1. 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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  2. Refining the case finding model

    27 Aug 2013
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    The Nuffield Trust has just published a paper on a new predictive model. We hope that the paper and the accompanying details can help both commissioners and providers of care refine the ways that they use risk stratification and case finding tools.

    The market for predictive modelling tools has grown a lot in the last few years. Alongside the old familiars, such as Patients At Risk of Re-hospitalisation (PARR) and the...

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  3. Can telephone health coaching prevent hospital admission?

    7 Aug 2013
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    Health services around the world are attempting to improve care for people with long-term conditions, as currently it is often fragmented and expensive. Many interventions have been tried and tested. To the long list of evaluations another can now be added – that of Birmingham OwnHealth (published today in the BMJ).

    Birmingham OwnHealth was England’s largest example of telephone health coaching, established in 2006. Operating as part of...

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  4. 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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  5. Community-based interventions: how do we know what works?

    26 Jun 2013
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    Over the past four years the Nuffield Trust have been asked to look at a range of service innovations and assess whether they lead to a change in service use – most typically a reduction in inpatient hospital activity, which is something that seems to have become the holy grail of health service planning.

    Our new report summarises observations from our studies and efforts that might help those planning and evaluating new services in the future. In particular, the report should provide useful learning for the new...

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  6. Pursuing nirvana

    27 Nov 2012
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    At last! We found evidence of an intervention which improves quality and reduces hospital costs. Is it telehealth? No! Is it greater competition? No!

    It is care by Marie Curie at the end of life. People receiving the home-based Marie Curie Nursing Service were more likely than matched patients to die at home, according to their wishes, rather than in hospitals, and less likely to have unplanned hospital care.

    This was our first excursion into examining the impact of home-based care from the 'third' sector – hopefully the first of many.

    On...

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  7. 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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  8. 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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  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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