Vision, Goals and Outcomes
Why is this important?
“We are better placed to know what we want and therefore we are not happy to just accept, oh this is what we’ve got... we actually have a vision now of how we are going to utilise it.”
“When we are looking at how we are using equipment we should be much more project focused and actually have a plan that’s followed and an evaluation.”
What are the key steps?
Establish a Shared Vision
Why should we, as commissioners, service providers and frontline staff invest our time and resources in telehealth?
Establishing a shared vision for telehealth can reduce uncertainty about why telehealth is being introduced and for whom, and shape how the service is developed and evaluated.
Agree on the Goals
What can telehealth help to achieve for commissioners and service providers, for frontline clinicians, and for users and their families?
Agreeing goals for telehealth is important because otherwise, different stakeholders may work towards different goals. This can make it difficult to measure the success of telehealth.
Select Appropriate Outcomes
What outcomes can we use to help measure or evaluate whether or not we are meeting the goals set for telehealth?
Outcomes are likely to include user outcomes, such as quality of life or user satisfaction, and service outcomes like cost per patient, or number of nurse visits or hospital admissions.
What are the goals for telehealth?
There are multiple and sometimes competing goals that telehealth can help to achieve. Here are some of the goals identified by staff taking part in the MALT study.
To replace face to face care with remote care
"Because telehealth helps me recognise some of the symptoms, I might have a telephonic consultation rather than a visit if I know a patient is being monitored."
To meet increasing demand
"If we increase someone’s ramapril we would bring them back to our clinics 7-10 days after ... If we had Telehealth to do this we could free up that clinic slot for someone else."
To improve service efficiency
"It’s meant that I can have a more structured approach to reviewing patients... So with a small number of patients it’s reduced the need for frequent visiting."
To enhance clinical practice
"Because I get the readings every day you can build up a good clear picture of what’s normal for your patient so you can see the decline much quicker."
To improve quality of life for patients and their carers
"You can show the carer or family how to use the machines ...that reduces their anxiety about the family member [patient] if they have got something that they can use to just check their health status."
To support patient self-management
"It’s helped them have confidence to manage their own condition and to help them decide when they needed to take anticipatory medication ...and being able to contact me or a GP for advice."
To reduce the cost of care
"The chances of keeping that patient at home and not going into hospital all the time was quite slim and I think the telehealth for him helped and it did highlight when he had a chest infection."