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BT HealthAchieving mainstream telehealth to support theneeds of clinicians and patientsDr Justin Whatling, Chief Clinical OfficerOct 2010
Working with the NHS in England for 60 years and counting1948Hearing aidsfor all1969Communicationfor people withdisabilities1985Life pagerservice fororgan recipients1998NHS Directestablished2002NHS numberfrom birth2007NHS NationalBroadbandnetworkcompleted2008Patient informationon the move
“Remote monitoring and managementallow homecare nurses and support staffto maintain patient contact, assessneeds, provide education and counselcaregivers, while reducing staff traveltime.”Lessons from the US: using technology and homecare to improve chronic disease management.Newhealth and Judge Business School, University of Cambridge. May 103
Tipping the balance for substantial benefits1. Assist clinical transformation to realise benefits Connecting community workers to patients to avoid visits Rich media to fully engage the patient and change behaviour Improve quality of care through consistency2. Fit for purpose solutions Lower software costs Lower training requirements Depreciate equipment over 7 years3. Reuse existing assets 4Utilise patients’ existing broadband servicesMultipurpose, economic re-use of health hubEasy reuse of existing content resourcesSweat the asset of community worker mobility solutionsConnect to health secure private networksIntegration to EPR and health informatics services
Telehealthintegrated toEPRTransform clinicianrelationship withpatient. Patient self-careand co-production.Transform clinicianworkingPlatform fortransforming utionsMobilitySolutionsElectronicPatient RecordSystem
Scaling strategyStrategicfactorsWhat is theexpected durationof the service?What is theestimated size ofthe patient base?How manyservices do youwant to shareTelehealth datawith?Strategy 1 Strategy 2 Strategy 3Strategy 51 -2 years1 -2 years2-3years3-4 years4 Less than500500 to 10001000 to50001000 to5000More than50000Not morethan 12-33-55 Requires operationalworkarounds6Strategy 4Flexible and scalableservice.NHS Technology Office presentation to Intellect Telehealth Group, London, 23 March 2010
Multi-vendor managed serviceCarerPatientTrustsClinicians1. Install & TrainPatient focusseddelivery and training.Promoting self care.2. MonitorVendor independentand consumer led.Web PhoneSMSVideo EmailContact &EducateVital SignsBT Health er3. TriageLocal clinically led andresourced service.TriageClinical TriageHealth Management Portal4. Self ManagementSelf care througheducation fromservice and systems
Benefits of platform approachPlatform to Drive InnovationPlatform aligned to EHRMobile working for community nursesConferencing & video supportVirtual training servicesWellbeing contentConnectedHealthIncreased Self ManagementDevices appropriate to patient needsTargeted trainingClinical guidance and supportMy readingsVideo / Messaging servicesClinical SupportEase of use for CliniciansLocally based support and training organisationClinical Governance for nurses and the serviceClinical reportingIndependent evaluationIn Commercial Confidence
BT’s Digital Connected Home Vision Leveraging low cost infrastructure Smart metering and utility usage analysis Buildings standards for homes Internet enabled set top boxes Social networks and video yHome hubMedia & EntertainmentMobile AccessConnectivityEntertainmentEnergy MgmtWell being/healthIn Commercial ConfidenceAssisted Living
Whole system approach required across health and wellbeingRisk factors(Modifiable behaviors)1 2 3 4 5 6 78 SmokingPhysical inactivityPoor dietAlcohol consumptionlevelsPoor standard ofcare (SoC)compliancePoor stressmanagementInsufficient sleepLack of healthscreeningChronic conditions1 2 3 4 5 6 7 8 9 10 1112 1314 15 10DiabetesCAD (Coronaryartery aArthritisAllergiesSinusitisHeart failureCOPD (Chronicobstructivepulmonary disease)CKD (Chronickidney disease)DepressionBack painSource: BCG- Healthways WholeHealth model documentationCosts & productivityimplicationsHealthcare costsProductivity Absenteeism PresenteeismTalentmanagementand retentionInterventionsInterventions Programmatic Managerial OrganizationalInterventions Engagement Talentmanagement Retention
Other scale considerations Other technology services supporting remote care Videoconferencing from providers to patients over N3 Interoperability services, Interoperability Toolkit Mobile health libraries New challenges arise Patient groups will no longer be self-selected Where best to provide clinical triage services And the price will start to fall 11
Disruption?What if we could provide all of this from just 10 per month? Would this enable Consumers to pay (or co-pay) for theseservices out of pocket? Would clinicians and commissioners recommend suchservices for the chronic disease population? Would Consumers be offered these services throughpersonal health budgets? Service upstream of care homes?12
Thank youjustin.whatling@bt.com
BT Health Achieving mainstream telehealth to support the needs of clinicians and patients . conferencing. 6 Scaling strategy. Strategic factors. Strategy 1. Strategy 2. Strategy 3: Strategy 4. Strategy 5: . Web. Phone Email 1. Install & Train Patient focussed delivery and training. Promoting self care. 2. Monitor
