Overview of Telehealth
Telehealth is the consistent and accurate monitoring of a patient’s vital signs and symptoms via easy-to-use technology in their home.
Patients take their readings and answer a series of health questions each day and the information is transmitted to a monitoring centre where technical triage personnel will verify the results and alert the patient's clinician if the data is outside of the parameters set for that individual patient.
Telehealth is not to be confused with Telecare, which is the term used for systems and equipment to support independent living, such as falls sensors and intruder alarms. Telecare systems are supplied by the county council.
Implementation in Gloucestershire
There are two types of Telehealth system in use in Gloucestershire.
'Specialist Telehealth' is the term used for the system used since 2008 by Gloucestershire Care Services' community heart failure and respiratory teams to support case management of their patients. At any one time there are up to 180 patients being monitored in this way in their own homes, using equipment supplied by Docobo.
'Large scale Telehealth' is the term used for a deployment of 2000 telehealth units to patients with long-term conditions in Gloucestershire. The programme is a partnership between NHS Gloucestershire and Tunstall's Healthcare. In most cases, the responsible clinician for these patients is their GP, although some patients are monitored by district or practice nurses, or by a specialist team.
Telehealth in GHNHSFT
There are a number of ways in which Telehealth implementation may be relevant for GHNHSFT staff:
Awareness of Telehealth patients
In the majority of cases, the case management responsibility for patients on Telehealth rests with primary care. However, it may be useful for hospital teams to be aware when a patient comes in to hospital that they have Telehealth monitoring at home. It may even be appropriate for hospital-based teams to view the past history of vital signs readings to identify trends and changes in a patient's condition. Data sharing agreements have been put in place to allow this to happen.
Considering or recommending Telehealth
Hospital staff are sometimes in a good position to realise when a patient might benefit from additional support at home, and might therefore recommend to the patient's GP that they consider Telehealth. This can be done as part of usual discharge processes or completing this form and faxing it to the GP practice.
Telehealth for patients under hospital care
In a small number of cases it may be appropriate for patients to be monitored using Telehealth while under the care of a hospital team. In this model the hospital team sets the patient's parameters and responds when the monitoring equipment senses an issue, rather than the GP.
The paediatric respiratory team is planning to pilot this approach with a small number of suitable patients from January 2013.
There is more information on NHS Gloucestershire's website.