The Journal of mHealth Vol 1 Issue 3 (June 2014) - Page 28

The Value of Video in Modern Health and Social Care Continued from page 25 ill-equipped to implement these services within the current structure. The need to re-engineer the way in which services are delivered and change the way in which payments for care are administered is often seen as too much of a risk to an organisation. The need for a body of evidence that demonstrates the cost-efficiencies and the improvements in care, particularly for patients with long-term or multimorbidity conditions, becomes the colloquial 'chicken and egg' situation. For the industry at large the need for cultural change within the UK NHS has in many cases prevented technology providers from gaining significant traction within the market. According to Dr Ali, this is slowly beginning to change, as UK Clinical Commissioning Groups, which are still in their relatively infancy, are beginning to understand that changes in the way that care is delivered need to be made. So that it is necessary to embrace technology in order to empower the individual to take greater responsibility for their own medical needs and as a means of controlling flows of information. The need for a clinical perspective Adam Hoare Managing Director at v-connect describes first-hand some of the barriers that have arisen in bringing a health care video solution to market, and the need to brand and convey the message of the solution effectively to healthcare providers, in order for them to make informed decisions on the effectivness and likely return on investment from commissioning video services. We have been deploying video to support care delivery for five years. In that time we have come to understand how to lower some of the barriers to adoption. The original decision to provide a service was developed out of our early experience. The service we have developed addresses barriers to adoption such as: 1. There is no one-size-fits-all approach. The video service we deploy underpins many different care services across primary, secondary and social care. Each engagement is unique and requires close collabora- 26 June 2014 tion with the customer to design and develop the network of connections. This leads into the second point. 2. In different deployments the user interfaces need to support different workflows. Implementing virtual waiting rooms, call transfers, mobile devices, touch sensitive triage panels and the set top box facilitate the use of video communication with different stakeholders. The ability to develop these interfaces and work with customers leads to the next point. 3. In order to have video underpin care delivery there needs to be a clear understanding of how the technology interacts with practice. This means working with practitioners to appreciate their needs. This bottom up approach is slower as we are working with very busy people. However, it is very necessary to understand how video can help without presenting another barrier to getting things done. These requirements cannot be met by a transactional, top-down approach where the technology and its implementation follow a template. Lowering the barriers takes time but all the evidence we are generating suggests that embedding the video in care produces health economic and quality benefits with many outcomes being emergent from the usage. These emergent behaviours often come when the network crosses traditional barriers or siloes. A further barrier to the adoption of video in care has been the idea that off-the-shelf or simple video approaches such as Skype can be used and that practice will assemble around them. We have worked on ensuring that our solution can cross secure networks such as N3 and that of Local Authorities so that the embedded video can enable these cross silo deployments. Many simple solutions cannot do this as they present a security threat to these networks. In fact we have developed our service approach to have minimum impact on internal IT systems so that deployment does not become an IT headache for care organisations. This serves to lower another barrier to adoption. The approach described is best navigated by a small enterprise that can be flexible in terms of technology development and collaborate with partners to develop the video in a way that underpins care delivery. Whilst developing this understanding we were very technology focussed in the way we initially discussed the service. We were lucky enough to deploy the service with Manorlands Hospice in Keighley. Here we met Steve Davison who was managing the hospice. He was impressed by what the video could do for the residents and has subsequently worked with us as a clinical consultant. With his background in nursing he was able to help us reshape the message to be about outcomes. We are currently launching our new brand for the service v-connect. When discussing the v-connect service we focus on three groups of stakeholders: »» Care – looks out outcomes related to connecting practitioners to people at home or in residential care. »» Companion – looks at outcomes related to connecting family members to people being cared for. »» Colleague – looks at the benefits to practitioners of being able to use the video to communicate between themselves. It is much easier to explain how care can become person-centred and better coordinated between care organisations using this new approach. We still have a lot to learn. Where we deploy the video it is disrupting current pathways and opening up new ways of delivering care effectively and efficiently. ‘v-connect’ will be presenting a number of papers at this years King’s Fund International Digital Health and Care Congress held in London in September that will give a flavour of how v-connect is impacting on care delivery and bringing new combined opportunities through interoperability. The topics that will be considered will include: The integration of cardiac monitoring with video to enable service transformation; promoting patient empowerment and sustainability in kidney care using telemedicine; and, technologies supporting integration and person-centred care. n