Digital Health

1. PREPARED BY
PROF.S.LAKSHMI
TJCN,BANGALORE

2. LEARNING OBJECTIVES
At the end of the session learners will be able to
- define TEC
- list out the aims of TEC
- list down the use ofTEC
- discuss the impact in health care and statistics
- describe the components of TEC
- enumerate the levels of TEC
- steps to implement TEC
- discuss the technologies in 1980s
- explain the technologies new role in health care
- lists the Benefits and components
- discuss the barriers to the uptake of technology enabled care
- future of TEC

3. INTRODUCTION
• The advanced digital technology is raising
exponentially, and its cost is becoming more
affordable.
• The need for more cost-effective healthcare also
rising. Now more than ever, healthcare authorities
need to adopt new technologies that help to meet the
demand.
• So health provision and care coordination is becoming
a core skill needed across the nursing profession.
• Technology Enabled Care is now seen as a fundamental
part of the solution to solve many healthcare challenges.

5. What is TEC ?
Technology Enabled Care is defined
as “where outcomes for individuals in
home or community settings are improved
through the application of technology
(such as Near Me) as an integral part of
quality, cost effective care and support to
look after more people at home”.

6. AIMS OF TECS
To provide the quality of cost-effective care and support to the
individuals
To improve outcomes for individuals in home or community
settings.
To enhance the application of technology as an integral part of
the care and support process

7. Statistics of TEC

9. COMPONENTS OF TECS
There are various modes for providing TECS, ie, through
telecare, telehealth and telemedicine/ teleconsultation and
self care apps.
 Utilising available technologies reduces NHS costs by enabling
people to live independently and safely in their own homes for
longer. Let’s take a better look into the different technologies
that make up TECS.

10. TELECARE
Telecare is the most common form of TECS and covers the
essential requirements for caring for vulnerable individuals. The basic
equipment starts with a personal alarm usually worn around the neck or
wrist. Depending on the complexity of the individuals needs, other
peripheral sensors such as bed mats, PIR’s and fall detectors can also be
provided. These sensors give an overall view of daily activities and in
some cases can act as prevention systems.

11. TELEHEALTH
Telehealth uses devices to monitor vital signs in the comfort
of your own home. Consequently, this is ideal for patients with long term
conditions. Daily data is collected from the do it yourself style kits such as
blood pressure monitors and the results analysed. Therefore, this remote
exchange of data between a clinician and a patient at home can reduce the
amount of required hospital visits.

12. TELEMEDICINE
Telemedicine, it’s like having a doctor in your front
room! Specialist apps or software transform smart device and
TV’s into video call devices which allows you to speak with a
doctor from anywhere.

13. TRANSFORMING HEALTHCARE WITH
TECHNOLOGY-ENABLED CARE
• Connected health or technology-enabled care (TEC) is the collective term
used for telecare, telehealth, telemedicine, mHealth, digital health, and
eHealth services. TEC is now seen as a fundamental part of the solution to
solve many healthcare challenges.
• TEC helps people self-manage their health and wellbeing, alert healthcare
professionals in case of any changes.
• It also helps clinicians and care providers deliver more efficient and cost-
effective care.
• Digital technology is advancing exponentially, and its cost is becoming
more affordable. The need for more cost-effective healthcare is rising.
Now more than ever, healthcare authorities need to adopt new
technologies to help meet this demand.

14. LEVELS OF TECHNOLOGY ENABLED CARE
• LEVEL 4 Patient enablers – telehealth, telemedicine,
teleconsultation, telecare, telecoaching, self-care apps.
• LEVEL 3 Integration enablers – unified communications across
multi-disciplinary teams, shared resource and schedule
management.
• LEVEL 2 Core enablers – shared electronic care record,
eReferral, eCorrespondence, ePrescribing.
• LEVEL 1 Underlying infrastructure – hardware, networks,
storage, security, email.

15. HOW CAN TECS SUPPORT INTEGRATED
HEALTH AND SOCIAL CARE?
TECS supports an individual’s health and social care needs from birth to death. It can enable
providers across the health and social care system to give better access to care, improve
communication, and enhance teamwork and efficiency. It can also support self-care.
Pregnancy & first
year oflife
Conception to age 1
700,000 births
Childhood
Age1–11
6.5m people
Adolescence
Age12–16
3m people
Young Adulthood
Age17–39
16mpeople
MiddleAge
Age40–64
17.4m people
Older Years
Age 65+ 9.3m
people
Telehealth monitoring
of high- risk pregnancy.
Telecoaching to stop
smoking.
Telecoaching for obesity,
parental skills and exercise.
Apps to help with
management of LTCs.
Telecare supporting parents
ofdisabled children.
Appsforadviceondiet
andnutrition.
Telecoaching for
early smoking/
drinking/sex.
Text reminders.
Teleconsultation
supporting Child and
Mentalhealth
Services (CAMHS).
Teleconsultation to
facilitate access to services.
Mobile telehealth
for LTCs.
Telecare supporting
independence of adults
withphysicaland learning
disabilities.
Teleconsultation for
convenient access to
mental health specialists.
Telehealth to manage LTCs
such as COPD, CHFand
other early onset chronic
conditions and support
carers’health.
TECS forscreening.
Apps and telecare
providing advice, support
andreassurance to carers.
Teleconsultation to support
familialand carer contact.
Telehealth to support
management of
multipleLTCsand
rehabilitation.
Telecare to maintain
independence and
providecarersupport.
Teleconsultation to
facilitate contact with
friendsand familyto
reduceloneliness.

