1. WSD & Interoperability– a missed opportunity?
Time allowed – 3 to 4 minutes
Key notes
Run through of Eddie’s experience on the trial using feedback provided in the feedback log
Run through of Patient feedback - can be categorised under the following:
Being able to manage their condition better as they can see their own readings and relate it to how they are feeling.
Promoting independence and peace of mind as they their health is being monitored
Feeling empowered to help themselves with their condition e.g. by losing weight due to them having weight scales and their weight being monitored
A belief that it has contributed to earlier diagnosis and treatment of condition e.g. a pace maker being fitted due to the fact that daily readings from the telehealth equipment pointed to this being a requirement
A ‘belief’ that for some it is stopping them from going into hospital
Talk briefly about the Newsletter that has gone out which has resulted in further positive feedback from patients – includes information on the programme, tips for patients etc.
Dave Tyas
Remote Health Services Lead

2. Whole System Demonstrator Results
Whole System Demonstrator was the largest randomised control trial of Telehealth & Telecare globally
Results (in case you missed them!)
45% reduction on Mortality rates
20% reduction in unplanned admissions
15% reduction in A&E visits
Cost effectiveness study showed based on QALY that TH was not cost effective
Quality of Life came out neutral
Randomised control trials are good for evidence but can be restictive

3. Whole System Demonstrator – was it?
Whole System Demonstrator was supposed to focus on the ‘whole system’ of health & social care
Reality: it focused very much on the individual elements of Telehealth & Telecare picking up parts of the system but in its component parts.
Can the study be blamed for this: the reality is that for many parts of the UK health and social care are operated separately by different organisations
We work in a world where different funding streams dictate care delivery with often ‘closed’ systems that take significant investment to ‘open up’
Should a national study have provided investment into interoperability rather than the limitations through randomised control?

4. Interoperability (or lack of it) – the impact
Lack of interoperability had a significant impact on many aspects of WSD
Data Collection & Evaluation: no central database linking all the 3 WSD sites to the evaluators for data collection. Result: Arduous manual process for collecting data from sites and patients
Systems and communication: stand alone Telehealth and Telecare systems that did not link into health and social care systems. Health & Social Care systems that did not link to each other. Result: ineffective information sharing and awareness. Duplication. Lack of buy in.
Patient access: no provision for patient education / information sharing via the devices in the home for 2/3rds of the trial. Result: patients reliant on reports being sent to them

5. What could have happened
Interoperability is ultimately about information and communication of it through a system or process. What could have happened with WSD……
Evaluation: a central database with restricted access to WSD sites and evaluators would have saved significant manual processing, provided real time information and enabled far greater consistency, reducing resources
Systems & Communication: linked systems would have meant better stakeholder engagement, understanding and buy in. Provider resources could have worked more collectively rather than silos. Everyone would have had an understanding of the whole system and the information in it
Patient information: patients would have been better informed with information available when they wanted it. Education could have been provided via media. They could see the trends of their readings. A more personal experience provided

6. A view of the future
Open systems that can talk to each other and share information without significant investment – system choice then becomes about functionality rather than data sharing. This would include communication flows and messaging
Telehealth and Telecare systems that are integrated with web / app based versions for patients / users. Biometric devices that can operate with any system
Home monitoring and information sharing in peoples homes using technology they already have – SMART TV’s, Tablets, PC’s, Smart Phones. Its about individual choice. Dedicated devices are not the way forward long term
Biometric devices that are small and wearable – people don’t have to remember to take their readings, they are just taken!
Funding streams that enable the above to happen – the focus being on overall care delivery and not a SILO approach
Freely available information to those that need it for care purposes

7. Integration and flow is the key
Condition Pathways
(COPD, Diabetes, Heart Failure, Stroke, UTI, Falls Prevention etc.)
Patient GP
Acute Services
Specialist Nurse
CommunityNurse
Pharmacist
Clinical Systems / Patient Systems / Portals / APPS
Information
Intervention
Escalation
Information
Intervention
Escalation
Telehealth Referral
Telehealth Service
Consent & Installation
Patient Support
Clinical Monitoring
Discharge

8. How does this relate to dallas
dallas’s focus areas cover a lot of the vision and is much wider than WSD
The initial key focus areas for dallas should be:
Multi-sourcing of TH & TC equipment
TH system integration with GP (and other) clinical systems
Shared messaging, calendar, alerts and notifications
The above 3 will really have a huge initial impact on the marketplace. They will:
Drive competition and an open marketplace with greater choice
Ensure that information is getting to the people that need it and make decisions on commissioning
Focus attention on efficient, collective working
The remaining focus areas are very important but will have more of an impact as the market establishes itself

9. Q&A Contact Details Dave Tyas – Remote Health Service Lead
Tel:
Q&A