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Telehealth 'does not curb GP workload' - GPOnline

October 18, 2013 — administrator

Remotely monitoring patients' health does not reduce the demands placed on local GP practices, a DH-funded study has found.

Patients using telehealth services visited their GP just as often as those receiving usual care, Nuffield Trust researchers found.

The findings suggest claims that telehealth can reduce demand on health services may only apply to secondary care.

Many practices are preparing to launch telehealth schemes in 2014/15, organised through the remote care monitoring directed enhanced service (DES). The GPC has criticised the DES as 'political interference' in the GP contract.

The research analysed data from the government-funded Whole Systems Demonstrator (WSD) trial of telehealth.

It comes after an original analysis of the trial showed mixed results. Despite a 45% reduction in mortality and a reduction in emergency admissions, researchers said telehealth was unlikely to be good value for money unless technology prices fell considerably.

Nevertheless, the DH pledged to roll out telehealth and telecare to millions of people in England through its Three Million Lives campaign, launched in January 2012.

In the latest study, researchers randomised 3,230 people with diabetes, COPD or heart failure from 179 GP practices across three areas of England to receive telehealth services or usual care.

A variety of devices were used across the three sites, but in all areas services used pulse oximeters for COPD, blood glucose monitors for diabetes and weighing scales for heart failure.

It had been thought that telehealth may reduce demands on primary care because signs of ill health can be detected earlier. In addition, patients may be encouraged to self care, or take vital measurements in the home rather than visiting the surgery.

However, there were also concerns it may increase support required from primary care, if extra data collected prompts the need for investigation when the reading might have returned to normal by itself.

Before the study began, patients taking part in the study visited their GP eight to nine times a year, far higher than the general population.

'No evidence' of reduced workload
Yet, after 12 months of the study, researchers found no difference in how often users of telehealth visited a GP or nurse compared with those receiving usual care.

Neither did they find differences in how often GPs recorded clinical measurements such as HbA1c, blood oxygen and respiratory flow in medical records.

Researchers said the findings showed 'fears that the widespread increase in the use of this technology may increase the burden on primary care are unfounded'.

'Conversely, we did not find evidence that telehealth led to a significant reduction in GP workload.'

The Three Million Lives website claims that when patients use telehealth services, health and social care professionals can be 'better informed of the status of these people and see less demand on services, with fewer A&E events and unscheduled inpatient episodes'.

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