WSD sites enrol just one patient in ten

A senior adviser on telehealth has told eHealth Insider Live 2010 that the whole system demonstrator sites have been able to recruit fewer than one in ten people eligible for support.

George MacGinnis, a consultant with PA Consulting and a former government adviser, said the three sites had typically sent out 27,000 letters to patients identified as meeting the WSD criteria – diabetes, chronic pulmonary disease or heart failure – to offer them home monitoring and additional support to manage their condition.

Of these, 9,000 responded positively but only 3,000 had enrolled. Once half of them had been allocated to the control group demanded by the WSD’s randomised control group methodology, only 1,500 people were offered any telehealth intervention.

Sarah Bruce interviews George MacGinnis at EHI Live 2010

The three WSD sites – Kent, Newham and Cornwall and the Isles of Scilly – were all selected for having a population of 1m. From this, it was expected that 30,000 people would potentially be recruits for the telehealth study.

MacGinnis compared this level of involvement with the US, where the Veterans Administration has reported data on 17,000 patients involved in a telehealth service.

He questioned the need for a randomised controlled trial, when the NHS and industry were crying out for answers to questions about how to provide a service that was cost effective and productive.

He said: “I do think we ought to be challenging the medics about whether this method of getting the data is the most appropriate for what is a service delivery question.”

He said that telehealth had yet to take off in the UK. Although some 70 primary care trust areas have schemes, only five of these involve more than 300 patients.

This meant that in most cases, too little was made of the infrastructure to deliver any economic benefits. He said: “Imagine a railway infrastructure where only one train a day runs. This is the situation we have in telehealth at the moment.”

MacGinnis, who is also lead officer for international standards at the Continua Health Alliance, said he was encouraged by movement on telehealth in the last decade and by the coalition government’s commitment to its development.

But he said there were many challenges to mainstreaming telehealth. These included: finding better ways to enrol patients; making betters use of the infrastructure; engaging GPs in the data sharing aspects; and developing the capacity within local teams.

He said: “Some of these questions very clearly need national answers but others, such as the service innovation, is an intensely local and must grow from the bottom up.”