Telehealth - Future Directions in Cardiovascular Care

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Abstract

Abstract
Over recent years, telehealth has increasingly demonstrated its value in supporting the delivery of cardiovascular healthcare. From teletriage services as a portal into healthcare through to telemonitoring of heart failure patients, technology is already increasing the ability of practitioners to provide care remotely, empower patients and improve clinical outcomes. In the future, telehealth services have the potential to have an even greater impact on the provision of cardiovascular care. Embedding telehealth services into mainstream cardiac care, the development of more sophisticated devices and the utilisation of technology in a wider range of clinical contexts will help to accelerate the adoption of telehealth throughout healthcare. This article evaluates the current state of the art in telehealth provision and explores some of the areas for future development in this fast-moving and exciting area of clinical practice.

Keywords
Telehealth, telemedicine, technology, remote monitoring, telemonitoring, telestroke, teletriage

Disclosure: John GF Cleland has received research support from Philips Healthcare and Corventis. David Barrett has no conflicts of interest to declare.
Received: 10 May 2010 Accepted: 16 August 2010 Citation: European Cardiology, 2010;6(3):30├óÔé¼ÔÇ£2
Correspondence: David Barrett, Lecturer in Telehealth, Faculty of Health and Social Care, University of Hull, Cottingham Road, Hull, HU6 7RX, UK. E: d.i.barrett@hull.ac.uk

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Health services in the developed world are faced with unprecedented challenges over the coming years. The ageing population and increased prevalence of long-term conditions have been factors for some time, but the pressure on resources has been exacerbated by the economic turmoil of recent years.

Increasing healthcare costs and expectations, coupled with the growing need for restraint in healthcare spending ├óÔé¼ÔÇ£ particularly in publicly funded systems such as the National Health Service (NHS) in the UK ├óÔé¼ÔÇ£ have led to increased emphasis on providing ├óÔé¼´åİbetter for less™. This quest for efficiency is particularly apparent in cardiovascular care, where enhanced management is paradoxically increasing the prevalence of patients with long-term cardiac conditions.

Technology provides just one solution to the problems faced by healthcare providers in the future. In particular, innovations such as telehealth and telecare give practitioners the opportunity to provide enhanced care with the same ├óÔé¼ÔÇ£ or fewer ├óÔé¼ÔÇ£ resources. These technologies may also enable patients to become much more active participants in the provision of healthcare. Indeed, innovative and well-planned deployment of technology may be the only method of delivering personalised, affordable, high-quality healthcare in the future. This article provides an overview of the current status of telehealth in cardiovascular care, and offers some possibilities for the next steps to be taken in this exciting and innovative area of practice.

Current Models of Telehealth Utilisation In Cardiac Care
Before exploring the current status of telehealth, it is important to clarify the nomenclature. Terms such as telemedicine, telehealth, telemonitoring and telecare are often used interchangeably, leading to some confusion. For the purposes of this article, telehealth will be used to describe any use of technology to remotely promote wellbeing, assess health status or manage disease. Under this umbrella term, a number of more specific applications exist. Telemedicine utilises two-way video consultation technology to allow remote discussion between practitioners and patients or between collaborating practitioners. Telemedicine can also be used to describe the transmission of healthcare data such as radiological investigations or 12-lead electrocardiograms (ECGs). Telemonitoring is the use of technology to remotely monitor vital signs or symptoms, and teletriage is the remote assessment and prioritisation of patient needs using technology. Other terms such as tele- or cyber-therapy will be required as telehealth technologies evolve from relatively passive systems to become methods for actually delivering healthcare interventions.

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