1. www.docobo.co.uk Sept 2006 TeleHealth in practice - the doc@HOME servicedoc@HOME Adrian Flowerday Managing Director Docobo Ltd

2. www.docobo.co.uk Sept 2006 TeleHealth - what? “the use of eHealth technologies to enable the monitoring and management of patients in their own homes” enabling: –management of long term chronic conditions –early discharge –better quality pre and post operative care –etc - limited by imagination

3. www.docobo.co.uk Sept 2006 Rationale for TeleHealth The increasing burden of chronic disease –17.5m in UK; > 3 billion in RoW; 6 in 10 UK adults –Currently >70% of healthcare spending The need for better chronic disease management –Better management requires better monitoring The reducing clinician resource The drive to get people out of hospital Increasing consumer demand and expectation for better healthcare

4. www.docobo.co.uk Sept 2006 doc@HOME Infrastructure System for clinically monitoring and interacting with chronic disease patients based at home. Key Design goals: available to a wide population of patients and chronic diseases; the encouragement of self-care; automated alerts for negative trends high healthcare provider productivity; low-cost, medical device directive compliant operation.

5. www.docobo.co.uk Sept 2006 Main Morning Screen

6. www.docobo.co.uk Sept 2006 4 week feedback display

7. www.docobo.co.uk Sept 2006 TeleHealth - does it work? In the USA –> 60% reduction in admissions for COPD (SHP) In the EU –Newham - 48% reduction on admissions –Lisbon - 16% reduction in symptoms, 21% reduced demand Challenging pre-conceptions –Hypertension - 47 consecutive readings needed to be 80% sure of 5mm change –People use it!

8. www.docobo.co.uk Sept 2006 To Date - lessons Used in Barnsley, Southampton, Surrey, Brent, Hull, Nuneaton –3 Acute, 2 PCT, 1 both - opportunities Question sets Training - courses needed Patient recruitment –Clinician time –Patient response - the way it is presented is crucial –Installation Workflow issues - new ways of working –Telehealth leads –Response path –Medicarer’s

9. www.docobo.co.uk Sept 2006 Some thoughts on costs Never truly count the cost - see as burden reduction –One typical admission in North Surrey costs £15K –reduce just one admission - pays for 20 people –reduce 10 admissions - pays for 200 patients Then consider socio-economic and environmental savings

10. www.docobo.co.uk Sept 2006 © Docobo (UK) Ltd 2005 Future Architecture ideas Regionalised response and false alarm confirmation Co-ordinated, localised care delivery Increased contact with carer and relatives

11. www.docobo.co.uk Sept 2006 Thank You !

12. www.docobo.co.uk Sept 2006 The clinicians view

13. www.docobo.co.uk Sept 2006 Chronic Disease Management Ideal situation –Everyone monitored, all of the time, to track trends and highlight problems Current Situation –Rarely monitored unless broken Inadequate treatment The misery of complications abounds –Chronic disease on increase –No time or resources