Telehealth and telecare are examples of assistive technologies that aim to improve outcomes for people with long-term health conditions or social care needs. They may also reduce use of hospitals and care homes. We are part of a major randomised controlled trial to assess the impact and effectiveness of these technologies.
Co-author Adam Steventon outlines the first findings of the Nuffield Trust’s analysis of the Whole System Demonstrator trial.
The Nuffield Trust is leading one aspect of a large-scale evaluation of telecare and telehealth:
In 2006, the Department of Health announced the establishment of three pilots, known as the ‘Whole System Demonstrators’, to test the benefits of integrated health and social care supported by assistive technologies like telecare and telehealth.
We believe that with over 3,000 participants, this study is the largest randomised trial of telehealth in the world
We are leading one strand of an evaluation of the Whole System Demonstrator trial, concerning the impact of telehealth on use of hospitals and mortality. This is important as investment in telehealth has often been justified on the basis of cost savings through reduced hospital use.
Our first findings have now been published in the research summary: The impact of telehealth on use of hospital care and mortality (June 2012) and in an article in the British Medical Journal.
In the trial – the largest of its kind to be conducted thus far – over 3,000 patients were recruited from three areas of England (Cornwall, Kent and Newham) to receive telehealth or to act as controls by receiving usual care. We found that:
Our work used innovative data matching techniques to build up a picture of each participant’s health and social care use. We extracted over a billion records of administrative data from more than 250 health and social care organisations.
To protect data confidentiality, we used pseudonymisation, which involves replacing a patient identifier such as an NHS number with a code that cannot be traced back to an individual (see the diagram below). The project also involved the implementation of the Combined Model, which was used in case-mix adjustment.
It was a complex evaluation with a multidisciplinary team led by Professor Stan Newman at University College London (now at City University). The four other themes of the evaluation are:
Findings from the other evaluation themes are forthcoming. As well as telehealth, the trial also tested a system of telecare and findings in relation to this are due to be published in late 2012.