NHS future could see you Facebook your doctor

ParkinsonNet is a website which links sufferers of the disease in the Netherlands with specialist doctors and nurses and is being hailed as a trailblazer for the era of telehealth
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Imagine if your doctor was as easy to contact as your Facebook friends - and you could Skype them whenever you liked to talk about your health concerns.

For anyone waiting to see their GP in today's cash-strapped NHS, and with doctors already working at full tilt to provide the universal healthcare we all depend upon, it seems like the realm of science fiction.

But telehealth, bringing care into the patient's home, is now one of the buzzwords of the modern NHS. In a population where more and more people, often the elderly, have long-term health problems such as heart disease, obesity, breathing problems or diabetes, the greater part of a doctor's work can be done in the home, advocates of telehealth say.

In the internet age, the best way to do that, is to have a doctor on a computer, signed in to a network of patients in the same way we are connected to our Facebook friends and Twitter followers.

In the British Medical Journal today, researchers from the Netherlands have reported on the success of a scheme which is being hailed as a trailblazer for the era of telehealth.

ParkinsonNet is a dedicated website which links Dutch Parkinson's disease sufferers with doctors and nurses who specialise in their disease. It acts, in effect, like Facebook for Parkinson's patients. The professionals communicate and collaborate on the website, where patients can also find information about treatment, about the professionals themselves and what they do and can also, if they want, request an at-home consultation via video link in their homes.

Since it was introduced in 2004, ParkinsonNet has expanded into 66 regional networks and links nearly 3,000 professionals from 15 different disciplines to Parkinson's patients all over the Netherlands.

Evidence presented by the researchers, from the Radboud University Medical Centre, suggests that the website “empowers patients, improves the quality of care, shifts care away from institutions and into the community and lowers healthcare costs.”

Patients also appreciated being linked to genuine experts on their condition, rather than having to visit generalists and endure referrals and lengthy waits to see a specialist. The researchers concluded that the model could be used just as successfully by patients with other long-term conditions like diabetes and breathing problems. 

But it's the cost benefits which may be of most interest to NHS bosses. The health service in England is under intense financial pressure and facing a £30bn funding gap by 2030 and its managers. The NHS in Scotland and Wales are also eager to save money.

A patient with a long-term problem coming to a hospital for something routine is a waste of time for them and a waste of money for the hospital - so the more that can be done in the home, the better, experts say.

The Dutch researchers estimated that ParkinsonNet has saved up to 20m euros: a small amount in the context of the NHS' budget, which exceeds £100bn. However, Parkinson's is just one of the less common long-term conditions. If the millions of patients who suffered from diabetes, had a heart condition, or breathing problem could be cared for in the same way the savings could be, in theory, enormous.

Dr Martin McShane, NHS England director for long-term conditions told The Independent that the NHS in England was developing similar models of care for more conditions and called ParkinsonNet “a very clear signal of the potential” of telehealth. England already has an online psychological therapy service operating in some parts of the country.

“I think this is a really exciting time,” he said. “The problem is we're almost being out-paced by mobile technology. There are also questions about how we ensure the right governance of these schemes - clear quality standards need to be maintained… But do we want to move to a National Health Service rather than a national hospital service? The answer is yes.”

In Scotland, a dedicated Centre for Telehealth and Telecare has been set up, with “patient-centred, at home care” a key part of the country's plans to “transform” the NHS by 2020. The country is beginning to move beyond “pilots” to “large scale” uses of remote consultations with doctors and therapists, he said.

“It's not about replacing face to face care with technology,” said Professor George Crooks, medical director of NHS 24, who has overall responsibility for the project.  “Technology can make face-to-face care more accessible: such as accessing specialist opinion remotely from remote rural or island communities.

”We will use it but only where it is safe, effective and, most importantly, appropriate to do so…but people use technology to run their day-to-day life - and they now expect to be able to use their tablet, smartphone or computer as a way to access their health and care services.“