News Summary – 26 to 27 November 2012 Reply

Plans to move some NHS services online criticised by charities representing pts with long-term illnessind.pn/TfmUh9 via @Independent

RT @HealthForumNews@cdw_healthcare — In fact, check out this great article, “Telehealth in the Developing World” #HITthanks ow.ly/ftx96

RT @SkyNews: Charity: More Help Needed For Cancer Carers bit.ly/TYbcX9

Printer Creates 3D Tissue in mice – in future, could Help Injured Patients Re-Grow Cartilage [VIDEO]mashable.com/2012/11/26/3d-… via @mashable

#RSMTelemed12 Earl Howe opens RSM conference looking at the importance of tele-technologies in the future. Sets out challenges

#RSMTelemed12 Earl Howe – need to have improvements in healthcare quality at time of financial pressures, higher expectations

#RSMTelemed12 Earl Howe raises question of healthcare affordability if we carry on as we are

#RSMTelemed12 Earl Howe refers to DH document Innovation, Health and Wealth 2011 – making progress on 31 recommendations

#RSMTelemed12 Earl Howe refers to @3MillLives and the setting up of AHSNs. There is a Long way to go to get tech in health/social care

Following @clarkmike reporting from #RSMTelemed12event at @RoySocMed bit.ly/QkUG7A #digitalcare

#Healthcare #IT @Skynapse is out!paper.li/skynapse/1327208373 ▸ Top stories today via@davidmore @MattHawkinsMD @clarkmike

#RSMTelemed12 Marco d’Angelantonio is now covering implementation of #telecare #telehealth and Smartcare integrated care in Europe

#RSMTelemed12 Claus Pedersen covering #telehealthimplementation in Denmark – National health data network which is IP based

#RSMTelemed12 CP – have used Telehealth videoconferencing for interpretation support. Talking about take up of VC in secondary care

#RSMTelemed12 CP using #telehealth for foot ulcer treatment in the home – takes pic, sends to expert for advice, saves hosp trips

#RSMTelemed12 CP – Denmark involved in Renewing Health programme. Closing hospitals – centralising in one area from ten to one

#RSMTelemed12 CP – designing the digital hospital of the future – new ways of supporting population – digital vision

#RSMTelemed12 CP – COPD patients get tech briefcase at time of discharge – daily consultations during discharge period

#RSMTelemed12 CP developing a platform of services for newborns, heart, geriatric, cancer Pts, – must reduce bed days for each new project

RT @LoweCM#RSMTelemed12 CP Denmark centralising hospitals, closing smaller ones, challenging to find innovative ways of managing with many fewer beds

#RSMTelemed2012 – Prof Nelly Oudshoom from Univ Twente – Telecare tech and transformation of healthcare – Desirable features

RT @LoweCM#RSMTelemed12 Claus Pedersen (CP): teleinterpretation changes the dynamics of consultations for the better, with more focus on patient

#RSMTelemed12 NO from the Netherlands –#telehealth – moving activity and responsibility to the patient. How do patients take on the role?

#RSMTelemed12 NO covering #telehealth programmes in Germany, Netherlands for Heart rhythm and ECG measurement. Pts need support in change

#RSMTelemed12 NO – Touch and face to face healthcare moving to digital proximity. Support provided by tele-nurses building trust in tech

#RSMTelemed12 Adam Darkins speaking on#telehealth from personal experience – health will be ubiquitous on multiple platforms

#RSMTelemed12 Adam Darkins talking about disruptive innovation, transformation of healthcare systems

RT @LoweCM#RSMTelemed12 Adam Darkins (AD) issue not whether, but how, telehealth will be implemented

#RSMTelemed12 Adam Darkins – involvement in#telehealth since 1995 – finding solutions to problems – is there a prob that needs to be solved

#RSMTelemed12 AD – how to find high volume and low costs, how to link across systems, money follows the Pt. Where does accountability lie?