16. WHO SHOULD BE ENGAGED TO IMPLEMENT TECS
Engagement with health and care organisations, delivery partners
and patients in a local health economy is important to co-produce a
mutually effective strategy for TECS.
• Social care TECS board / networks
• Commissioning Support Unit (CSU)
• Academic Health Science Network (AHSN)
• Patient, service user and care groups
• Suppliers of technology solutions
• Collaboration for Leadership in Applied Health Research and Care (CLAHRC)
• Strategic Clinical Networks
• Health and Wellbeing Board

17. IMPLEMENTING TECS
KEY STEPS
• STEP 1 Establishing buy-in
• STEP 2 Workforce requirements
• STEP 3 Service design
• STEP 4 Implementation
• STEP 5 Evaluation design

18. IMPLEMENTING TECS- KEY STEPS (continuation)
STEP 1- ESTABLISHING BUY-IN
• Establishing buy-in Who are the stakeholders for TECS?
• What are their needs?
• Does the project have clinical and social care leadership?
• Does this include finance leads?
• What is our strategy for patient, provider and public
engagement?
• What training or support will patients, care providers and
carers need?

19. IMPLEMENTING TECS- KEY STEPS (continuation)
STEP 2 - WORKFORCE REQUIREMENTS
• How will TECS impact on the workforce?
• What training and change management are needed?
• Who will lead the project?
• How will the workforce be consulted?
• Do partners understand their roles and responsibilities?
• Are appropriate governance structures in place?

20. IMPLEMENTING TECS- KEY STEPS (continuation)
STEP 3 - SERVICE DESIGN
• What services should be included?
• Is finance in place across partners?
• Has benefits realisation been scoped and agreed?
• Have all partners including commissioners, clinicians, patients, carers
and suppliers been involved in redesigning the new pathway?
• Have the revised pathways been approved and communicated by all
relevant parties?
• Have existing resources and funding streams been mapped to
understand how they can support delivery of TECS?

21. IMPLEMENTING TECS- KEY STEPS (continuation)
STEP 4- IMPLEMENTATION
• Have clinical protocols and plans to recruit patients been
developed?
• Will equipment be interoperable with existing technologies?
• What infrastructure is required?
• What are the risks and how are they mitigated?
• Are the benefits clearly defined and how will we know when they
are realised?
• How will we move users off TECS?

22. IMPLEMENTING TECS- KEY STEPS (continuation)
STEP 5- EVALUATION DESIGN
• Will the evaluation measure impact on the individual, the
service and the whole health economy?
• What plans are needed for evaluation?
• How will findings feed into further improvement of the
service?

24. Technologies in the 1980s
Personal computers
Graphical user interface
CDs
Walkmans
VCRs
Camcorders
Video game consoles
Cable television
Answering machines
Cell phones
Portable phones
Fax machines

26. TECHNOLOGIES NEW ROLE IN HEALTH CARE

51. INCREASING PATIENT TRUST IN HEALTH APPS
• There is strong evidence that patients are now more than ever
concerned about self-care, and they are interested in boosting
their health and wellbeing.
• Health technology companies are working to improve the
quality of apps, increase user confidence and trust, and launch
informed decision-making in app selection for health
professionals, patients and the public.

52. BENEFITS OF TECHNOLOGY-ENABLED CARE
• Allow patient to assess their care anywhere.
• Improve patient and carer experience
• Improve prevention of long term conditions
• Improve clinical benefits
• Develop a stronger evidence base
• Work with industry to stimulate the market
• Enabling greater independence
• Getting the balance right between ‘tech’ and ‘touch’ is vital
• Funding challenges
• Promoting technology-enabled care
• Analogue to digital switch

53. How TEC can help tackle increasing demands on
healthcare – today and tomorrow
• There is a growing body of research showing that TEC, in
particular mobile and digitally enabled technology, has the
potential to reduce healthcare costs, increase access and
improve outcomes.
• The power and reach of the technology can improve access,
overcome geographic distance and shortages of HCPs, while
providing a more versatile and personalised approach to
healthcare.

54. BARRIERS TO THE UPTAKE OF TECHNOLOGY
ENABLED CARE
• The lack of agreed standards for data protection, privacy and security, of
both the data and the devices
• Concerns over patient safety, quality and liability
• Concerns around a lack of evidence on cost effectiveness and the time
needed to develop this evidence
• The lack of a clear legal and regulatory framework
• Poor interoperability and a need for common interoperability standards
• Inadequate funding and reimbursement models
• Inequality in patient and career access to technology
• Cultural resistance from HCPs.

55. THE ACTIONS SUGGESTED BY STAKEHOLDERS FOR
OVERCOMING BARRIERS
• Build trust by developing strong privacy and security arrangements
and clear governance structures for the use of big data, including
being able to share data from health apps with electronic health
records.
• Adopt key principles of data minimisation, data protection by
design, and data protection by default, once the planned data
protection regulation is adopted
• Give patients control over their own data, specifically the kind of
information he/she wants to share, while maintaining the right not
to share, as well as enabling the patient to see who is using data
and for what purposes

56. THE ACTIONS SUGGESTED BY STAKEHOLDERS FOR
OVERCOMING BARRIERS(CONTINUATION)
• Develop binding rules on the delineation between lifestyle and
wellbeing apps and clarify rules for when an app is a medical
device and how these differences should be regulated
• Gather evidence on the economic benefits and involve hcps,
patients and carers in co-designing solutions
• Develop new business models, as most mobile technology
services are not reimbursed in many EU countries nor is there a
specific budget for it
• Help entrepreneurs access the healthcare

60. CONCLUSION
The Technology Enabled Care Services Resource for
Commissioners has been developed by NHS commissioners to
identify practical tools that can help maximise the value of
technology enabled care services for patients, carers,
commissioners and the whole health economy. Technology has
the power to radically transform the way we deliver healthcare
by enabling all patients to take a more active role in their own
health and increase prevention through supported self-care.