago, when you went into a surgery, nobody used to ask for your email address. Now they do, because it’s a great way to engage with patients. In the near future, I expect it to be routine to ask patients for their Skype ID. Skype is public, everyone’s got it, and most people, regardless of demographic, seem to use it. It federates instantly into Lync, which could be in use in GPs surgeries. That’s a huge opportunity for telehealth, and it’s one all CCGs should be considering as they design the next generation of healthcare services.”
By 'Nick Saalfeld for
Microsoft UK Healthcare