The real reason why Telecare & TeleHealth is still delivering too little Value


EU healthcare systems do face trouble. So does the system in the UK. A recent study by Deloitte explains that the average number of primary care consultations per person increased from 4.2 in 2000 to 5.5 in 2008. If you look at the age of 75+ group, an even more troubling picture is presented. An increase of 4, to 12.3 consultations is confirmed. Why? Has it to do with the fact that the system has to deal with more patients with less doctors? Or because nowadays people are actually more educated on their personal health and ask questions that are being answered by Dr. Google? The fact is that individuals are looking for more consultations from their physicians. And the dilemma remains: how can we deal with it?

In the UK, there will be 1.7million more people in the 65+ range until 2020, and 4.3million more in 2030. It will continue to contribute to the number of consultations. We need a solution. And the solution has to come fast.

One good way to tackle the problem is using telecare and telehealth. Two Messiah terms that should bring a long awaited change to get our systems back on track. So what happened since 2008? Little potential has been realized. Positive market trend calculations brought much excitement, and with it, several Startup investments placed on the wrong cards because investors and participants read studies maybe too blindly. In March, a report by research2guidance predicted that the mobile healthcare services market would begin the commercialization phase and reach 26 billion worldwide by 2017 and smartphone apps help to monetize. A way to monetization is great and a trend driver.

Don’t  get me wrong: I do believe that the market will rocket, but I also know that such market research institutes earn pleasingly from their reports. There are more metrics that need to be taken into account. Sometimes, it may just require more honesty: execution is difficult and things may take a little longer for a trend to be realized.  Gladly, much money has been spent on testing. However, only a few large trials have been conducted in the field that showcase reliable results for the broader audience. One of the largest is the Whole System Demonstrator (WSD) program on telehealth and telecare. It is one of the most complex and comprehensive studies the UK Department of Health has ever undertaken. Launched in May 2008, it is the largest randomized control trial in the world. Findings explain the enthusiasm: “Used correctly, telehealth can deliver 15% reduction in A&E visits, 20% less emergency admissions, 14% reduction in bed days – but most impressively: a 45% reduction in mortality rates. It sounds all really ,really good, doesn’t it?

MedCrunch wanted to know more and promptly met with the lead nurse for district nursing and the Whole Systems Demonstrator program (Nhs newham), Yvonne Fenn. Yvonne explained in her presentation that the WSD was a fantastic experience because patients embraced the technology and confirmed the value it brings. Apart from obvious points, telecare and telehealth bring peace in patient’s lives and reduce anxieties.

However, it resulted that one of the issues implied that many nurses did not show the same enthusiasm and had trouble embracing it (even-though most do carry a latest generation smartphone with them). A telecare service needs to be integrated completely into a patient’s care delivery system, and all participants need to play along to guarantee quick response rates. That is where the biggest benefits come from. For old people and end-of-life care the existing approach, including self empowerment in care, healthcare needs to be reevaluated too, says Charles Lowe, the President of the Telemedicine and eHealth Council of the Royal Society of Medicine,. Old people that get sicker do not want telecare sensors telling them that their status worsens. Instead, they want peace and somebody else taking care of them.

Back to our sparkling forecasts. UKs spending on telecare are predicted to reach 252 million pounds in 2015, which is more than double from 2010. Large companies should have successfully picked up on the trend and ruled out. However, just last week we heard disappointing news from  Telefonica’s O2 Health division. The company decided to stop selling their telecare (Help at Hand) and telehealth (Health at Home) services in the UK. The primary reason being what O2 calls “a slower than expected uptake”. While this is not the only example, little impact and benefits have been reported. For anyone that has not heard of it, Telehealth is defined as a delivery of healthcare services where distance is a critical factor, and Tele-care is a term that describes a tool that is used to provide health and social care from a distance with the help of telecommunication.

So, let’s take a break and get this right. We don’t need more technology, nor a whole lot more money. We need a change in our mindset and a plan to make telecare and telehealth marketable. One company already starting it is Dr. Mortons – the medical helpline, commercializing on the fact that access to a GP or a specialist is still too difficult. If people are willing to pay for access to medical advice, it’s a great step forward. We also need governments to understand that without proper telecare infrastructure, a national health system can easily fall back into the Stone Age, and that large companies or government-owned initiatives do not do their job sufficiently. Instead, small companies need to be supported in order to commercialize as well as supported in marketing decisions towards consumers and patients. In sum: a support process that enables to scale and not shy away from pure commercial models. In other words, a commercial approach needs to be treasured instead of stigmatized. The US, even with a broken system, can teach us Europeans a lot. It has seen so much more successful integration projects because the government is standing behind remote care. We need to push for an integrated healthcare startup development model that is increasingly being led by governments. Governments are the ones that make the rules and regulations, the biggest barrier for our trends to be realized.

At the end of the day I wish that marketing of future developments will become more realistic. Trends need to become more reliable and telecare and telehealth stories need to make a long lasting impact. Our governments need to get excited. If we fail, it will affect us when we get old. Watch out.

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Ben Heubl is a Health 2.0 advocate and an expert in the innovation business consulting arena of this industry. His main interest is how to use technology to make an impact for patients and hereby targeting the intersection between entrepreneurship, open innovation, technology and large corporations. Ben co-organized TEDMEDlive Bologna and is TEDMED delegate, is non-for-profit founder of Health 2.0 Copenhagen, Medstartr (EU division) and MyHealthInnovationBlog. Meanwhile he is a mentor at HealthXL, works with ICG and supports KairosSociety and its student's engagements in healthcare innovation. You can follow him on Twitter (@benheubl)