Technology and telecare

Telecare and telehealth are both types of assistive technology that enable health and social care services to be provided ‘remotely’ to people in their own home; however, they are quite distinct in their definitions and uses. Telecare is characterised by continuous, automatic and remote monitoring to manage the risks associated with independent living. Examples include sensors that can detect movement, falls, and bed occupancy. Telehealth is the remote exchange of data between an individual and a health care professional, and aims to assist in the diagnosis and management of health care conditions. Examples include monitoring blood pressure and blood glucose levels for clinical review by a health professional using phone lines or wireless technology.

Both telecare and telehealth have the potential to support a number of key policy objectives, for example around delivering care closer to home, preventing unnecessary hospital admissions, providing choice for people with long-term conditions and supporting independent living.

The technology driving these developments has improved vastly with the introduction of broadband and secure web-based services for exchanging data between patients and clinicians. Many studies have also shown the potential benefits of telecare/telehealth to users but there remains a lack of robust evidence, particularly related to cost-effectiveness. Telecare/telehealth has not yet been implemented on a large scale.

In April 2006, the government injected £80 million across social care authorities in the form of a Preventive Technology Grant to help initiate telecare innovations seeking to maintain the wellbeing and independence of older people. Over £30 million was additionally allocated to establish a Whole System Demonstrators Programme seeking to demonstrate how telecare/telehealth innovations can help in the management of people with long-term conditions. This involves a large randomised control trial of 6,000 patients.

In July 2008, the Whole System Demonstrators Action Network (WSDAN) was launched. WSDAN is seeking to develop the evidence base and examine the progress of telecare and telehealth adoption in 12 member sites.

The Department of Health has most recently outlined the benefits offered by telecare and telehealth in Your Health, Your Way, a guide to the choices available to patients who need long-term care. However, it does point out that these services are new and may not yet be available in a patient’s local area. For telecare and telehealth to become mainstream, commissioners need robust economic evaluation, as well as shared learning on targeting relevant populations and service design.