WIRELESS COMMUNICATIONS
are still some concerns around security and confi dentiality which could be responded to a little bit more thoughtfully by some of the providers.”
But some of the caution is misplaced, Ford says.
He explained: “There’s perhaps been a degree of over-caution from the NHS about some of these issues, and that has impeded progress, and perhaps there’s been a lack of understanding from the technology providers about what those concerns are. That’s part of the explanation for why things haven’t sprung forward as quickly as they might, but that’s certainly only a partial explanation.”
Revolution or evolution
The rise of the form of wireless healthcare with which patients have most direct con- tact, usually known as telehealth or tel- ecare, encourages some health commenta- tors to see a future much less centred on the GP surgery and the hospital, and more on remote monitoring, digital contact and home diagnosis.
Some of this is hardly new – witness the success of NHS Direct – but does telehealth technology really have revolutionary potential?
Ford told us: “It’s interesting that although there has been a lot of research done in various parts of the world looking at the benefi ts of employing telehealth solutions for people with chronic conditions, par- ticularly, the talk for a long time has been about the lack of a robust evidence-base for the widespread adoption of these kinds of technologies.
“Of course, we’ve now seen recently the Whole Systems Demonstrators (WSD) pro- ject in England, which is seeking to provide that large-scale evidence, and actually, to most people’s minds, the business case for the adoption of some of these technologies is fairly clear – if you’re careful in choosing and selecting the patients and conditions.”
The two-year WSD project, expected to start reporting back this summer, is thought to be the largest randomised con- trol trial of telecare and telehealth in the world.
Ford said: “Although we do welcome large- scale trial evidence about its effectiveness, there’s been a lot of consolidated learning already. Many trusts and other health or- ganisations around the world are recognis- ing this now and starting to perhaps move
forward – still in relatively tentative ways – but are starting to grasp the nettle.
“A lot of the impediments to progress are centred on the same issues that you see in any other type of new development in the health service; it costs money to start something new, and the savings don’t al- ways accrue into the budget from where you’re paying for the new thing.
“So, fi nancing something and realising the savings that are potentially deliverable by using these kinds of technologies is quite hard under the current NHS fi nancial mechanisms, particularly when some of those benefi ts might accrue to social servic- es rather than the NHS itself, for example.”
Diving right in
What about the public’s view of these technologies?
Ford explained: “Due to the nature of most people’s lives these days, they are quite content with having ‘remote contact’, usu- ally through websites and so forth, with other organisations. There’s no particular reason why healthcare should be any differ- ent in that respect. You can see NHS Direct in England, and its equivalents in Wales and Scotland, really trying to push forward that agenda.
“These remote access ‘mechanisms’ can be very reassuring and are appreciated,
national health executive May/Jun 11 | 37
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