January 2009: Expecting the unexpected - issues influencing the roll-out of telehealth and telecare in the WSD Pilots

At the first of eight regional events hosted by WSDAN on 22 January 2009, Tim Ellis (WSD Programme Manager, Department of Health) and Martin Scarfe (WSD Director, London Borough of Newham) reported on the progress of ‘scaling-up’ the implementation of telehealth and telecare.

Tim Ellis reported that the complexity of the implementation process - within the confines of a randomised control trial - meant that, on average, it took about 80 days from gaining the consent of a GP practice to be part of the trial to patients going ‘live’ on the trial itself. However, significant progress had been made in ‘sign-up’ across the three WSD pilots with over 650 individuals now benefiting from new technologies.

Tim Ellis also reported that the process of implementing telehealth and telecare technologies for people with long-term conditions had thrown up a number of ‘unexpected’ challenges:

  1. The target population were expected to have both health and social care needs, but in reality very few individuals were eligible for both telehealth and telecare.
  2. Product recall and supplier administration meant that selected technologies and suppliers were not guaranteed to be around for the duration of the trial.
  3. Data quality problems meant that it was not easy to identify eligible individuals from current records.
  4. The administrative energy and time required to gain clinical and professional leadership and input was essential, but had been underestimated. However, most professional staff once exposed to the technology were supportive of its use.
  5. Not all individuals and/or their families and carers welcomed telehealth/telecare in their homes with many claiming they were either well enough not to require the service or simply did not want to be reminded about their condition on a daily basis.
  6. Those consenting to be part of the trial often dropped out at different stages of the process, even at installation.
  7. It was often difficult to arrange installation during working hours as candidates were unavailable for visits.
  8. Integrating data sharing between multiple organisations took time to establish and required the development of sharing agreements.

Tim Ellis also reported that the trial had uncovered a lot of unmet demand - most of those eligible for the trial were not currently known to the wider range of health and social service providers.

Martin Scarfe reported Newham’s experiences of applying the new technologies and reported similar findings.