From Telemedicine to Telehealth

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From Telemedicine to Telehealth

• Dr Nicholas Robinson
• Associate Medical Director NHS Direct
• (Long Term Conditions and Telecare)
• n.robinson_at_nhs.net

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What is telehealth?
Telecare
eHealth
Assistive Technology
Telemedicine
Telehealth
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http//www.choose-independence.co.uk/
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History

• 1890 Lancet
• 1st documented remote consultation
• 1906- Einthoven
• ECG
• 1920s
• Radio Doctor for ships
• 1924
• Radio News

• 1955 telepsychiatry
• Via TV
• 1970s
• Nurse call centres (HMOs)
• 1998 -
• NHS Direct
• Call Centres
• NHS Direct Online

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Radio news1924
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Telecare - 1990s to date

• A thousand pilots
• Technology focussed
• Industry driven
• Limited long-term impact
• Few UK Services resulted
• Few Mainstream services

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NHS Changes

• Polarisation of Management
• Policy (DH) v Responsibility (PCT/Trust)
• Fragmentation of market
• Implementation of Connecting for Health
• Increase in demand
• Population changes
• Change in Focus
• Personal care / responsibility

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Societal changes

• Ageing of Population
• Increase in Incidence of Long Term Conditions
  (Chronic Disease)
• Reduction in Workforce
• Increase in costs
• 10 increase in over 60s by 2028 (UK)

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Long term Conditions

• Conditions that
• Are enduring
• Are not curable and require ongoing care
• May get progressively worse
• Whats included?
• Arthritis, diabetes, heart failure, COPD
• Mental health
• Renal dialysis, cancer and HIV/AIDS
• Sickle Cell and Thalassemia
• Neurological Conditions
• 65 of all deaths Worldwide (2005)

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Matching care to user needs The Pyramid of Doom