Making sure your online doctor will always have time to see you

Last month, the care minister Paul Burstow claimed that within five years 3m patients could be consulting their doctor and managing their health conditions online.

Last year’s Government study of 6,000 patients with conditions such as diabetes showed that telehealth reduced deaths by 45pc

9:42PM BST 31 Mar 2012

After a Government-funded study last year found that so-called “telehealth” or “telemedicine” could dramatically cut deaths and emergency admissions, politicians are aiming to save lives – and money – by ensuring patients suffering from illnesses such as heart or lung conditions can monitor their illness at home.

Accelerated adoption of telehealth should prove beneficial for the likes of Tunstall, a Yorkshire-based business that provides telemedicine technology and services. Many other mid-sized businesses could also flourish in this area, as the NHS looks to the private sector for solutions.

With an annual turnover of around £148m, Tunstall’s products include the “mymedic”, which prompts users to take their vital signs and answer some questions about their health before transmitting that information to healthcare professionals.

Such a device allows patients to keep track of illnesses such as chronic lung disease at home, rather than going to their GP or being visited by a nurse. Doctors can monitor their condition for any changes and get in touch with the patient if necessary.

Tunstall’s services are used as far afield as Spain as well as in Britain and they have been used for managing long-term conditions in areas including Sheffield and Swindon.

Gil Baldwin, Tunstall chief executive, said that the key priority was ensuring their technology is safe, secure and easy for doctors and patients to use. “The box wakes itself up and asks you to take a reading at certain times of the day so you get proper trend data, and asks all the relevant questions a nurse would ask, for example, ‘are you coughing today’. That richness of data helps clinicians maintain the stability of your condition.”

Baldwin adds: “The really interesting patient feedback is they value the service because they know if any of their readings are slightly out of whack, they know a human being is going to pick up the phone and ring them.

“That reassurance is critical to keeping people out of hospital and giving them the sense of security and well-being that allows them to cope with minor niggles.”

On fears that it could lead to cuts in community nurses, he said: “My view is that there are no savings to be had in community nursing,” said Baldwin. “It’s been woefully underfunded for many years. If our problem as a society is an ageing demographic, we need to invest more in community services not less.”

Instead, he added, savings would come from the avoidance of visits to accident & emergency departments, which are expensive. While the Government calculates that telemedicine could save the NHS £1.2bn, questions have been raised over its cost-effectiveness. But Baldwin stresses that scale will prompt savings: “If the market opens up to 3m service packages, I can guarantee that the cost of service, including equipment, will reduce – it is the nature of competition and scale.

“One should not forget the shift in mortality rates for the patient [last year’s Government study of 6,000 patients with conditions such as diabetes showed that telehealth reduced deaths by 45pc]. To my mind people should concentrate on this aspect and then challenge industry to produce solutions that make financial sense for all, give great outcomes for patients, make it easy to refer and deliver the required savings.”

Finalising contracts with the NHS brings its own challenges, not least due to the rejigging of organisations such as primary care trusts, which means that buyers are changing. He added that Government procurement processes do not necessarily encompass the same notions of risk-sharing that are common practice in industry, and that contract lengths are too short.

As such, the tender and contracting process needs shaking up, he says, arguing it is “onerous” and expensive.

Add to that a “cultural inertia” that can make doctors wary to adopt new technology and it can be difficult to accelerate the take-up of telemedicine. Tunstall sent 2,000 units to North Yorkshire, but deployment of its systems there has been “slow”, although it is now improving.

Such challenges, however, have not dented the company’s determination. “I think this genuinely underpins what we’re trying to do, which is rebuild the NHS to address the needs of population and nation in terms of demographic and chronic conditions. That revolution will start to accelerate as you come over the inertia of bureaucracy,” said Baldwin.

But Tunstall acknowledges that if telemedicine is to fulfil its potential and doctors feel confident in its applications, then business has a role to play.

“We in industry have got a job to do. We’ve got to make it easy, reliable, and you’ve got to be able to exercise clinical judgment off that,” said Baldwin. “If there’s any hiccup in that, you’re back to the drawing board because clinicians won’t trust it.”