Home telehealth: connecting care within the community

edited by Richard Wootton, Susan L Dimmick and Joseph C Kvedar (London: Royal Society of Medicine Press, 2006)

Reviewed by Elizabeth Hunter, Director, Atlantica Prompt Advice Ltd

The white paper Our health, our care, our say: a new direction for community services (January 2006) clearly acknowledges that there will be a “radical and sustained shift in the way in which services are delivered”. That paper states that “90% of people’s contacts with the health service take place outside hospitals,” and among the issues it tries to address are the increasing ageing population and “widening inequalities”.

Home telehealth addresses some of these issues and provides the reader with some very clear, practical ideas of how telehealth can be used to provide high-quality care in the home. In addition, it illustrates how it can enable practitioners to deliver health care to more people within a short timeframe.

From the basics to the future

The book is divided into four sections:

  • The basics explores the benefits of and concerns with the use of this technology in the following areas: outcomes, economic evaluation, patient satisfaction, return on investment and the “evidence base”.
  • Techniques continues the theme, addressing the planning and implementation of telehealth, but starts to relate it to the applications.
  • Applications takes a disease-state-oriented approach to illustrate home telehealth technologies in practice.
  • The future provides insight into the implications of an extensive use of this technology and the impact that that may have, plus the cost savings that could be realised. It also discusses the widespread use of home monitoring in support of preventative and diagnostic medicine.

Global perspective

The following are just some of the innovative ideas that the authors put forward:

  • In a quarantine situation, to ensure that care is delivered while minimising contact, a wide range of home telehealth technologies can be used, from “asynchronous individual emergency alerts” to “synchronous televideo systems”. Some of these tools enable people to remain at home while receiving specialised care.
  • When a clinician needs to ensure that children undergoing peritoneal dialysis have been complying with their dialysis schedule, they can be monitored at home using a “teleperitoneal cycler” and a video-conferencing system. 

The contributors come from 10 different countries, which gives the book a very interesting global perspective. Many of them are practising clinicians, which means that they can clearly convey the reality of using telehealth while still maintaining the academic rigour of their professions – not an easy task.

Readership

Home telehealth, although aimed at the practising clinician, would also be very useful for health-care planners, managers of health-care services and anyone with a broad interest in how health care might be delivered in the future. The technical information has been kept to a minimum, which adds to the book’s practical usefulness and makes it much easier for the “limited technophile” to read and understand. Interested patients may also be fascinated by the contents.