Telerehabilitation in Scotland: Current Initiatives and Recommendations for Future Development

Hill, Anne J.

doi:10.5195/ijt.2010.6055

Cited by 9 publications

(7 citation statements)

References 2 publications

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“…31 The potential for telehealth to reduce waiting times for rural patients and assist in meeting the rising demand for specialist rehabilitation services was also highlighted in the review by Hill. 25 Attendance rates were also improved in SAC-T, possibly due to the presence of a local physiotherapist at the preliminary consultation. The new patient-to-review ratio (7.3:1) and the new patient discharge rate (64%) in SAC-T were comparable with SAC-O.…”

Section: Discussionmentioning

confidence: 97%

“…This research contributes to the growing body of evidence that telehealth is cost-effective in comparison to face-to-face consultations. Evidence of cost-savings in favour of telehealth has been demonstrated in teleoncology, 22 pulmonary rehabilitation 25 and speech pathology for adults with dysarthria, 26,27 as well as children with hearing loss. 28 The principal contribution to cost savings was avoided travel by either patients or clinicians.…”

Section: Discussionmentioning

confidence: 99%

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Overcoming the tyranny of distance: An audit of process and outcomes from a pilot telehealth spinal assessment clinic

2016

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Introduction There is consistent evidence to indicate people living in rural and remote regions have limited access to healthcare and poorer health outcomes. One way to address this inequity is through innovative models of care such as telehealth. The aim of this pilot trial was to determine the feasibility, appropriateness and access to a telehealth clinic. In this pilot trial, the telehealth clinic outcomes are compared with the outreach clinic. Both models of care are commonly utilised means of providing healthcare to meet the needs of people living in rural and remote regions. Methods A prospective audit was conducted on a Spinal Assessment Clinic Telehealth pilot trial for patients with spinal disorders requiring non-urgent surgical consultation. Data were recorded from all consultations managed using videoconferencing technology between the Royal Adelaide Hospital and Port Augusta Community Health Service, South Australia between September 2013 and January 2014. Outcomes included analysis of process, service activity, clinical actions, safety and costs. Data were compared to a previous spinal assessment outreach clinic in the same area between August and December 2012. Results There were 25 consultations with 22 patients over the five-month telehealth pilot trial. Spinal disorders were predominantly of the lumbar region (88%); the majority of initial consultations (64%) were discharged to the general practitioner. There were three requests for further imaging, five for minor interventions and three for other specialist/surgical consultation. Patient follow-up post telehealth pilot trial revealed no adverse outcomes. The total cost of AUD$11,187 demonstrated a 23% reduction in favour of the spinal assessment telehealth pilot trial, with the greatest savings in travel costs. Discussion The telehealth model of care demonstrated the efficient management of patients with spinal disorders in rural regions requiring non-urgent surgical consultation at low costs with no adverse outcomes reported.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Overcoming the tyranny of distance: An audit of process and outcomes from a pilot telehealth spinal assessment clinic

2016

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“…In total, 19 articles looked at health care provider cost, patient cost, or costs incurred by both. This comprised 5 RCTs [25,26,41,60,71], 3 systematic reviews [73,75,104], 2 nonsystematic reviews [54,91], 1 retrospective study [27], 1 case-control study [78], 1 service report [96], 3 pilots [12,43,55], and 3 protocols [38,68,106]. Nearly all of the studies reported higher costs for health care providers, including all RCTs.…”

Section: Costmentioning

confidence: 99%

“…A pilot study of teleconsultations in a rural dentistry setting found that up to £270 per patient appointment could be saved by the health service if it adopted teleconsultations to allow rural patients access specialist services [55]. In Scotland, a report on telehealth services found teleconsultations for a 10-week rehabilitation course could be delivered for 3% to 10% of the cost associated with an outreach model (where the therapist travels) or a centralized model (where the patient travels), with the savings primarily being delivered through reduced travel costs [91].…”

Section: Costmentioning

confidence: 99%

The Use of Patient-Facing Teleconsultations in the National Health Service: Scoping Review

O’Cathail¹,

Sivanandan²,

Diver³

et al. 2020

JMIR Med Inform

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Background The National Health Service (NHS) Long-Term Plan has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. Objective This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. Methods We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. Results The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians’ workflow. Conclusions Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.

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“…Telerehabilitation practices are examined from the viewpoints of an individual taking part in the ISBN: 978-989-8704-19-1 © 2020 rehabilitation, the rehabilitation service provider and their employees, and the municipalities responsible for offering rehabilitation services. Testing of new telerehabilitation practices include an examination focusing on their costs and benefits on monetary terms, contributing thus to an ongoing scientific debate on the economic aspects related to healthcare (Hill, 2010, Tousignant et al, 2015. Our economic analysis is based on the cost-benefit analysis method presented by Oxenburgh and Marlow (2005) and in this article we present the categorization of the costs related to telerehabilitation and calculate different scenarios for those cost elements in which we consider variation exists.…”

Section: Introductionmentioning

confidence: 99%

Estimating the Monetary Benefits of Telerehabilitation in the Countryside - Case of Introduction of Tele-Homecare

2020

Proceedings of the International Conferences on ICT, Society and Human Beings (ICT 2020), Connected Smart Cities (CSC 2020) An

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Digitalization provides new solutions for health and welfare services. In cases where the customer has a long distance to reach the face-to-face services or has other limitations related to mobility, telerehabilitation can be used to provide the needed services for the customer. This study presents a tele-homecare service introduced in a municipal health and welfare services provider for the elderly. The cost saving potential of tele-homecare service as compared to traditional homecare service is a key interest. A categorization of costs in cases of traditional and tele-homecare is presented and further effects of tele-homecare in terms of costs are discussed. The case study is a part of an on-going project, the aim of which is to provide information that can be utilized in making well-grounded decisions on introducing telerehabilitation services that take into account the special needs and characteristics of rural areas.

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Telerehabilitation in Scotland: Current Initiatives and Recommendations for Future Development

Cited by 9 publications

References 2 publications

Overcoming the tyranny of distance: An audit of process and outcomes from a pilot telehealth spinal assessment clinic

Overcoming the tyranny of distance: An audit of process and outcomes from a pilot telehealth spinal assessment clinic

The Use of Patient-Facing Teleconsultations in the National Health Service: Scoping Review

Estimating the Monetary Benefits of Telerehabilitation in the Countryside - Case of Introduction of Tele-Homecare

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