#RSMTelemed12 How to use tech to coordinate care. Healthcare systems are fragmented. AD covers VC applications, home #telehealth etc

#RSMTelemed12 Adam Darkins – provision of just in time care, appropriate interventions. Services must be self sustaining, re-engineer care

#RSMTelemed12 AD -patient and caregiver based services. Must be volume. what happens if system goes down is important for tech/bus processes

#RSMTelemed12 AD – home #telehealth – must put systems in place. Development of IP based systems clinic to clinic then into the home

#RSMTelemed12 AD – elements of standardisation and interoperability eg covering a VC cardiology clinic – people need to know what to do

#RSMTelemed12 Adam Darkins – healthcare systems can be like a cottage industry. we have valued beds cf knowledge

#RSMTelemed12 AD – The importance of valuing decisions and ensuring made appropriately – how solve decisions locally that makes sense

RT @LoweCM#RSMTelemed12 AD re #telehealth, ask “what do you do if the system goes down?” – if there is a good answer then you are double-running

#RSMTelemed12 – AD – understanding processes for scaling #telehealth. Need standardisation and training for staff, quality mgmt systems

#RSMTelemed12 Adam Darkins – need to look at programmes of care rather than episodes of care. Important to get relationships right

RSMTelemed12 AD – developing world may leapfrog developed world in healthcare – networks through mhealth – we may have to deconstruct

RT @3MillLives#rsmtelemed12 earl howe “3millionlives will transform the UK into the largest#telehealth market after the US”

RSMTelemed12 Adam Darkins – tech needs to be reliable – a service for thousands/millions – needs to be scaled effectively

RSMTelemed12 Dr Marit Dekker – telemedicine service to improve self-mgmt in active lifestyle in chronically ill patients in Netherlands

RSMTelemed12 – MD – personalised system to support self-mgmt at home – web based exercise, online monitoring, VC, daily metrics

RT @LoweCM#RSMTelemed12 AD “#Telehealth is for life not just for Christmas”

RSMTelemed12 MD health professionals able to select appropriate exercises via web eg strength, condition for rehabilitation

RSMTelemed12 MD – health professional can capture data on progress, deal with problems eg pain from exercise, links with smartphone/activity

RSMTelemed12 Dr Harmesh Moudgil – Shrewsbury & Telford – #telehealth in acute community acquired pneumonia

#RSMTelemed12 Harmesh Moudgil from Shrewsbury & Telford Hosp – proof of concept for #telehealth in pneumonia using wristwatch device

#RSMTelemed12 – HM – reduced length of hospital stay from #telehealth group. Some cost data/coding difficult to establish. Pts were positive

#RSMTelemed12 – Anke Workowski, Germany – telemonitoring in cardiology secondary prevention – evaluation results

#RSMTelemed12 AW – home-based cardiac rehab – exercise bike with screen – linked to clinic/server – pt does not need to attend rehab clinic

#RSMTelemed12 AW – there is integrated alarm system – individualised training – online and offline training – Dr can see 6 pts at one time

#RSMTelemed12 AW – positive early results – would need to work towards a clinical trial having understood the issues form the project

 

#RSMTelemed12 James Ferguson, Scottish Centre for Telehealth – remote clinical leadership for stroke rehabilitation

#RSMTelemed12 JF – number of sites in Scotland using telestroke. Now moving into stroke telerehabilitation in Western Isles

#RSMTelemed12 JF – Western Isles 6 bedded stroke unit – linked to NHS Lanarkshire – remote doc had access to data, info

#RSMTelemed12 JF – small trial (n=20) – hospital length of stay reduced from 50 days to 21.5 days – also impact of thrombolysis

#RSMTelemed12 Plans for future services include VC into the home, iPad use by consultant and home visiting staff, further sites

RT @clarkmike#RSMTelemed12 – AD – understanding processes for scaling #telehealth. Need standardisation and training for staff, quality…

#RSMTelemed12 Christina Gomez Suarez from Air Products – Home #telehealth service for patients with severe COPD – PROMETE study

#RSMTelemed12 Hoosain Ebrahim – Univ Limpopo, SA – central med photo service can assist transformation of care pathways using #telemedicine

RT @LoweCM#RSMTelemed12 Ferg: future telestroke devpments include continued monitoring with#telehealth units, and reciprocated monitoring OOH in NZ.

