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Jeremy Blackman Kent County Council

? Kent Telecare Pilot ? Kent TeleHealth Pilot ? Benefits seen from local trials ? Future WSD Evaluation . Population: 1.4 million peopleArea: 1537 square miles, 98 miles long with the longest coastline of any county. 18 towns and 400 villages 3 Acute NHS Hospital Trusts 2 Primary Care Commissioning Trusts Over 65's due to increase by 30% and over 85's by 10% in next 15years.

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Jeremy Blackman Kent County Council

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    6. Background to Telecare in Kent KCC: invested in Telecare services to promote security, independence and wellbeing. Telecare is not new - There were already a number of existing community alarm providers. Social care / health services needed to make more use of technology if we were to provide more flexible services for the ageing population.

    7. The Kent Experience 6 pilot sites across the county consisting of 900+ service users Just another tool in the bag Positive feedback from service users and carers - 93% felt more independent since Telecare was installed, and 93% also felt safer in their own homes.

    8. Key Lessons So Far Response / Support infrastructure essential to success Realising potential of Telecare means:- Better use of existing resources, Improved communication and partnership working between professionals, users and carers, and across agencies, and More flexible services focused on the needs and priorities of service users and carers.

    11. Key Lessons Time investment Infrastructure & Resources Partnerships & Relationships Marketing Targeted intervention Case finding & data quality inclusion criteria Partnerships & Relationships delivery models

    14. TeleHealth Significantly reduced acute sector activity. Case-study: 85 year old male with COPD, with a history of frequent hospital admissions as a result of exacerbation. Managed successfully within the comfort of his own home through early pharmacological interventions and physiotherapy and as a result has not needed any further admissions to hospital. Early detection of imminent exacerbation. Case-study: Female with weight monitoring. Rapid increase was highlighted and risk of exacerbation identified. Treated with diuretics and weight was controlled.

    15. TeleHealth Better medicines management Case-study: 86 year old female taking a beta blocker for hypertension. The drug caused bradycardia which was detected and an ace inhibitor successfully used to replace the beta blocker. In some cases diagnosis of previously undetected conditions Case-study:...gentleman with COPD and CHD was set up on the system recently and was found to be bradycardic. Subsequent investigations have identified that the patient will need to have a pacemaker fitted, Community Matron Interventions change from reactive to proactive Case-study: 49 year old male, ISD, uncontrolled malignant hypertension. Hypertension now controlled, a plan of action established for the patient to follow and care packaged better tailored to suit. Result is 0 admissions in 6 months since installation.

    19. > 64 years made up 16% of the population but accounted for 47% of hospital and community health spending (Evandrou,2005) 20% of older people had attended an outpatient or casualty department in the previous year 10% of older people had a hospital inpatient stay in year Use of personal social services also increased exponentially with age (Evandrou, 2005) Health & Social Service Use and Age

    20. Participants Patients with long term conditions (heart failure, COPD and diabetes) Patients with social care needs Patients with long term conditions AND social care needs

    21. Evaluation Themes Theme 1 Impact on service use and associated costs for the NHS and social services (return on investment). Theme 2 Participant-reported outcomes and clinical effectiveness. Theme 3 Cost and cost-effectiveness, relationship of costs to other outcomes? Theme 4 Qualitative Studies to determine experience of TC & TH Theme 5 What organisational factors facilitate or impede the sustainable adoption and integration of telehealth/telecare?

    22. Proving the Business Case

    23. World Class Evaluation Team

    24. Evaluation design c6000 service users in the evaluation Randomised controlled trial: Intervention groups and control groups to assess the impact of AAT in addition to usual care i.e. both groups receive the same care and the only difference is that the intervention group are also receiving AAT Real time Cluster design: minimises administration when compared with individualised randomisation

    26. Evaluation Process

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