Cornish patients to lead way in UK's largest Telehealth trial

It is routine these days for hospital patients to have their condition monitored electronically but now telehealth technology is available to provide similar reassurance at home. From April, 2008 people who live in Cornwall and who have one or more of the following long term conditions of diabetes, congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD) will have the opportunity to try out telehealth services. These incorporate proactive monitoring technology designed to enable people to stay in their own homes and take greater responsibility for their own care. The aim is to prevent them from having frequent unplanned hospital admissions and allow them to maintain their independence.

Telehealth services are likely to become a common feature of NHS care in the future and this project will promote joint working between health and social services and forward-looking GP practices.

Patients selected to take part in the trial will be able to monitor their health from their own home through a simple touch screen monitor called the RemoteNurse. The RemoteNurse unit is connected to a home telephone line and sends information to a highly secure web-based server at the Royal Cornwall Hospital, Truro. This ensures confidentiality of patients' data.

The small RemoteNurse telehealth device has an eight inch colour display. Every day it instructs patients to take their blood pressure, breathing measurements, weight or blood glucose readings, as appropriate to their long term condition. It can also provide medication reminders and ask them questions about their health. Patients respond simply by touching the screen. All this information is sent via the Internet to an NHS computer that is managed by community matrons and other healthcare professionals in Cornwall. Between them they keep a close eye on the patients' day-to-day health. They are notified automatically if any readings exceed thresholds pre-set by the care professionals.

Quality of life benefits for patients

Christopher Wightman, who himself lives with COPD and is Chair of the Breathe Easy North Cornwall Group is strongly in favour of this attempt to bring the benefits of telehealth to patients. "It's great for people to be monitored so closely in the comfort of their own home," he said. "You might not notice changes yourself each day, and if you do, you might not want to bother the doctor. And then, suddenly, it's got a lot worse and you have to be whisked into hospital. The telehealth system should make it possible to get treatment before it reaches that stage. It should also help our members understand their health better and be more independent."

This is a view confirmed by Andrew Forrest, Cornwall and Isles of Scilly PCT's Programme Director for the trial. "We are using RemoteNurse telehealth technology to evaluate whether we can help educate people about their condition, identify any deterioration early on and reduce the number of acute problems and unplanned admissions to hospital in Cornwall each year. If we can do that it will be of significant benefit to patients who can take control of their own care and lead the normal life they want to at home. It could free up clinical resources to meet the increasing demands of an ageing population."

UK Health Commissioners still to be convinced about telehealth

The largest previous projects using telehealth in the UK have involved much smaller numbers of patients. The results, whilst encouraging, have not yet convinced doctors and commissioners of health services generally that telehealth monitoring is more than a 'good idea'.

However, the trial of the RemoteNurse system in Cornwall is one of three Department of Health 'National Whole System Long-Term Condition Demonstrator' projects. The aim is to show, using rigorous evaluation by a group of universities and the King's Fund healthcare think tank, that wide scale adoption of telehealth and telecare systems can have significant benefits across the whole NHS and social services. The other two places selected by the Department for similar projects are the London Borough of Newham and Kent. They will test different approaches and equipment.

Sophisticated and flexible telehealth

Research has identified that a high percentage of acute hospital admissions by patients with long term conditions (LTC) is due to anxiety and uncertainty, causing the patients to seek medical care for reassurance.

Many people with LTC have already benefited from education about their condition and their clinical management plans. The RemoteNurse takes this one step further: using the equipment the patient can now record their own vital signs, empowering them to make accurate assessment of their current clinical condition and act accordingly. The sophisticated RemoteNurse system can distinguish, for example, between changes in a patient's breathing owing to a worsening of COPD or increased anxiety. Its extensive library of clinical protocols and patient pathways also allow multiple health conditions to be managed effectively by patients in their own homes, or regularly, by clinicians, with minimal intervention.

The system is being supplied and supported to the Cornish project by Home Telehealth Limited, based in Cardiff. Ongoing project management is provided by another experienced telehealth consultancy, CareCymru Limited.

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1. Other telehealth background material and general links are available from: http://www.hometelehealthltd.co.uk/ehealthinfo.htm

2. Cornwall-related enquiries to: Cornwall Whole System Demonstrator Programme wsd@cornwall.nhs.uk – Tel: 01208 252512

3. Breathe Easy North Cornwall Group supports the British Lung Foundation. The Group's members suffer with chronic obstructive pulmonary disease (COPD) which is a general term covering diseases such as emphysema, chronic bronchitis and chronic asthma, but not lung cancer. Contact Mr Wightman – Tel: 01840 213171

4. Home Telehealth Limited: General telehealth system comment; Contact: Peter Range, Managing Director, on: peter@hometelehealthltd.co.uk Tel: 07976 139848 or David Muxworthy, Director, on david@hometelehealthltd.co.uk Tel: 029 2044 4795

5. Home Telehealth Limited: Clinical Telehealth comment: Contact: Paul Murphy on: paul@hometelehealthltd.co.uk Tel: 02890 224014

Home Telehealth Limited (HTL) works with the entire health and social care continuum from senior adult care to paediatric specialty care. HTL is a telecare and telehealth management company focused on delivering integrated, comprehensive programmes to health and social care providers, insurers and users.

Our goal is to reduce start-up time and costs for such programmes and effectively guide organisations attempting to find their way through the technology labyrinth and change management issues.

All Home Telehealth Limited (HTL) supplied products and services have been FDA 510k approved for security and accuracy. HTL does not manufacture any medical devices and every medical device used with this system has been FDA 510k, CE approved and MHRA registered. HTL has gone through an extensive programme to ensure full compliance with the European Council Directive 94/32/EEC of 14 June 1993 concerning medical devices for the RemoteNurse.

This release was published on openPR.