Professional Engineering

ll-health is an acute problem in Barnsley, South Yorkshire. Astonishingly, a quarter of the borough’s 225,000 residents are recognised as living with chronic conditions such as coronary heart disease, hypertension and diabetes. That puts the local primary care trust – Barnsley PCT – under immense financial and organisational strain.

With serious illness so endemic among the local population, it’s perhaps not surprising to see that Barnsley has emerged as one of the most progressive centres of telehealth in the country. Later this year, the second phase of a trial that began in 2010 will see several hundred patients start to use a sensor-based system that will allow them to take vital measurements such as blood pressure and blood glucose levels in the comfort of their own homes. The telehealth system then transmits the data to health providers across secure links through the internet, with the patient and medic connected via display interfaces. The system is aimed at reducing the number of visits that patients need to make to local medical facilities, which in turn saves money for the PCT.

Such remote-monitoring technologies are already popular in the US, but the Barnsley trial is the first of its kind in the UK. And now other health bosses are watching the progress closely: primary care trusts in Leeds and Hull are also considering adopting the system in a bid to cut costs.

The first stage of the trial has been deemed a success, with initial fears that the use of telehealth would lead to patients feeling isolated from doctors and nurses proving unfounded. Instead, says Sue Wing, deputy director of operations at Barnsley’s health delivery unit, the system has encouraged patients to take a greater interest in their own specific health conditions. People living with chronic conditions who are supported with telehealth have been found to be more likely to take control of their own well-being, such as stopping smoking, losing weight, taking more exercise, and looking after their mental condition. 

Wing says that medical care has also improved. Once patients access the telehealth system, care providers can assess their needs and direct them to the right services based on the findings recorded, providing greater efficiency in time and resources.

“It has really empowered people to manage their long-term condition,” says Wing. “The vast majority of those involved in the trial have embraced the technology – they absolutely love it. We have had some quite elderly patients with complex conditions telling us that it has delivered real benefit to them. I view telehealth as a vital toolkit for the delivery of our clinical services and for increasing self-directed care. It also brings us some real efficiencies, as well as helping us drip-feed educational support.”

The Barnsley trial is based on the Telehealth Plus system developed by Bosch. The key components are the patient’s home-based display interface, the required monitoring devices and tailored health management programmes that are delivered across a telephone line or Ethernet connection. Patients measure their vital signs such as blood glucose, blood pressure and pulse rate, weight, oxygen saturation and peak expiratory flow. The interface automatically transmits these measurements and the healthcare professional can call up the results through a web-based terminal. With the help of a partially automated process, the healthcare professional can identify the level of risk associated with each patient and act accordingly, therefore preventing and/or reducing the number of acute situations that may lead to hospital treatment. 

Telehealth Plus can be used to monitor a wide range of conditions, including congestive heart failure, coronary heart disease, diabetes, chronic obstructive pulmonary disease and hypertension, and mental health.