Perspectives on telehealth and telecare: Learning from the 12 whole system demonstrator Action Network (WSDAN) sites

Key Points: Between 2008 and 2011, The King’s Fund and the Department of Health CareNetworks worked with 12 sites in England to undertake research and provide educational and experiential learning opportunities as part of the Whole System Demonstrator Action Network (WSDAN) One of WSDAN’s key aims was to examine the progress and impact of telecare and telehealth interventions across these sites, to provide evidence and learning to feed into the larger Whole System Demonstrator evaluation. Three themes emerged as particularly important areas for consideration whenadopting telehealth and telecare: leadership; working practices, skills and development; and data management.• Key characteristics for growth and sustainability exhibited across the 12 sites included: collaboration within and across organisations; leadership; developing alliances and partnerships; identifying critical services; developing a sharedvision; cultivating participation; building capacity; exploiting funding opportunities;and working across professional boundaries. While these factors appear necessary to sustain and expand telecare and telehealth services, they are insufficient on their own. Other areas that need to be addressed include: fostering fundamental service redesign; supporting professional development and staff training; analysing and designing the infrastructure prior to equipment being deployed; applying recognised standards; making decisions based on good interpretation of available data and evidence; and developing governance arrangements at national level to avoid regional variations in services. The changing political environment, including NHS reforms and reductions in local government funding, have also had a significant, negative impact on the adoption of telehealth and telecare services. As resources for investment have become squeezed, the continuity of focus provided by local leaders and champions has been eroded. For new technologies to be taken forward, it has been paramount to present robust business cases and sustainability plans that are structured around improved health and social care outcomes as well as efficiency deliverables(Quality, Innovation, Productivity and Prevention, or QIPP