‘There are two worlds in the NHS: policy and practicality’ – Dick Vinegar, Patient from Hellgu.com/p/3c2na/tw via @guardian

#RSMTelemed12 – Sebastian Marche, Orange Healthcare – SMARTVIEW – remote monitoring solution for patients with implanted cardiac devices

@clarkmike Hi Mike 🙂 Where can I follow the discussions aside from Twitter? Your #RSMTelemed12tweets are really interesting.

#RSMTelemed12 – SM – data from cardiac implanted devices sent via network on daily basis to hosting centre with clinical ccess & helpdesk

#RSMTelemed12 – SM – advantages for healthcare staff and patients for remote monitoring but also challenges eg dilution of responsibility

#RSMTelemed12 – Saneth Wijayaratna from InHealthcare Ltd – looks at tipping point examples from radio, internet – relevance to #telehealth

#RSMTelemed12 – SW – #telehealth as a service not a box, needs to be affordable, flexibility of systems, partnership working

#RSMTelemed12 SW – importance of standards in moving data from one place to another – can an NHS Trust become the #telehealth vendor?

#RSMTelemed12 – case study from Co Durham and Darlington – rethinking INR services in community – remote support for anticoagulation Service

#RSMTelemed12 SW – Case study – virtual Ward in East Lancs using NHS Direct for 7 day triage using#telehealth hub

#RSMTelemed12 – SW – other applns – atrial fib checks at home, pre-op monitoring, BP monitoring in pregnancy, Med reminders, electronic MAR

#RSMTelemed12 – London Conf via @roysocmed now closes for the day – continues on 27 November –#telehealth #telecare #ehealth #mhealth

‘@VideoCentricLtd – Tweets cover RSM conf presentations in London 26/27 Nov bit.ly/R6qHen – no video stream

@ShahanaRamsden Well done Shahana! I’m dabbling with #Storify now. Look out tomorrow. Great mentor in@clarkmike … #give and take 🙂

@clarkmike if you’re interested in Smartview there is a video @ oran.ge/USMoRk

Thx @shirleyayres! It was fun. I am very much experimenting with @Storify, Got links working in#WordPress but not sure how! @clarkmike

@WhoseShoes the lovely @clarkmike is so patient with us all!

RT @shirleyayres@WhoseShoes the lovely@clarkmike is so patient with us all!

@shirleyayres He is! #Storify: Google Chrome. Bookmarklet. Divide by number u 1st thought of.. & Bob’s your uncle! @clarkmike @simonaflorio1

#RSMTelemed12 it’s day two of a great conference – well done @LoweCM and the @roysocmed organising team #telecare #telehealth

#RSMTelemed12 Prof Stanton Newman opens the 2nd day – 65% of people admitted to hosp 65 and over – system not sustainable, burning platform

#RSMTelemed12 Prof Newman – tech works, services and integration are key. Complex interventions. Requires new practices.

#RSMTelemed12 – Prof Newman – healthcare does not respond particularly well to innovation. Strong attitudes about what could change practice

#RSMTelemed12 SN – covers some of background to#WSD trial – cluster arrangement, 5 themes – quantitative and qualitative approaches

#RSMTelemed12 SN – covering #WSD results from recent BMJ paper. Do services that integrate Telehealth work? Depends how you design services

#RSMTelemed12 SN looking at qual of life measures for#telehealth in #WSD trial – able to look at sub-samples eg ppl with initial low level

#RSMTelemed12 – SN looking at frontline professionals perceptions of pt focused benefits of #telehealth – positive responses from nurses

#RSMTelemed12 SN – responses from docs more variable. Engagement of clinicians is crucial – clinical champion with resources.

