1. Virtual reality: observations from the Nuffield Trust study of Virtual Wards

    6 Nov 2013
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    Implementing new models of care is not easy – and especially so when organising community-based services that aim to tackle the challenges of more chronic disease and greater levels of emergency care.  

    One of the more interesting approaches of the past few years has been the Virtual Ward and we recently published a report, funded by the National Institute for Health Research Service Delivery and Organisation Programme, looking at three early examples of Virtual...

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  2. Can telehealth reduce demand on GPs?

    28 Oct 2013
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    After several years in gestation, the Whole Systems Demonstrator (WSD) trial of telehealth is now producing a steady stream of outputs – most recently in the form of a paper looking at whether telehealth changed the frequency with which people used GPs and practice nurses.

    The WSD, one of the largest trials of its type in the world, focussed on one use of telehealth as a form of remote monitoring and support to help people better manage their chronic health conditions – which in this study meant either...

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  3. Predictive risk: an idea whose time has come?

    (Guest blogger)
    29 Jul 2013
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    The Nuffield Trust recently held its fourth annual conference on predictive risk - or applying statistical models to populations in order to identify patients who might benefit from health interventions of various kinds.

    The mere fact that this was the fourth conference on the subject shows that this is an idea with legs. And, indeed, it has just been given a boost by the Department of Health, which has included a directed enhanced service for ‘risk profiling and care management...

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  4. NHS @ 65: transparency is the future of the people’s NHS

    (Guest blogger)
    26 Jul 2013
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    You attend a hospital with your disabled daughter. You do this pretty much every day because your daughter has regular seizures and emergencies. Every time, you have to start all over again because the hospital doesn’t know who your daughter is. More paperwork.

    Then you wait and wait because the staff have to find a hoist to lift your child out of her wheelchair onto a bed. Why couldn’t you have called in advance to tell them she was coming? Hours and hours of waiting.

    This is the NHS in the experience of one mother I met recently: everyday indignities and inhumanities and, in...

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  5. Predictive risk: to app or to automate?

    25 Oct 2012
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    The purpose of predictive risk modelling is to segment a given population on the basis of their risk of experiencing a particular outcome, for example an emergency hospital admission (Billings and others, 2006).

    This is often used for case finding, where appropriate prevention techniques are matched to each risk stratum. High risk patients will be a small minority of the total population, and the form of the intervention will change depending on the level of risk.

    The highest risk patients might receive a personal...

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  6. Should clinical commissioning groups invest in telehealth?

    8 Oct 2012
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    Telehealth is increasingly being advocated as a way to monitor patients remotely and better manage long-term health conditions. The Nuffield Trust was part of the largest randomised controlled trial in this area, “the Whole System Demonstrator” (WSD) – the initial results were published earlier in the summer.

    We held a seminar with practitioners, researchers and funders to discuss the remaining research that needs to be done, post WSD. Priorities were identified as;...

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  7. How useful are randomised controlled trials in evaluating new ways of delivering care?

    24 Aug 2012
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    In the Whole System Demonstrator (WSD) trial, a team of researchers studied the impact of installing telehealth technologies in patients’ homes to monitor their vital signs such as blood sugar levels. 

    Debate continues over whether the findings justify the Government’s policy of encouraging the NHS to invest more in telehealth. At the same time, the trial has raised a potentially even more significant discussion. 

    How useful are randomised controlled trials...

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  8. NHS VistA: The enlightened choice?

    (Guest blogger)
    12 Jul 2012
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    The potential value to the NHS of learning from the international experience of the electronic medical record (EMR) system, VistA, was identified in the January 2002 NHS Information Authority White Paper:Open Source Software and the NHS.

    Ten years on, and several billion pounds of investment later, the NHS is still without a satisfactory comprehensive electronic medical record system.

    Open-source software has gone from strength to strength...

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  9. Does telehealth reduce hospital costs? Six points to ponder

    28 Jun 2012
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    The first results of the largest randomised controlled trial on telehealth were published in the British Medical Journal last week. Of the five arms of the Department of Health-funded 'whole system demonstrator' (WSD) trial, the first (conducted by a team here at the Nuffield Trust) examined the impact on hospital admissions and costs.

    The headline results so far: patients receiving telehealth care had just 0.14 fewer emergency admissions in the one year of follow up; and...

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  10. What is the impact of telehealth on hospital use?

    22 Jun 2012
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    This week, the British Medical Journal published the first results from one of the world’s most complex randomised controlled trials. Researchers at the Nuffield Trust led this analysis, which relied on collecting over a billion records of administrative data from more than 250 health and social care organisations.

    The trial’s aim was to evaluate “telehealth” – a way of using technology to support people with long-term health conditions such as diabetes, heart failure or chronic obstructive pulmonary disease....

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  11. Digital revolution: bringing the NHS into the 21st century

    24 Mar 2011
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    This morning I logged in to my bank account on my smartphone, checked my balance, transferred some funds, and rated the service received for a book that I ordered online—all before my morning shower.  I then sent an email to my boss explaining that I would be late today because it was going to take me most of the morning, including travel time, to attend a ten minute follow-up appointment at my local outpatient clinic. Why is health care so far behind the times?

    This was the topic we recently explored at a breakfast session at the Nuffield Trust’s 2011 Health Strategy Summit....

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