Telehealth and Telecare in Scotland Donna Henderson Service Development Manager Scottish Centre for Telehealth and Telecare, NHS 24
Scottish Health Board / Local Authority areas
Health and Care System Drivers • Long Term Conditions • Ageing population • Health Inequalities • Workforce Challenges • Affordability • Sustainability
Our Vision for 2020: • Everyone is able to live longer healthier lives at home, or in a homely setting. • We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self management. • When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. • Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. • There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission
Framework for Integration • Consistency of outcomes across Scotland • Applies in every council and health board area • Statutory underpinning • Joint Officer clearly accountable for agreed outcomes • Professionally led by clinicians and social workers • Simplifies rather than complicates existing structures • Achieved with minimal disruption to staff and services • Integrated budget for primary, community and social care and some acute services
Reshaping Care: Integration in Action • 10 Year National Programme 2011-2021 • £300 million Change Fund 2011 – 2015 • 32 Partnership Change Plans agreed by: – NHS: primary, acute and mental health services – Local Authority: social care and housing – Third sector – Independent sector • Reshaping Care and Integration Improvement Network to support partnerships to transform care
Reshaping Care Pathway
NHS 24 is: A statutory national NHS Health Board Provider of national Telehealth and Telecare services to the population of Scotland The Scottish Centre for Telehealth and Telecare Budget for 2011/12: £62 million 12
Telehealth – Health Services provided using one or combination of: Telephone Internet Telemedicine Mobile Devices Digital Television Remote Home Monitoring
NHS 24 - Web Services • NHS24.com • NHS Inform • Life Begins at 40 • MSK Service • Social Media • Care Information Scotland 14
Digital TV Starter Kit TV Main Menu Drs Appointments NHS Choices Prescriptions Travel Job centre Plus Report it Slide 30 Choice Based Letting Public Service Repair Your Council
Scottish Centre for Telehealth and Telecare • National Telehealth & Telecare Programmes established by Scottish Government in 2006 • Parallel programmes but increasingly integrated activity • SCT joined NHS 24 in April 2009 • Merged in April 2010 into SCTT within NHS 24 • Telecare Action Plan & Strategic Framework for Telehealth up to end March 2012
4 Key Objectives Telehealth and telecare will enable choice and control in health, care and wellbeing services for another 300,000 people People who use our health and care services will increasingly demand Telehealth and Telecare as positive options Establish an Innovation Centre where academics, care professionals, service providers and industry innovate to meet future challenges and provide benefits for Scotland ’ s health, wellbeing and wealth. Scotland develops an international reputation for research, development, prototyping and delivering innovative Telehealth and Telecare at scale.
Telehealth in Scotland • 4 National Programmes: – stroke, – paediatrics, – mental health – COPD • Underpinning activities: - Technology standards - Workforce development - Stakeholder engagement - Convergence with telecare
Impact • Reduced A&E Attendance • Reduced transfer rates • More appropriate transfers • Patients cared for locally • Reduced delays in receiving specialist intervention • Staff supported by senior decision makers • Monitoring data forwarded to emergency centres
Telecare in Scotland • Monitoring ‘ Health at Home ’ – LTCs, epilepsy, medication • Preventing & managing falls • Redesign of supported housing • Local training & awareness raising programmes • Promotion of telecare across different user groups
Impact • Over 163,000 people receive a telecare service, at least 4,000 people with dementia diagnosis • All 32 local partnerships have a telecare service in place • Gross cost benefits of £20m TDP funding estimated to be £78.6m • Continuing positive feedback from service users and carers Helsekonferansen 2010
Technology Strategy Board dallas Programme In 2012 the Assisted Living Innovation Platform launched dallas (delivering assisted living lifestyles at scale), a large scale demonstrator of independent living products and services. Scotland project – Living it Up
“ Effective services must be designed with and for people and communities ” The future delivery of public services - Christie report
dallas LiU aim LiU will co-design sustainable and innovative improvements and choices in health, care and wellbeing for 55,000 by 2015 Using familiar technology.
Collaboration - Key to Success
Health, Care & Wellbeing – person focussed • Increasing: wider world wider world • Self management locality locality • Resilience and Capacity home home • Connectedness • Effectiveness • Communications • Knowledge • Innovation • Choice • Collaborations
http://www.coproductionscotland.org.uk/
Innovation Centre for Digital Health • Funding • University led • Industry Supported • Delivery Organisations founding PARTNERS
Digital Health Institute - Network Embedded in Delivery
Rich Opportunities • Multiple opportunity flows: companies, NHS24, bottom up from health and care contexts, top down from policy/exploratory • Strong relationship management • Building the ecosystem of large and small companies, delivery agencies, academia • Events to build and strengthen network • Launch in late October 2013
Market Challenges How does this help me practice better healthcare? • positive patient / user outcomes are paramount • internal champions are key How much time am I going to save / lose? • resistance to change = concern over time + efficiency • product disrupts practice + loses time = ^ resistance How will information be provided / made actionable ? • information overload / not able to process more data • enabling technologies need to provide analytics and provide escalating levels of user patient / user interaction How much risk am I taking? • risk is always a concern for health and care professionals
Evolution of Telehealthcare solutions Current solutions Future solutions • Single application is sold • Many wearable devices as a solution connecting remotely via • If using more than one, the cloud to single patient providers use multiple record • Sophisticated analytics dashboards / interfaces • Lots of single use devices provide holistic view of or hubs designed for the users parameters, driving application or the target care interventions • Applications connected via user group • Purchased by health or common user devices • Purchased by users, care service providers • Collecting patient / user providers and employers • Driving patient / user data is the goal behaviour is the goal
Provide systems, not just technology • Monitor AND engage with patients / users • Drive two way patient / user interactions • Analytics / actionable decision making support , not just more data • Make systems accessible to smaller providers and patients / users • Multiple contact methods, follow-up channels to escalate contact Collect Transmit Analyse Notify Intervene
European Engagement United4Health SmartCare Momentum CASA ACT
Inaugural European Telemedicine Conference 29 th October 2013 Innovation Showcase 30 th October 2013 Edinburgh
Donna Henderson Service Development Manager Scottish Centre for Telehealth and Telecare donna.henderson1@nhs.net
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