#RSMTelemed12 SN looking at attitudes of patients to#telehealth – culture change in healthcare – Pts could see enhancement to their care

#RSMTelemed12 SN – some Pts could be concerned about changes to their healthcare. Diabetes group felt had increased support

#RSMTelemed12 SN covering #WSD papers published and those to come – could be as many as 15 in all – Telecare papers have been submitted

#RSMTelemed12 SN – answering questions on impact of#WSD on control group and criteria for #telecare and#telehealth groups

RT @LoweCM#RSMTelemed12 SD #WSD people with diabetes regularly monitor/record so overall more comfortable with telehealth than those with COPD/CHF

#RSMTelemed12 Adam Steventon, Senior Res Analyst from @nuffieldtrust covers some of results from #WSDpublished by BMJ in June 2012

#RSMTelemed12 AS looking at information flows in#WSD trial and links with combined model scores (risk of hospitalisation)

#RSMTelemed12 AS – trial looked at admission data for#telehealth for 3 yrs pre-trial and one year during trial. Picks up control Gp issues

#RSMTelemed12 AS – looking at comparing control group with people outside of #WSD trial to pick up on higher control group admissions

#RSMTelemed12 AS looking at mortality, admissions, impact on tariff from the #WSD trial on #telehealth

#RSMTelemed12 Caroline Sanders from Manchester Univ covering service user and carer views, experiences in #telecare #telehealth – interviews

#RSMTelemed12 CS Covering how qualitative #WSDtrial data was collected in homes, shadowing staff, interviews – how would people respond?

#RSMTelemed12 Caroline Sanders speaking at eHealth and Telemedicine conference in London at @roysocmed#telecare #telehealth

@clarkmike Great thanks Mike!

#RSMTelemed12 CS – interviews included people who didn’t wish to participate in the trial – various responses

#RSMTelemed12 CS – examples of people with diabetes who felt they benefitted from extra support in self monitoring- able to discuss progress

#RSMTelemed12 CS looking at non participants perceptions of technology – felt alienated, concerned about typing/use of Internet

#RSMTelemed12 CS looking at examples where Pts have recorded metrics on paper in the past and how it could differ with #telehealth

#RSMTelemed12 CS – some examples of trial non participants where did not want to upset good levels of support from healthcare professionals

#RSMTelemed12 CS on positive side – examples where people felt additional support from #telehealth – eg access to named nurses

@clarkmike That’s the sort of ideal practice I’d like to see developed!

#RSMTelemed12 CS – examples where intervention perceived as threats to identity and independence. Interaction/communication important

#RSMTelemed12 Dr Theopisti Chrysanthaki and Dr Jane Hendy from Imperial College looking at #WSDorganisational issues #telehealth #telecare

@clarkmike Which depends upon mutual co-operation in evolving services …. otherwise barriers will exist.

#RSMTelemed12 JH explains methodology – study now published in draft – also wider work with additional sites not covered by a major RCT

#RSMTelemed12 JH/TC looking at alignment issues between gathering trial data & whole system service redesign – addtl work from running trial

#RSMTelemed12 TC – sites not able to alter service design processes as RCT trial took priority. Challenges of finding new users for trial

#RSMTelemed12 TC – different configurations across 3 sites with PCT/local authority involvement. Views of Professionals changed over time

#RSMTelemed12 TC – sites had to think about how they would scale after the WSD trial finished. Technologies were changing quickly

#RSMTelemed12 TC #telehealth has potential for picking up unmet need – has impact on costs and services

#RSMTelemed12 TC clinicians questioned whether whole system working better – could see advantages of more joined up working, but not unified

#RSMTelemed12 TC – removal of fixed care group for#telecare and #telehealth had an impact on whole system/integrated working

 

 

#RSMTelemed12 TC – #WSD trial did, however, identify duplication, gaps, areas for improvement, barriers to integration/whole system design

