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Telehealth Hub Know How….
past, present and future
Rebecca Malin
Head of Business Development and Investment
• District General Hospital
• Population of 217,000 over 700 square miles
• £140m Turnover
• 7 Commissioners (CCGs), 5 x LA
Context
Introducing telehealth
• tele care
• tele coaching
• tele monitoring
teleconsultation
A1
Slajd 3
A1 Use for no. 2
AGH; 2013-05-17
Past….nothing is ever “new”
Past….nothing is ever “new”
Past….nothing is ever “new”
so less in
here…
We need to move to a system
designed for purpose
and more “near me”
“I didn’t
have
to
travel
to
clinic”
“I could get advice – now”
“….you could bring the specialist to me”
Exemplar...Prison
Teleconsultation
• Risks, Costs, Quality
• 2006 HMP Full Sutton
• ISDN lines
• Results….
Prison Teleconsultation
specialist opinion
nurse with patient
shared record
n = 20 prisons
up to 50% cases no
longer need transfer out
0
200
400
600
800
Number of Consultations
2011‐12
2012‐13
Teleconsultation –
2010 - Present
Care Homes
consultation in room
or central location
results……
12 Month Results -
Care Homes
Patients at home
Long Term Conditions
SALT / Parkinson’s
Lee Silverman voice
treatment
1hr/day x 4days/week x
4weeks
Supporting people
at the end of life
supporting patients
(and carers) at home
supporting staff
delivering consultant
opinions to hospice
team
shared record
Results:
25 COPD patients at home
Bed Days used
0
50
100
150
200
250
300
Year pre post Year pre post
-29.5%
-36.5%
Other uses
handover to paramedics
use within the hospital
supporting clinical handover (HEE funding)
Current status…
20 prisons
30 care homes
+ 15 care homes
+ 50 care homes
60 @ home
1 hospice
e-learning
Customers, Partners….
What are the challenges?
 technical (care homes)
 tariff
 scheduling
 collaborative working
(community teams, GPs)
 culture change…STILL
(evidence?)
 the importance of scale
 noise in the system
 ED pressures
Final (obvious) thoughts
Redesign means deploying many new approaches
together
Focus on the right things – services not kit
Redesign means stopping something else
This is where the headroom comes from
Change in healthcare can be delivered
what are we waiting for?
•

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Telehealth Hub Know How for Past, Present and Future Care