Can remote care be embedded in healthcare systems?

ecg image 4  

Can remote care be embedded in healthcare systems?

Governments around the word see ‘remote care’ – telecare or telehealth – as a key vehicle for improving the quality of care, increasing efficiency and controlling costs. The UK has spent at least £200m since 2006 supporting pilot projects and it has been highlighted in over 20 official reports and government white papers. Despite this activity, remote care has been slow to become mainstream. My interest is in how it can be sustainably and efficiently embedded into the care system.

Building on two initial EPSRC funded projects (2000-2007), my colleagues Jane Hendy, Theti Chrysanthaki, Steffen Bayer, Richard Curry and I developed a major programme of research on the organisational and economic factors that influence the way remote care is adopted, implemented and subsequently spread.

We then helped design and evaluate the Department of Health’s Whole System Demonstrators programme, along with colleagues at UCL, LSE, Oxford and Manchester universities and the Nuffield Trust. This was the world’s largest trial of remote care and it underpins current UK government policy in the field.

The breadth and depth of this qualitative research means that we now have perhaps the most comprehensive longitudinal data collected in this field. This has provided deep insights into different approaches for planning and implementing remote care, and how organisational challenges may be overcome. 

Our second area of research has been on the potential system-wide impacts on the costs and benefits of remote care, focusing on different populations and health conditions (frail elderly, stroke and heart failure). We have used simulation and modelling – system dynamics, discrete event and Markov approaches – in several projects selected supported by EPSRC / HaCIRIC and a project funded by the Department of Health.

We have also conducted other projects directly informing policy makers and industry, notably:

  • Development of a tool to assist in strategic remote care business case models for local authorities.
  • A roadmapping exercise in 2007 for the Department of Trade and Industry, Technology Strategy Board and EPSRC to support its Assisted Living Innovation Platform.
  • A review for the Welsh Assembly Government of its remote care programme and modelling its impact (2010).
  • A review for Ofcom of the implications of remote care for UK wireless spectrum allocation (2008).
  • A report for the Audit Commission on remote care implementation challenges (2005).

Together, insights from this body of work have helped to shape the debate and policy around the potential benefits of remote care, the challenges in deploying it and its potential role in health policy. Our work has also influenced the UK and international remote care industry, directly through the involvement of specific companies as research partners (e.g. Tunstall, Philips, BT, Docobo, Legrand, Orange) and indirectly through the activities described above.