Quod erat demonstrandum

The waiting is up for the Whole System Demonstrator programme to report its findings and the headline is a careful yes to telecare: "if delivered properly, telehealth can substantially reduce mortality, reduce the need for admissions to hospital, lower the number of bed days spent in hospital and reduce the time spent in A&E." Started in 2008, this was the largest telecare RCT, covering 6191 patients and 238 GP practices in three areas (Kent, Newham and Cornwall) and covering three major long-term conditions, diabetes, heart failure and COPD . The figures look encouraging: in addition to reductions of 15% in A&E visits, 20% in emergency admissions and 14% in elective admissions, there's a 45% drop in mortality rates. However, this is only the top level data - the small print is yet to be released. The caveat of "if used properly" may constitute something of a warning: last month the King's Fund suggested that there's danger in the technology leading where the organisations cannot effectively follow without substantial change. DH has indicated that the yes is enough: its new campaign, "3 million lives," is aimed at "providing national leadership, strategic direction, and advice to NHS and social care organisations" in implementing telecare more widely. Again, the detail is to follow "in due course."

At arm's length

Ahead of the long-awaited reporting from the UK Whole System Demonstrator (WSD) telehealth projects, Audit Scotland provides a review of the issues and looks at programmes north of the border. There's some compelling evidence on the use of telehealth to avoid hospital admissions for people with COPD. The King's Fund has published the third in a series of papers on the experience of implementing telecare and telehealth across the 12 WSD Action Network sites, which takes a more cautious view of the options for implementing telecare nationally. According to the King's Fund, significant cultural and organisational barriers may present more of a challenge than the development of the technology. Meanwhile the Good Governance Institute takes a much more bullish approach, although, like the King's Fund report, does suggest that this will only work if accompanied by systemic change.