Telehealth is Associated with Lower Mortality and Hospital Admission Rates

The 3millionlives Industry Group welcomes the paper which states "Telehealth promises better quality and more appropriate care for each patient, as well as more efficient use of healthcare resources by reducing the need for expensive hospital care."

The paper "Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial" is the first of five papers which provide the detail behind the headline findings published in December 2011.

It confirms that the differences in admissions and mortality remained significant after adjustment as follows:

• Mortality rates reduced by 45% - Intervention patients were significantly less likely to die within 12 months than controls. 4.6% of the intervention group (with telehealth) died over a 12 month period, compared with 8.3% of control group. This is statistically very significant and 60 fewer intervention patients died compared with the control group.
• Proportion of patients admitted to hospital reduced by 11% - telehealth patients had a lower hospital admission proportion than those without telehealth (odds ratio 0.82 vs. 0.70) during the twelve month trial.
• Emergency admissions reduced by 20% - The mean number of emergency admissions were 0.54 per person in the intervention group (with telehealth) compared to 0.68 in control group. This equates to 20.6% less emergency admissions for those people with telehealth.

Angela Single, Chair of 3ML industry leadership group says: "The paper confirms a significant reduction in hospital admissions and mortality rates which, if scaled up across the UK, would bring major benefits to healthcare resources and patient outcomes. Industry must now work hard to deliver on the promise to enable millions more people to benefit from improved health and independence, working with our health, social care and housing partners to develop effective funding models to enable telehealth at scale."

Gil Baldwin, Vice Chair of 3ML industry leadership group, added: "Many NHS and social care organisations have already commenced large scale roll out. This paper gives them further legitimacy, clinical assurance and finally the data set to back up their innovative approach to transforming health and social care."

The research was led by Adam Steventon, senior research analyst at the Nuffield Trust as part of the Whole System Demonstrator trial, the largest RCT on telehealth and telecare in the world.

A total of 3230 people with diabetes, chronic obstructive pulmonary disease or heart failure were recruited from 179 general practices, across Newham, Cornwall and Kent between May 2008 and November 2009.

Researchers examined mortality over 12 months and pre-specified secondary endpoints (including the number of inpatient bed days, emergency admissions, elective admissions, outpatient attendances, and emergency department visits, as well as the notional cost of hospital activity to commissioners of care based on national tariff costs).

This is the first of five peer reviewed papers on the WSD programme (funded by the Department of Health in England). The second paper in the series will detail the effect of telehealth on costs.