Telemedicine in care homes in Airedale, Wharfedale and Craven

Abstract

Purpose -The purpose of this paper is to observe and analyse the effects of the use of telemedicine in care homes on the use of acute hospital resources. Design/methodology/approach -The study was an uncontrolled retrospective observational review of data on emergency hospital admissions and Emergency Department (ED) visits for care home residents in Airedale, Wharfedale and Craven. Acute hospital activity for residents was observed before and after the installation of telemedicine in 27 care homes. Data from a further 21 care homes that did not use telemedicine were used as a control group, using the median date of telemedicine installation for the "before and after" period. Patient outcomes were not considered. Findings -Care homes with telemedicine showed a 39 per cent reduction in the costs of emergency admissions and a 45 per cent reduction in ED attendances after telemedicine installation. In the control group reductions were 31 and 31 per cent, respectively. The incremental difference in costs between the two groups of care homes was almost £1.2 million. The cost of telemedicine to care commissioners was £177,000, giving a return on investment over a 20-month period of £6.74 per £1 spent.Research limitations/implications -The results should be interpreted carefully. There is inherent bias as telemedicine was deployed in care homes with the highest use of acute hospital resources and there were some methodological limitations due to poor data. Nevertheless, controlling the data as much as possible and adopting a cautious approach to interpretation, it can be concluded that the use of telemedicine in these care homes was cost-effective. Originality/value -There are very few telemedicine studies focused on care homes.

Videoconferencing for Health Care Provision for Older Adults in Care Homes: A Review of the Research Evidence

“…Eight papers recounted research that had evaluated the use of videoconferencing for more than one purpose [ 31 , 32 , 55 – 60 ], for example, both assessment and management [ 60 ]. Other combinations included assessment and treatment, patient education, management, and falls prevention [ 31 ]; diagnosis and developing a treatment plan [ 32 , 56 ]; assessment and treatment [ 55 ]; assessment, review, prescriptions, and follow-up [ 57 ]; treatment, prescriptions, advice, referrals, and follow-up [ 58 ]; updating a remote team, reviewing care needs, and developing care plans [ 59 ]; follow-up and urgent review [ 60 ]; and teleeducation, telecounselling, and telemedicine [ 38 ].…”

“…Table 2 shows the papers grouped by country of origin. Twelve of the identified papers originated from the USA [ 32 , 38 , 39 , 43 , 45 , 48 – 51 , 54 , 55 , 59 ]; five were from China [ 31 , 44 , 53 , 56 , 60 ], three were from the UK [ 47 , 52 , 58 ], and three from Australia [ 33 , 42 , 57 ]. The remaining three papers were from Korea [ 40 ], Sweden [ 46 ], and France [ 41 ].…”

“…Ten of the papers used purely quantitative data [ 33 , 39 – 41 , 47 , 50 , 52 – 54 , 58 ]. Secondary data included the use of postcode data to compare admission rates between care homes with and without telemedicine [ 58 ] and papers that reported on consultation records and electronic billing [ 33 ]. One collected primary data and secondary data to look for trends in areas such as cost reductions [ 55 ].…”

Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

“…All of the 38 UK studies were published after 2010. They comprised 14 reviews or reports relating to technology and care homes, 21,22,[27][28][29]35,83,96,99,170,208,234,254,267 three case studies, 80,134,246 three qualitative studies, 115,124,194 two observational studies, 16,139 one pilot RCT, 277 one protocol, 45 12 descriptive studies 58,59,71,109,113,123,188,195,207,223,242,284 and two opinion pieces. 34,53 Telehealth and surveillance technologies were both the subject of six articles, 16,71,113,115,195,234 and single articles were identified on gaming, 125 robots, 80 digital records 134 and communication technologies.…”

Can a smartphone-delivered tool facilitate the assessment of surgical site infection and result in earlier treatment? Tracking wound infection with smartphone technology (TWIST): protocol for a randomised controlled trial in emergency surgery patients

“…There are several advantages to this approach, in particular the potential to improve access to care, and help streamline usage of emergency services. Indeed, there is evidence that these technologies have been used to improve outcome,5 as well as to reduce specialist workload6 and ED attendances 7. In addition, the increasing use of healthcare technology is likely to help improve automatic data collection and recording, which may be used to identify areas for future research and drive quality improvement 4…”