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Telehealth progress at Scottish practices

Telehealth plans are being tested in Scotland to see if they are viable, reports Oliver van Helden.

The Scottish Centre for Telehealth (SCT) was launched with a flourish in October last year, and several trials involving the use of new technologies in general practice are now being developed.

But there have already been successful telemedicine projects in Scotland.

An evangelical few have traditionally promoted telehealth. However, when it first began to emerge 15 years ago, the technology was expensive, clunky and unfamiliar.

Today, the patient population is increasingly technology-literate and mobile phones and broadband can disseminate a wide range of health-related information.

Videolink consulting
Professor Gordon Peterkin, the SCT's director, is a former GP whose practice in Forfar, Tayside, served a dispersed, rural population.

Over a decade ago, he helped set up a project called the Letham Nurse-Led Videolink, which is still operational and highly praised.

The videolink originated from a pilot in the Forfar area to deliver out-of-hours care using video conferencing. Local GPs shared video equipment which they took home when on call, for remote consultations at the regional minor injuries unit.

'Patients loved it, and preferred it to seeing a GP face to face. It was quicker than waiting for a home visit,' Professor Peterkin says.

The only drawback was that the equipment was too heavy to be easily moved between GPs' homes, so eventually it was used to launch a virtual in-hours surgery in Letham.

Located five miles from Forfar, the village did not have a GP practice, but has now had a videolink to a surgery in the town for over a decade.

Improving access
Sylvia Harvey, a district nurse at Letham's sheltered housing complex, runs the weekly clinic.

'I assess patients for suitability then arrange for them to be seen by a GP over the videolink', she explains.

'For specific issues, such as dermatology, I use an additional hand-held camera so the doctor in Forfar can examine the patient remotely. It's more convenient for patients and doctors.'

Professor Peterkin explains that the current drivers behind telehealth are that 'the technology has improved significantly and medical time has now become much more expensive'.

Professor Peterkin adds that telehealth negates the need to travel for both patients and doctors and can concentrate expertise.

Barrier to funding
However, Professor Peterkin also acknowledges that telehealth will not take off on a large scale until financial incentives are introduced.

'This is boundary-breaking technology and so far, financial solutions that will make it an essential part of the healthcare system haven't been developed,' he comments.

'The incentives won't arrive until we can prove that what we're doing is cheaper or of higher quality, but the body of evidence is building up.'

However, he predicts huge advances in telehealth over the next 10 years.

Patients satisfied
Former GP Dr Fiona Mair who now works in A&E in Grampian is a clinical associate for the STC and part of her remit involves training.

She believes that there are other obstacles to implementation: 'People are afraid of technology and there's always resistance.

'It is now just over a year since the launch of the SCT and time will tell whether the current generation of pilot projects will make it into mainstream practice.

'Or whether, despite high levels of patient satisfaction, obstacles impeding progress will be found to be insurmountable,' she adds.

Telehealth key points

Advantages

  • Facilitates provision of healthcare in remote locations.
  • Liked by patients.
  • Removes the need for clinicians and patients to travel.
  • Has potential to generate efficiency savings.

Disadvantages

  • Progress towards more widespread use is proving slow.
  • Clinicians need to be educated about the benefits.
  • Funding is dependent on proving service quality andcost-effectiveness.

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