NHS savings of £1bn a year, a 40 per cent reduction in hospital admissions and improved patient care are some of the benefits promised by telemedicine, according to medical experts who describe it as the future of healthcare. Patients will benefit from faster life-saving treatments for a range of illnesses from strokes to diabetes, regardless of where they are.
Despite the revolutionary potential of telemedicine – the use of information and communication technology to assess, diagnose and monitor patients who are thousands of miles from a doctor or consultant – both here and abroad, Britain is failing to exploit the advantages, a new report warns.
A Royal Society of Medicine conference, which starts tomorrow, will highlight the extent of telemedicine’s potential, showcasing projects from the Scottish Highlands to Swansea and Somaliland that demonstrate its impact on healthcare, from psychiatry and speech therapy to cardiology.
One trial, on the Isle of Bute, saw monitoring systems in the homes of people suffering with chronic bronchitis or emphysema. The project, run by Telehealth Solutions together with NHS Highland and Aberdeen University, led to hospital admissions being reduced by 91 per cent.
Telehealth’s Charles Lowe said: “Information provided by our systems can be interpreted and used to head off a pulmonary incident. We cut the numbers of admissions right down. That’s £2,500 to £3,500 [per] admission.”
Telemedicine is not limited to connecting geographically remote patients to medical resources. It can also be used to streamline the delivery of clot-busting drugs for patients suffering strokes. Dr George Crooks, medical director of NHS 24, responsible for Scotland’s telemedicine provision, said it was vital that such drugs were given within four hours of a stroke occurring.
“We speed up that process by having a doctor consult via videolink. Not only does this have the potential to completely reverse the paralysis a stroke can cause, it could represent a real-life saving of £20m over 10 years,” he said.
Telemedicine can also have an equally important but less dramatic impact on other conditions. The NHS spends 70 per cent of its budget on 15m people with long-term illness such as diabetes, heart and lung diseases. More than two-thirds of acute hospital beds are filled with people with these conditions, often because consultants see them too late, according to diabetes specialist Dr Richard Pope, from the Airedale NHS Foundation Trust Hospital.
Under new plans set out by the Secretary of State for Health, Andrew Lansley, acute hospitals face financial penalties every time a patient is re-admitted to hospital within 30 days of discharge. Dr Pope says telemedicine would improve patient care and reduce costly re-admissions. His trust is monitoring diabetics at home using a simple system that works via their TV. “Patients love it because they don’t leave home, pay for public transport or parking costs. We see them on our office computers, so it frees up space in the outpatient clinics. Our vision is that this will become the default way of seeing outpatients,” he said.
Although the clinical and economic advantages are clear, experts say a sluggish uptake of telemedicine means the UK is falling behind other countries such as the US, Australia, India and China in exploiting them.
A report recently published by 2020health, a right-of-centre think-tank, said the Government must be more “proactive” and “drive” the roll-out of telemedicine across the country. A government study into telemedicine is expected to report next spring.
A Health Department spokesperson defended its record, stating: “We fully recognise the potential of telemedicine to save lives … we are publishing standards for use across the NHS to enable different information and technical systems to work together … We are also actively involved in developing international standards.”
For some, the revolution cannot come quickly enough. Professor Richard Wootton, editor of the Journal of Telemedicine and Telecare, said: “We know that patients like it, and it has great potential to save lives and money. Why hasn’t it happened in the NHS? NHS inertia is one reason.”
While the potential of telemedicine in the UK is enormous, others are excited about its use in the developing world. Lord and Lady Swinfen set up the Swinfen Charitable Trust in 1998 with four British doctors volunteering to advise doctors in Bangladesh.
The trust now has 471 specialists worldwide, ready to help 199 hospitals in 60 poor countries to deal with complex cases. A laptop and a digital camera are provided to doctors who email referrals with attached scans and video clips. Working from home, Lady Swinfen, a former nurse, then sends the referral to the most qualified specialist. “This is terribly simple, but it has a global impact.”
Nina Lakhani
The independent