1. STRICTLY CONFIDENTIAL © Telehealth Solutions Dr Julian Neal Senior Partner Portsdown Group Practice Telehealth: The Future for Primary (and all) Healthcare ~ COPD Monitoring in Primary Care ~

2. STRICTLY CONFIDENTIAL © Telehealth Solutions Portsdown Group Practice 30,000 patients four sites

3. STRICTLY CONFIDENTIAL © Telehealth Solutions Innovation “ We will need to create pull for new ideas from patients and the NHS rather than relying on the traditional top down push. We should reward those individuals and organisations that adopt best practice and new ideas and we should ask those organisations that don’t to explain why. We need to have the courage to make changes and be less risk averse, we need to take a longer term view on investments and we need to ensure staff are supported to introduce new ideas and technologies” Sir David Nicholson, Chief Executive of HNS England 5 December 2011

4. STRICTLY CONFIDENTIAL © Telehealth Solutions A brief history of Telehealth 2006 - a bright idea, Telehealth! Presentation to partners This led to................

5. STRICTLY CONFIDENTIAL © Telehealth Solutions Initial misunderstanding

6. STRICTLY CONFIDENTIAL © Telehealth Solutions The story continues Ignorance Cynicism Scepticism Ok – let’s try 2010 South Central SHA Innovation Challenge Pilot 100 COPD patients winter 2010/11 Positive outcomes Partnership with Telehealth Solutions since November 2011 Two year observational study with Imperial College, London

7. STRICTLY CONFIDENTIAL © Telehealth Solutions COPD Pilot 2010/11 Outcomes Proof of concept Technology Patient acceptance GP acceptance Increased patient engagement Reduced use Primary Care Reduced use OOH Reduced unscheduled care – 11 hospital admissions avoided in 3 months Additional time

8. STRICTLY CONFIDENTIAL © Telehealth Solutions Portsdown – Telehealth Solutions Partnership Development of robust clinical algorithms 100 COPD patients 100 CHF patients 100 Diabetic patients Two year observational study of Telehealth effect on clinical outcomes and NHS usage Central triage system Huge potential for integration

9. STRICTLY CONFIDENTIAL © Telehealth Solutions Portsdown – Telehealth Solutions Partnership Applying lessons learned in real practice setting Greater insight into patient selection Evolving technologies New algorithms for: Depression Post traumatic stress Hypertension Parkinson's Disease Exporting a UK success story

10. STRICTLY CONFIDENTIAL © Telehealth Solutions Six early lessons Win hearts and minds GPs Careful patient recruitment Communicate with community staff Integrate with secondary care Central triage by specialist nurse mandatory Simple technology with excellent support

11. STRICTLY CONFIDENTIAL © Telehealth Solutions Innovation – final thought First they ignore you, then they say you're mad, then dangerous, then there's a pause and then you can't find anyone who disagrees with you.” Tony Benn

12. STRICTLY CONFIDENTIAL © Telehealth Solutions Thank you Dr Julian Neal