<While our patient records are being transformed into electronic form, technology is also making profound changes to the way that healthcare is being delivered. Two new tools – telehealth and telecare are, in very different ways, attempting to bring health and social care to patients at home.

Telehealth lets patients measure vital signs such as blood sugar levels or blood pressure from home and submit it to professionals electronically. This, it is hoped, will allow patients with long-term illnesses to avoid endless tests and visits to hospitals. For example, a diabetic patient could simply prick his finger and hold it onto a test strip. His doctor, on the other side of the city, can then check that the dosage is correct and intervene if necessary. Although the NHS is beginning with the monitoring of vital signs, the potential for telehealth’s effect on the way that we get healthcare is staggering. ‘Real Time’ telehealth could include examinations and consultations through video conferencing or teleradiology, which allows x-rays to be conducted remotely.

Telecare, however, although it is often used by those with healthcare problems, is part of social care, rather than healthcare.It is provided by social service departments, rather than the NHS. It is essentially an emergency service, including push button alarms, flood sensors and smoke detectors. Telecare supports elderly or frail people to remain independent in their own homes safely

While allowing chronically ill people to manage their own health, and elderly people to remain in their own homes is generally thought to be a good thing, this is not the main impetus behind telehealth and telecare. They are responses to the huge costs of caring for a growing and ageing population.

Although these techniques seem promising, it’s vital to gather evidence on how effective they are and the best way to use them. Last July, the Department of Health launched the Whole System Demonstrator programme.

This is a study to test whether telehealth and telecare reduce hospital admissions, lengths of stay, and doctors’ workloads. The program is running a trial with 6,000 people with long-term illnesses in the boroughs Kent and Cornwall and Newham, East London to test the cost effectiveness of telehealth and telecare.

The Department of health has been very quiet on how these initiatives relate to the NHS’ wider IT development, particularly Electronic Patient Records. Telehealth is clearly another move to storing patient information in electronic form, but little has been said on how or where this information would be stored if telehealth and telecare were adopted more widely. As Smarthhealthcare.com reports, before the WSD programme it was ‘difficult for stakeholders, ranging from local authorities to primary care trusts, ambulance services, police and mental health bodies, to share information due to data protection issues.’

For privacy campaigners the project’s emphasis on an ‘integrated networks’ needed to provide ‘integrated care’ might ring alarm bells. Although sharing potentially highly sensitive information between organizations about patients who require a range of social and health care is nothing new, doing so electronically is new in many cases. It remains to be seen how this information will be integrated into NHS databases and its implications for patient privacy.