If the results are positive in terms of patient experience, care outcomes and costs, then the trial will have proved that telehealth has a significant role to play in the way we care for patients, and the way they care for themselves. But would this evidence be enough to stimulate the wider adoption of new technologies and the service redesign innovations that are needed to support them?
A new report from The King's Fund's recently completed WSD Action Network project reflects on three years of experience from 12 innovator sites. We conclude that even though a positive evidence base would provide helpful context, a significant number of cultural and organisational barriers remain. The technology itself is only a small part of making telehealth a success; some wider service redesign is needed.
We identify a number of factors that support widespread adoption and sustainability of telehealth. These are collaboration within and across organisations; a shared vision; strong leadership and engagement at every level; capacity and skills to do system redesign; quality standards, and investment in professional development and staff training. In other words, one cannot hope to make a success of telehealth without acknowledging that a fundamental shift is needed in the way in which care is delivered.
One key lesson was that data and evidence must be constantly reviewed to ensure that telehealth projects are delivering their intended benefits. A cultural shift is required away from 'evidence-based practice' towards accepting the value of 'practice-based evidence', enabling organisations to implement technologies on a larger scale. The report argues that producing evidence on the clinical benefits and cost-effectiveness of telehealth is never going to be enough to formulate a strong business case for change. Rather, what is needed is a clearer understanding of the operational processes that are required at an organisational, clinical and service level that will ensure commissioners and providers make the right decisions.
- The King's Fund will be debating these issues during its second International Congress on Telehealth and Telecare, 6-8 March 2012
- For more on the WSDAN project, visit our telehealth and telecare topic pages
- This blog was written in conjunction with Philippa Last, NHS Graduate Management Trainee at The King's Fund.