#RSMTelemed12 Catherine Henderson from LSE covering economic evaluation of #telehealth – update from #WSD trial

#RSMTelemed12 CH – can be harder to compare costs for #telehealth historically – changing over time

@Gemma_Finnegan I read this & was trying to work out where the disconnects are happening & how they can be addressed! @clarkmike #deukcare

#RSMTelemed12 CH explains how costs were identified in the #telehealth trial – eqpt, service costs, service use costs, national ref costs

#RSMTelemed12 CH – calculated incremental cost effectiveness ratio. Av annual cost £1847 per Person (37% were eqpt costs). ICER £92k

#RSMTelemed12 CH – various sensitivity scenarios down to £12k per QALY. Little else in peer reviewed literature to compare with

#RSMTelemed12 CH continuing to look at how particular users benefit and targeting

#RSMTelemed12 Martin Cartwright covering impact on self-efficacy and self care behaviour in #WSD#telehealth trial. Different models

#RSMTelemed12 MC covers professional surveillance and patient self-care pathways to improve pt outcomes. Self-efficacy impact on behaviour

#RSMTelemed12 MC covering scales used for self-efficacy and self-care behaviour in #telehealth from#WSD trial – looking at site analysis

#RSMTelemed12 MC covering scales used for self-efficacy and self-care behaviour in #telehealth from#WSD trial – looking at site analysis

@shirleyayres @clarkmike I’ve observed demarcation of policy and practice space. E.g. hospital on one side and research centre on another

#RSMTelemed12 MC – WSD #telehealth model does not improve self care behaviour from the methodologies used – some limitations identified

#RSMTelemed12 MC – alternative #telehealthapproaches may be needed if self care behaviour to be improved – looking at separate diseases

@clarkmike Any information regarding any organisational changes that occurred during the study?

#RSMTelemed12 Prof Jeremy Wyatt , Leeds Medical School – looking at different systems for #telehealth – measuring impacts/harms

Aha! When I take my #Storify in2 #Wordpress it brings through “conversations” not just tweets: bit.ly/U0ArYX@clarkmike @shirleyayres

#RSMTelemed12 Jeremy Wyatt looking at theories for#telehealth – examining trials for Telehealth + usual care better than usual care alone

#RSMTelemed12 JW – lot of variation in #telehealthtrial approaches – are certain age gps affected differently? What about illness severity?

#RSMTelemed12 JW – many #telehealth trials are short term, trials are often not balanced, few studies cover feedback to patient

#RSMTelemed12 JW looking at #telehealth for heart failure admissions – HF admissions dropped by 21% but no change in all cause admissions

#RSMTelemed12 JW – Richard Wootton – Overview of evidence on #telehealth for managing LTCs – looked at 148 RCTs – published in JTT

@clarkmike for more on #telehealth see Nov/Dec NHE, reporting on #teleconf2012 how one council is commissioning services

#RSMTelemed12 JW – looks at potential biases & confounders in #telehealth trials – who can best benefit – which protocols/devices/services?

@clarkmike interesting #RSMTelemed12 many#telehealth trials are short term, trials often not balanced or cover feedback to patient

#RSMTelemed12 Dave Tyas Peninsula Community Health – involved in Cornwall #WSD trial – currently around 1000 Pts on #telehealth in C’wall

 

 

#RSMTelemed12 Dave Tyas from Cornwall – commissioners questioning costs of technology/service from #WSD – QALY not used in #QIPP bus cases

#RSMTelemed12 DT – commissioners waiting for Cornwall #telehealth data so can identify people who could benefit, impact on 1ary care etc

#RSMTelemed12 DT – lot of change in NHS at this time – affects how innovation gets adopted & services changed- other priorities at this time

#RSMTelemed12 DT – patients may be very positive and love use of tech in managing their conditions but clinicians say ‘so what’

#RSMTelemed12 DT explains how #telehealth could be used in future pathways – local anecdotal info from Cornwall says that Pts feel supported

#RSMTelemed12 DT – need better service design – future looks bright – but needs to be better integrated – impetus from @3MillLives

#RSMTelemed12 DT looking at other #telehealthexamples eg BP monitoring in pregnancy, UTI sympt checking with emergency meds at home, falls

#RSMTelemed12 Alison Mlot talking about scaling up tech approaches with the @dallas_connect programme – started with ALIP programme in 2007

#RSMTelemed12 AM mentions innovations to date and Dallas communities – action research for @3MillLives – looking also at retail mkt

@clarkmike yes we do! It’s got to be shown to be effective to convince clinicians.

