MobiHealthNews had the opportunity to interview George MacGinnis with the Assistive Technology Programme at the NHS Connecting for Health in the UK at the Mobile Healthcare Industry Summit in London earlier this month. MacGinnis explained the differences between telecare and telehealth, how the UK enjoys a lead on the US and other countries when it comes to some telemedicine penetration rates, and how Continua's work toward personal medical device interoperability is key. MacGinnis stressed that the UK learned from its EHR rollout that interoperability was what would really make these systems very useful. He seems determined not to lose the fight for interoperability among remote monitoring devices and systems.
(Scroll down to the end of the article for the video version of the interview with MacGinnis moderated by your very jet-lagged editor).
MobiHealthNews: Is the UK out in front of others, including the US, when it comes to smart homes, telecare and telehealth home health care technology adoption?
MacGinnis: The UK starts from a position where we have state provided social care. With that we had a history of using technology and social care to move people out of residential care homes and keep them in their own homes. There is a significant infrastructure there already. In terms of penetration rate: We have upwards of 1 million people who enjoy some form of remote monitoring technology and around 300,000 or more "smart homes" are already out there and wired.
That's probably very different from what is classically talked about more often in places like the US for instance in terms of chronic disease management. [For chronic disease management] we are starting out along with everyone else -- we are still in the stage of early pilots.
Previously you made a distinction between telecare and telehealth -- how do you distinguish those terms?
In terms of telecare we think of tele-social care. The main focus is on managing risks to peoples' lives. They might have a panic button, a fall sensor and these might be people who are suffering from dementia. There are risks that they might leave the oven on and create a fire, so there are remote control fire detectors or remote gas shut off valves, etc.
Whereas [telehealth] is much more about chronic disease management: Diabetics might be checking their sugar, others might be checking peak flows, blood pressure or weighing themselves and answering questions about their health.
There is perhaps some convergence of these two technologies but I don't see that happening in a mainstream way for some time. We currently offer two different wireless technology services to those people who need both [telecare and telehealth] services in order to meet both those needs.
Your team at the NHS has worked very closely with the Continua Health Alliance -- can you tell us about some of that work?
First and foremost, what we have learned in the UK is that an open system based on standards is absolutely where it is at. We have been there with medical records -- we have had electronic medical records for ten year. We couldn't do many of the things that we really wanted to do with medical records because those standards weren't there. Actually we want to move much faster in remote monitoring space and solve some problems. First, there is a new breed of system -- wellness data, which is huge amounts of data -- not necessarily what the doctor wants or needs in their current system, but they probably could learn something from it. How do we get those two systems to interface? That's our first interest.
Our second interest goes back to telehealth/telecare. If you look at it we could be putting three different systems into people's homes: A health system, a care system and a system set up to check on the people paid to check-in on those older people to go in and check on those people. There's no sense in that.
Standards are clearly the way to go forward: You can meet the needs of all different groups simply by adopting the standards. If you need a phone with big buttons with massive numbers because you are poorly sighted, then you can rest assured that you can now use that device because the person running the network has adopted those standards. So yes, I really look forward to the work of Continua and really hope they win the big prize of interoperability. Keep at it!