An industry study into the takeup of e-health technology within the UK has concluded that health professionals are not taking full advantage of what’s available to them, and that waiting for supporting infrastructure to be put in place by the National Programme for IT is not necessary.
The study [PDF, 350K], undertaken by The E-Health Innovation Professionals’ Group of the Institute of Healthcare Management, ASSIST and the British Computer Society Health Informatics Forum, (TeHIP) said that the "only sensible option" is to install services such as telemedicine and assistive technologies before NPfIT comes to fruition as "there are almost certainly lives that can be prolonged and improved."
"Many clinicians are not interested in NPfIT as such, but they are much more likely to engage enthusiastically in e-health projects that offer practical ways to help their care for patients on a day-to-day basis," says the report.
Ian Jardine, independent telemedicine consultant, member of TeHIP and co-author of the report, said: "It’s important that the people understand the potential of e-health applications. They won’t do that until they start integrate that into their care pathways."
People should not have to wait for infrastructure to be put in place by the National Programme for IT, urged Jardine: "Some people have said we’d better wait until the infrastructure is in place. There’s a lot of potential available now… We can do a lot in terms of home monitoring outside having a full electronic record."
Another problem is a "lack of understanding" about the importance and potential of e-health, as well as confusion over what exactly e-health is. Because of this, small-scale projects tend to stay that way, petering out due to the inability to prove clinical benefits.
The National Programme for IT is also having an effect on some smaller companies being able to sell into the NHS, due to uncertainty about what would be provided by the programme. But smaller companies also need to bear in mind how healthcare services can fund the purchase of their equipment, the pricing of which can often be quite complex.
Proving savings can also be a problem, said the report: "The introduction of these technologies has been slower than we anticipated and only a few of the potential benefits have been realised. Most of the applications introduced so far have been single-discipline, local and small. As a result they have been individually difficult to justify financially."
As savings were difficult to quantify, Jardine suggested that success ought to be measured in clinical, rather than financial, parameters. "There’s a very mixed industry. Teledermatology has not been that successful. On a smaller scale, home telecare has proved very valuable, as has video conferencing for access."
One example given by the paper was Kent County Council’s scheme to monitor 275 people with chronic conditions across the county using video links and a touch screen. The council says the service, which was installed by US company Viteron, encouraged people to self-monitor their conditions and had the potential of saving money and travelling time.
However, the paper points out that one must not "underestimate the difficulty of making such a radical change" to the way care workflows are organised. "There are just a few successful small projects. These are led by local enthusiasts but are still failing to be adopted either locally in other specialities or within the same clinical speciality in another locality."
For a project to be successful, explains the report, it must be "able to command attention and priority at the right level within healthcare organisations". Jardine added that primary care trusts needed to concentrate on investing in e-health technologies: "The money needs to be spent in primary care and in PCTs," he said. "I think as the PCTs mature there’s more chance of it."
Clinicians and policymakers interviewed by the study said that e-health was often seen as an IT and never a care issue, and that clinical benefits were not generally understood by IT staff. Issues about the scope of N3 to cope with traffic generated by telemedicine were also raised.
The report was published by TeHIP to coincide with last month’s launch of the consultation for Out of Hospital Services. It was backed by the Department of Trade and Industry and the Department of Health.
Links
Related documents
The Impact on e-Health and Assistive Technologies on Healthcare [PDF, 350K]