#RSMTelemed12 – AM – 60% NHS budget spent on lifestyle issues. Dallas focus on the person – 6C’s – empowered communities

#RSMTelemed12 AM – importance of interoperability, links between statutory provision and consumer models across tablets, smartphones etc

#RSMTelemed12 AM – Dallas in UK includes Living it up in Scotland led by @NHS24 and Feelgood factory in Liverpool. Also Warm Neighbourhoods

#RSMTelemed12 AM – in Liverpool using football clubs, museum, Liverpool One to support well-being in community

#RSMTelemed12 AM – Year Zero covers cradle to grave health records based initially on e-red book to replace paper version, local apps etc

#RSMTelemed12 – AM – Year Zero aiming for 1m users by 2015

RT @LoweCM#RSMTelemed12 Dr Jeremy Wyatt: 37 RCTs for heart failure give average impact of#telehealth is 18% reduction in mortality

#RSMTelemed12 AM – Dallas able to look at wider popln for health and wellbeing

#RSMTelemed12 Jeremy Wyatt – GP gatekeeper role could be challenged by #telehealth

#RSMTelemed12 Jeremy Wyatt – savings on new models of care means changing balance of risk – £ may only be released by closing wards/hospital

No surprise here.. RT@clarkmike: #RSMTelemed12 Pts may be very positive using tech in managing their conditions but clinicians say: so what?

@dean_jenkins @clarkmike even if its better for me from my perspective / what to measure varies

#RSMTelemed12 Helen Rollings from @tunstallhealthexplaining how patients are supported on ground – involved in #telehealth implementation

#RSMTelemed12 HR explaining Tunstall LifeCare and how services can be scaled – examples from Northern Ireland, Gloucs, Birmingham

#RSMTelemed12 Helen Rollings with nursing background from @TunstallHealth explains how#telehealth can be deployed – NHS Gloucs case study

#RSMTelemed12 HR – acute hospital trust looking at how #telehealth can be used at discharge into community to stop rebounds

#RSMTelemed12 HR explains how reservations can be overcome -education, discussion forums, clarification, GP Incentives, provision of support

#RSMTelemed12 HR – must involve all stakeholders in change, work together, keep messages consistent for successful #telehealth

#RSMTelemed12 Andrew Corbett-Nolan from Good Governance Institute – how will services be delivered in future? Role of digital technologies

#RSMTelemed12 ACN – work at B’ham to look at independent qual assurance of #telecare – focus gps, videos, diaries with users to get feedback

#RSMTelemed12 Lord Nigel Crisp – role of eHealth and telemedicine in a rapidly challenging world – challenges of non-communicable diseases

#RSMTelemed12 NC – universal systems being developed in China, India – how will they develop h’care – skill mix, community activation, tech

#RSMTelemed12 NC – community champions to improve healthcare, comm health workers and action groups in Africa

#RSMTelemed12 Lord Nigel Crisp talking about how tech can assist in Africa. Desmond Tutu – vehicle for healthcare interventions is mob phone

#RSMTelemed12 Lord NIgel Crisp – drop the e of ehealth – is it not just health and medicine?

