Could a ‘Virtual Doctor’ improve patient care and save money?

For many elderly patients particularly ones suffering from diseases such as chronic obstructive pulmonary disease (COPD), heart disease or diabetes, getting to the doctors can be an ordeal.

Such patients need to have their vital signs and other parameters regularly monitored in order to effectively control and treat their conditions. However such patients may only see their doctor or nurse for such checks every few months, and if there is a problem in between then often they will have to be admitted to hospital.

However there is now a programme called Telehealth that has been in development since 2007, and is now being trialed by the North Yorkshireand York Primary Care Trust, using 500 patients suffering from diseases such as COPD, heart disease and diabetes.

The equipment called a Telestation is placed in a patient’s home and can monitor key readings from a patient within just five minutes every morning. The equipment has an integral scale to weigh the patient, a blood pressure cuff to take blood pressure readings, a pulse oximeter to measure pulse and blood oxygen levels, a glucose meter to measure blood sugar levels and even has a video camera built in so the doctor/nurse can physically see the patient if the need arises.

The really clever part of the Telehealth system is that the Telestation wirelessly transmits the readings once taken, to the patient’s phone line where they are transmitted directly to the Telehealth central control, where their own dedicated Telehealth nurse will daily review the readings.

The machine verbally takes the patient step by step throughout the five minute checkup and will also ask pre-set questions as well as taking various readings. If any of the readings fall outside of the pre-set parameters, an alarm will be triggered and the patient will immediately be contacted by their own dedicated Telehealth nurse.

Vera who is 71 and is suffering from COPD was initially skeptical about the scheme, but after taking part in the year long trial Vera claimed that the Telehealth system is “the best thing since sliced bread and that they should be in everybody’s home.” Normally patients suffering from COPD can easily be susceptible to infections that though may be easy to treat, often escalate into much larger problems necessitating hospital admission. The reason for this is that often patients leave it too late to get help, however with the Telehealth system the infection can be nipped in the bud by early diagnosis and treatment. Patients such as Vera suffering from COPD are given medication rescue packs containing antibiotics and steroids that can be taken as soon as needed after a consultation with their Telehealth nurse.

Telehealth nurse Dawn Watson who looks after Vera, tells how by working remotely she can look after more than 200 patients instead of the normal caseload of closer to 30 patients. As well as improved patient care the Telehealth system could obviously cut costs for the NHS especially when you consider that seven out of ten hospital beds are occupied by patients with long term conditions like Vera’s.

Paul Burstow, the minister for care services, claimed at a conference in March that “Telehealth could save the NHS up to £1.2 billion by 2014.” That claim seems to be well backed up as the trial which claims to be a success was launched in 2007, cost £30million, lasted three and a half years and was one of the most complex trials ever carried out by the NHS.

However the jury is still out on whether the Telehealth system is capable of saving the amount of money claimed, and also whether it can provide the improved patient care it claims. The reason the jury is still out on this is that the data analysis is being carried out by five academic institutions, and that for the findings to be both credible and useful, the academic analysis needs to be peer reviewed (a vital process of evaluation by independent experts.)