UK dials up 'virtual doctors' in big telehealth push

Jean-Sebastien Evrard, AFP/Getty Images

LONDON (Reuters) - Shirley Silvers thinks the "virtual doctor" who monitors her chronic lung condition via mobile phone is wonderful.

"It is like having my doctor sitting on my sofa," said the 64-year-old from Stoke-on-Trent in central England, explaining how her temperature, oxygen levels and sputum color - a barometer for infection - are now checked daily from home.

She sends her readings by text message and gets a reply within minutes, removing the need for regular trips to the doctor.

British health minister Jeremy Hunt is equally enthusiastic.

He announced plans in November to roll out telehealth to 100,000 people with long-term conditions in 2013 and have 3 million on the system by 2017.

It will make Britain second only to the United States as an adopter of technology to monitor patients at home, luring technology and telecoms firms looking for somewhere to test ideas in a global market that may soon be worth tens of billions of dollars.

Remote monitoring has the potential to save money by keeping people like Silvers - who suffers from chronic obstructive pulmonary disease (COPD) - healthy and out of hospital.

Indeed, the department of health claims it could save up to 1.2 billion pounds ($1.9 billion) over five years.

Savings of that scale are hard to ignore in an age of austerity, and other governments across Europe are also exploring the concept.

A range of options are now available to keep tabs on patients at a distance, including home health computers, smartphone applications and video check-ups, while more futuristic projects involve wiring homes with sensors to feed medical and behavioral data to a central server.

NOT A PANACEA

But telehealth is not a panacea - and a fierce debate has sprung up in Britain since the government outlined results a year ago from the world's largest telehealth trial, involving 6,000 patients, which triggered its commitment to the concept.

"Headline" data highlighted by officials from the so-called Whole System Demonstrator program suggested that using telehealth could cut emergency admissions to hospitals by 20 percent and slash mortality rates by 45 percent.

Those reductions, however, were relative - in other words, how much better patients on telehealth fared compared with those on standard care.

When detailed results were published in June, the absolute reduction in mortality came in at a less compelling 3.7 percent, representing 59 lives saved among the 3,000 patients on telehealth who were followed for 12 months.

What is more, researchers wrote in the British Medical Journal that the positive findings could have arisen by chance and the scale of potential cost savings was unclear.

Other research paints a mixed picture.

Some studies looking at specific diseases like heart failure and diabetes have made a strong case for telehealth, but a 200-patient U.S. study published earlier this year in the Archives of Internal Medicine linked telehealth to more deaths, for unknown reasons.

The muddy picture probably reflects the interplay of multiple factors and indicates that telehealth cannot be viewed in isolation, since overall management of patients is likely to be just as important as use of technology, if not more so.