#RSMTelemed12 NC – patients and patient organisations can be the main allies for #telehealth – working with clinicians

#RSMTelemed12 NC – importance of APPGs in working across parties on cross-cutting issues – many in HoL are interested in telemedicine

#RSMTelemed12 Guy Giles covering the Looking Local service initiated in Kirklees – can be accessed across platforms – over 120 LA’s

#RSMTelemed12 GC – 8.64m people in UK still do not have Internet access. Solution must be multichannel – fish where the fishes are

#RSMTelemed12 GC – using Nintendo Wii as interface – booking GP appointments, repeat prescriptions – services designed with end users

#RSMTelemed12 GC – people in care homes using Wii with TVs to interact with wide range of content. ALIP proj – Freedom to Roam using tablet

#RSMTelemed12 GC – problems looking for simple apps for older people in app stores – software community do not recognise this audience

#RSMTelemed12 GC – Freedom to Roam – tracking, messaging included – being tested in Northumbria and will be part of dallas prog in Scotland

#RSMTelemed12 GC – Dallas prog in Scotland – Living it up – will have a broader independent living marketplace in future

#RSMTelemed12 Paul Marriott NHS South of Tyne and Wear- looking at #telecare hardware over the years from property centric to person centred

@clarkmike That would be fascinating! Slides available?#RSMTelemed12

Intriguing. MT @clarkmike: Paul Marriott looking at telecare hardware over the years from property-centric to person-centred. #RSMTelemed12

#RSMTelemed12 PM looking at the development of#telehealth – race to the moon – vital signs sensors in Neil Armstrong’s space suit

#RSMTelemed12 PM – web-enabled system using telephony and IP moving to mobile systems using 3G, 4G – wide range of options- telephony is key

#RSMTelemed12 PM – landline use in decline – fastest growth in mob phones is 65 and over. 4G coverage expected to be wider than 3G

#RSMTelemed12 PM – the future – more discreet body sensors, integrated approaches in one product, cheaper smartphones, fewer landlines

#RSMTelemed12 Roger Donald – delivery team for multichannel in NHS Direct looking at apps use – improved access wherever they are

#RSMTelemed12 RD – around 13000 health apps – how do you find the best? Deliver services into the home, informational, monitoring trends

#RSMTelemed12 RD – decision support and symptom checkers on NHS Direct. Big interest in remote health assessment via online and apps

#RSMTelemed12 RD – more than a channel shift – tapping into new market- how do we get through situation where online says do a certain thing

#RSMTelemed12 RD – example of Twitter where person tweeted skin rash pic asking for advice. accreditation – Info standard, CQC, NHS Evidence

#RSMTelemed12 RD – digital transaction on NHSD is around 5 pence compared to £25 for nurse call. Challenge for user experience & testing

@markhawker not sure yet on slides, will storify tweets shortly

@clarkmike Cool beans. Interested in the hardware presentation! 🙂

RT @LoweCM#RSMTelemed12 Roger Donald: serious issue for builders of health Apps is getting patients to respond to resulting advice

.@clarkmike Adding #telehealth app links to relevant pharmacy shelves wld be cheap way of making knowledge relevant #RSMTelemed12

#RSMTelemed12 Prof James Barlow from Imperial College Business School looks at developing the capacity of remote care industry for future

#RSMTelemed12 James Barlow covers new report – interviews with tech suppliers, health and social care teams in #WSD programme

#RSMTelemed12 JB – market moving very quickly with Govt announcements for @3MillLives. 223 remote care companies identified, market surveys

#RSMTelemed12 JB looks at current users beyond simple alarm – can be difficult to estimate. We don’t know which adoption curve we are on

#RSMTelemed12 JB – looking at blockages from supplier side, fragmentation in health & social care -more intelligent approach to procurement

#RSMTelemed12 JB – tech still at early stage, commissioners know eqpt will be cheaper in future. Commissioners worried about lock-in

#RSMTelemed12 JB – hard to identify what will be the most appropriate business model, what does value chain look like?

