Let's stop hanging up on telehealth

Jack, who lives the other side of the road, had a stroke eight years ago. He lives bed-bound at home tended by an angelic wife and a lot of social and private care. He gets infections from time to time, some of which are treated at home, but with some, ambulance men have to get him down the stairs and take him off to hospital. This happened last week, and the next day his wife found him in an isolation ward, tended by nurses and doctors in masks. You've guessed it. He had contracted MRSA. I am not suggesting that his infection was not serious enough for him to go into hospital. But I mention Jack, because it highlights my argument for telehealth, which I have deployed in this column many times before. Hospitals – and GP surgeries – are essentially dangerous places for the old. For me, the fewer hospital visits, the better. Telecare is a tool to reduce the number of visits. That to me is a no-brainer. But there seems a strange reluctance by those in healthcare to accept what seems to me self-evident. Back in June at SmartHealthcare Live, a speaker said that the "business case" for telecare had not been fully made. To hell with the business case, I say. I want to stay alive. Isn't that what the NHS is for? A glimmer of hope was offered for government support of telecare by the publication this month of the NHS's 'A vision for adult social care'. This acknowledged that "technologies such as telehealth help people with long-term conditions to better manage and understand their condition" adding that that "telecare enables people to live at home independently for longer by providing technologies that make their homes more safe and secure". Great stuff, but the mentions of telehealth took up all of two paragraphs in a 42-page report. It follows with a downer: "Robust evidence on how to target telecare and telehealth, to ensure both cost-effectiveness and successful outcomes is lacking." I remember reporting on telecare pilots 15 years ago. Why have they not resulted in "robust evidence"? Because nobody has bothered to read the reports of these pilots. However, great news: "The £31m whole system demonstrator programme will start to address this problem. It is the largest ever randomised control trial of these technologies. Over 6,000 people across Kent, Cornwall and Newham are involved in testing assisted living services, and the evaluation by six of the UK's leading academic bodies will report in spring 2011." Gosh, all of 6,000 people! Big deal. And reporting as soon as spring 2011. Wow! This means that most of 2011 will be spent evaluating the report and deciding that the sample is too small, and ordering a further survey of a larger population, which will report by 2013, if we are lucky. Then rollout will happen by 2015. Jack and I are already in our eighties. We will probably both be dead by then.