Telehealth Hub Know How….past, present and future

Rebecca Malin

Head of Business Development and Investment

• District General Hospital

• Population of 217,000 over 700 square miles

• £140m Turnover

• 7 Commissioners (CCGs), 5 x LA

Context

Introducing telehealth

• tele care• tele coaching• tele monitoring

teleconsultation

A1

Slajd 3

A1 Use for no. 2AGH; 2013-05-17

Past….nothing is ever “new”

Past….nothing is ever “new”

Past….nothing is ever “new”

so less in here…

We need to move to a system designed for purpose

and more “near me”

“I didn’t have

totravel

toclinic”

“I could get advice – now”

“….you could bring the specialist to me”

Exemplar...Prison Teleconsultation

• Risks, Costs, Quality• 2006 HMP Full Sutton• ISDN lines

• Results….

Prison Teleconsultationspecialist opinionnurse with patientshared record

n = 20 prisonsup to 50% cases nolonger need transfer out

0

200

400

600

800

Number of Consultations

2011‐12

2012‐13

Teleconsultation –2010 - Present

Care Homesconsultation in roomor central location

results……

12 Month Results -Care Homes

Patients at home

Long Term Conditions

SALT / Parkinson’s

Lee Silverman voice treatment1hr/day x 4days/week x 4weeks

Supporting peopleat the end of life

supporting patients (and carers) at homesupporting staffdelivering consultant opinions to hospice teamshared record

Results:25 COPD patients at home

Bed Days used

0

50

100

150

200

250

300

Year pre post Year pre post

-29.5%

-36.5%

Other uses

handover to paramedicsuse within the hospitalsupporting clinical handover (HEE funding)

Current status…

20 prisons30 care homes+ 15 care homes+ 50 care homes60 @ home1 hospicee-learning

Customers, Partners….

What are the challenges?

technical (care homes) tariff scheduling collaborative working

(community teams, GPs) culture change…STILL

(evidence?) the importance of scale noise in the system ED pressures

Final (obvious) thoughtsRedesign means deploying many new approaches togetherFocus on the right things – services not kitRedesign means stopping something elseThis is where the headroom comes fromChange in healthcare can be delivered

what are we waiting for?

•