#RSMTelemed12 – JB – some orgs worried about hiving off remote care – need to think about new types of public private partnership models

#RSMTelemed12 JB sets out some important recommendations – dealing with systemic problems of silo working and fragmented thinking

#RSMTelemed12 JB – need to look at disincentives in tariff, impact of remote care on hospital trust incomes

#RSMTelemed12 Dr Sidna Tulledge-Scheitel from Mayo Clinic – mhealth meets patient portal – uptake and use of dedicated mobile patient portal

#RSMTelemed12 STS from Mayo Clinic – business case for a patient portal – meaningful use under Obamacare – existing patient info site

#RSMTelemed12 STS looking at features of Mayo web portal and app for online patient services – appts, how to get to right place, lab reports

#RSMTelemed12 STS – patients can see test results, secure messaging etc – looking to increase clinical service coverage beyond 7-7pm

#RSMTelemed12 Molly Reyna from Children’s National Med Centre in Washington DC – #telehealth services at Children’s Hospital

#RSMTelemed12 MR – live child and parents medical consultation, wide range of specialities, global reach from metro DC -challenge of borders

#RSMTelemed12 MR – telemedicine services from 1998 – coverage of telecardiology – helicopter transport is upto 10000 dollars for newborn

#RSMTelemed12 MR – looks at business drivers for telecardiology services – able to keep less acute Pts with heart disease at local site

#RSMTelemed12 MR – Virginia, Maryland passed law for telemed reimbursement – DC to follow – links to Middle East, Morocco, Uganda, Germany

#RSMtelemedi12 – MR – Models of care based on ‘anywhere patient’ to ‘anywhere physician’

#RSMTelemed12 Cristina Gomez Suarez – case study from Spain – PROMETE study for severe COPD – national strategy for chronic conditions

#RSMTelemed12 CSG – 70-80% of health costs from long term conds in Spain – learning lessons quickly on integrated approaches for #telehealth

#RSMTelemed12 CSG – small RCT of 30+30 for#telehealth & COPD (but comorbidities) – simple tech & metrics – protocol response on severity

#RSMTelemed12 CSG – reduced hospitalisations and length of stay by 60% for short period of trial – peer review underway

#RSMTelemed12 Bhaki Garjer and Kings College Team looking at tele-medical education link with Sumaliland – sharing with MedicineAfrica

#RSMTelemed12 Conference ends – congratulations to@roysocmed @LoweCM Dr Beverly Castleton (President) & organising team on excellent event

‘Guardian Healthcare Network survey highlights NHS safety concerns’ gu.com/p/3c523/tw via @guardian

@clarkmike important Q there are around 13000 health apps – how do you find the best? Do we have any answers yet? #RSMTelemed12

@clarkmike PM – landline use in decline – fastest growth in mob phones is 65 & over. Do we know where the stats come from? #RSMTelemed12

Coalition plan for £75,000 cap on elderly care bills via@Telegraph soc.li/2z0Tbel

‘How #telecare is transforming social care’gu.com/p/3akc9/tw via @guardian

How telecare is transforming social care | @scoopit via@clarkmike sco.lt/5b8L7R

@shirleyayres Landline use decline/growth in mob phones – not checked fully, but likely from Ofcom Mkt Report – bit.ly/TkCFng

‘@cpeanose No reference to #telecare or #socialcare in the DM article – refers to NHS Mandate (Section 2.6) and Digital First plans

‘#Telecare services in Hillingdon’ gu.com/p/3c4g5/twvia @guardian

@clarkmike thanks Mike I’m just thinking about the obvious implications for #deukcare if the fastest growth in mobile phones is 65 & over

@shirleyayres also important – reducing no of landlines, potential coverage of 4G, superfast broadband (eg C’wall), cheaper smartphones

‘Three factors that make a supported housing scheme a success’ gu.com/p/3c5dt/tw via @guardian

RT @profchrisham: my new blog on treacherous waters ahead for the NHS and social care. the public will judge the govt on navigating wellkingsfund.org.uk/blog/2012/…

RT @clarkmike: ‘How #telecare is transforming social care’ gu.com/p/3akc9/tw via @guardian

Follow Mike Clark on Twitter (@clarkmike)

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