The use of telehealth services does not impact on the number of times patients contact healthcare professionals in general practice, suggests a new analysis of the government-backed Whole Systems Demonstrator (WSD) study.
Looking at data from 179 practices, researchers from the Nuffield Trust found no change in contact frequency between patients being remotely monitored and those receiving standard care.
This finding, published in Biomedcentral Health Services Research, flies in the face of fears that widespread use of such telehealth technologies could increase demands on primary care.
But conversely, it also fails to lend support to claims that telehealth can lead to a significant cut in GP workload, suggesting that it might have a more significant role to play in secondary rather than primary care.
The authors did note, however, that telehealth could have a different affect on workload if the system were designed differently.
For instance, the frequency with which clinical measurements – including weight, HbA1c and blood oxygen – were recorded by practice staff remained unchanged between the two study arms, despite the fact that patients in the telehealth group were themselves recording similar measurements (up to five times a week).
This “may indicate scope to improve the integration of information systems and care between the telehealth intervention and general practice,” and thus reduce some of the workload, the researchers said.
Speaking to PharmaTimes World News, Graeme Duncan, Group Director Strategy+Marketing, Healthcare at Home, said “the findings are interesting but probably only tell half a story”.
“I am not surprised that some observations show that technology alone seems to make no demonstrable difference to service utilisation,” he said, and stressed: “remote monitoring technology alone is unlikely to transform care and service utilisation. However the appropriate use of technology in a well understood and researched patient pathway can make a huge difference”.
Early intervention
Also commenting on the study, Firas Sarhan, Director of Centre of Excellence for Telehealth and Assisted Living (CETAL), told PT that telehealth “will help to early identify changes in individuals’ health and wellbeing, which leads to early intervention preventing complications and [reducing] access to healthcare – either general practice or hospital acute services”.
It will also help patients to be more involved in their healthcare and become aware of changes which could warrant appropriate use of health services, leading to a more effective use of time, he argues.
Back in 2011, headline results from the WSD study showed that telehealth, if used properly, can deliver reductions of 20% in emergency hospital admissions, 8% in tariff costs and 45% in mortality rates.
However, other research has proved less conclusive. In fact, a US study published in the Archives of Internal Medicine in June linked remote telemonitoring with increased mortality in vulnerable patients, while a report published by the British Medical Journal concluded that the cost per QALY of telehealth when added to usual care was £92,000.
The Department of Health remains confident in the potential of the field, with three million people in England set to get access to telehealth by 2017.
Explaining the need for telemedicine, Loretta MacInnes, Marketing Manager at Telecare Services Association, told PT that health and social care need effective service redesign to cope with huge increases in demand, and reducing resources (both in terms of finance and personnel).
“Change must happen. Technology enabled services, including telehealth and telecare, have a part to play in this service redesign but must be introduced as a core part of care pathways, not as a bolt-on to existing services,” she stressed.
