The Whole System Demonstrator programme was set up by the UK Department of Health to show just what telehealth and telecare is capable of. To provide a clear evidence base to support important investment decisions and show how the technology supports people to live independently, take control and be responsible for their own health and care.
The programme was one of the most complex trials ever undertaken by the Department of Health and will continue to provide useful information as the analysis continues, in particular we await the final results for telecare. But we want to share the telehealth headlines now, to help as many people as possible, as early as possible.
The first set of initial findings from this programme is now available. They show that, if delivered properly, telehealth can substantially reduce mortality, reduce the need for admissions to hospital, lower the number of bed days spent in hospital and reduce the time spent in A&E.
The key is to integrate these technologies into the care and services that are delivered. Going forward this evidence gives us confidence that we can transform the way services are delivered and ensure that we use appropriate technology to put people at the centre, and in control.
The Whole System Demonstrator programme
The Whole System Demonstrator (WSD) programme has been one of the most complex and comprehensive studies the Department has ever undertaken, and has yielded a wide range of very rich data.
The WSD programme was launched in May 2008. It is the largest randomised control trial of telehealth and telecare in the world, involving 6191 patients and 238 GP practices across three sites, Newham, Kent and Cornwall. Three thousand and thirty people with one of three conditions (diabetes, heart failure and COPD) were included in the telehealth trial. For the telecare element of the trial people were selected using the Fair Access to Care Services criteria.
There are many different types of telehealth and telecare but each of the three sites made their own decisions on the equipment they would use in their health and social care economies. That in itself was not a problem for the study, as the proposition being analysed was "Does the use of technology as a remote intervention make a difference?" As each site used different equipment and had differing populations there is confidence that the results are transferable to other locations.
Evaluation
The study was set up in such a way that there was at least 12 months data on all participants by the end of September 2010.
Evaluation of the data from the programme has been undertaken by six of the major academic institutions - City University London, University of Oxford, University of Manchester, Nuffield Trust, Imperial College London and London School of Economics. The study looked at the data under five themes (service utilisation, participant reported outcomes such as quality of life; cost effectiveness; user and professionals experience; and influence of organisational factors to adoption) and papers will be published in due course, including the WSD evidence on telecare. More detailed analysis of the data will result in further papers being published over the coming months and years.
Early headline findings
The early indications show that if used correctly telehealth can deliver a 15% reduction in A&E visits, a 20% reduction in emergency admissions, a 14% reduction in elective admissions, a 14% reduction in bed days and an 8% reduction in tariff costs. More strikingly they also demonstrate a 45% reduction in mortality rates.
What Happens Now?
At least three million people with Long Term Conditions and/or social care needs could benefit from using telehealth and telecare. To achieve this level of change the Department of Health is planning to work with industry, the NHS, social care and professional partners in a collaboration with a difference, the "Three Million Lives" campaign.
This is not a national target or a government guarantee of delivery, instead it is about the Department providing national leadership, strategic direction, and advice to NHS and social care organisations; with support from industry who would be responsible for creating the market and working with local organisations to deliver the change.
The detailed workplan for the 'Three Million Lives' campaign is still in the early stages of development with all stakeholders and further information will be available in due course.
About the Department of Health
The Department of Health provides strategic leadership for public health, the NHS and social care in England. The Department of Health's purpose is to improve England's health and well-being and in doing so achieve better health, better care, and better value for all.