MSPs want to widen telehealth's range

The sheer geographical spread of Scotland, from an array of islands in the west to vast expanses of land in the north, has always made the delivery of healthcare challenging. Internet technology has made that task easier but the message from the Scottish Parliament's Health Committee is that NHS Scotland could do better. A report published on 8 March 2010 urges the SNP-controlled Scottish Government to improve NHS computing systems to ensure that patients do not miss out on better care and treatment. MSPs criticised the "slow and inconsistent" provision of clinical portals – which allow clinicians and GPs to access medical data on patients across Scotland – and telehealth over the last decade. Telehealth systems can remove the need for patients to travel to towns and hospitals to receive care and treatment by using broadband or mobile services such as video conferencing, which is of particular benefit in rural areas. Although widely utilised in Aberdeenshire and the Highlands, provision varies between health boards in other parts of Scotland. To rectify this, the committee wants targets for all health boards to offer telehealth to patients. "It has the potential to release much-needed resources in these economically difficult times for front-line patient services," said committee convener Christine Grahame. "The Scottish Government has some serious work to do in encouraging health boards to use and evaluate this technology." Conservative health spokesperson and committee member Mary Scanlon agreed. "The NHS in Scotland and successive governments in Scotland have been far too slow to embrace new technology," she said. "Telehealth could be used much more extensively, particularly in remote and rural areas, to monitor local conditions." Scanlon added that the integration of the Aberdeen-based Scottish Centre for Telehealth (SCT) – which has an annual budget of £1m – with NHS24 in April should "lead to more innovative solutions to monitor and complement healthcare in Scotland". The merger was the outcome of a review by the Scottish Government, which is also drafting a telehealth strategy to support the process. A Scottish Government spokesperson said: "Using the latest technologies has the potential to make a huge difference to healthcare in Scotland. Ministers place great importance on the development of a clinical portal – it is one of the priorities of the eHealth programme and will make a significant contribution to the safety, effectiveness and efficiency of care. "We welcome the committee's support and good progress is being made in partnership with health boards, although we agree with the committee that progress on telehealth has not been fast enough. That's why a review of progress recommended that the Scottish Centre for Telehealth become part of NHS24, Scotland's provider of national telehealth services." Richard Simpson, a Labour member of the committee, said: "The committee were clearly very frustrated with the fact that we haven't made more progress. We really have the potential to be a world-leader in telehealth but we're not at the moment because the SCT has been purely advisory and health boards don't have to buy into it, so the most important recommendation is the target for telehealth delivery across all Scottish boards." Other recommendations include the establishment of safeguards around patient confidentiality and IT systems; value for money being placed at the heart of any NHS telehealth strategy; patients, midwives, nurses and other health representatives to be members of the Clinical Portal Programme Board (which oversees clinical portal projects in Scotland); and the creation of an 'eHealth' professional standards group. The committee also urged "tackling resistance from medical staff in using technology" but Alan McDevitt, joint deputy chairman of the British Medical Association Scotland's GPs' Committee, said: "We have to remember that for some staff, using telehealth will be quite unusual. But they will ultimately decide whether it genuinely saves time and improves services. "The more geographically remote an area is then the keener staff will generally be to accept new technology. But it's harder to argue for using telehealth in an urban area. Inevitably it's enthusiasts who advocate more widespread use, but it's important that both clinicians and patients think it represents an improvement on existing services." Despite these qualifications, a professional and political consensus appears to support wider use, where appropriate, of new technology including telehealth. The health committee, meanwhile, expects to see tangible progress towards making Scotland a smaller country – in virtual terms – by 2014.