Providing remote treatment and advice, otherwise known as ‘telecoaching’, enables a patient to be treated without the need to attend a clinic often, or on occasions, at all. As such they offer significant benefit to a carer (and patient):
• Reduced need to contact/visit clinicians;
• Reduced need to travel/take significant time out of work;
• The opportunity to engage in more intensive rehabilitation, resulting in much-improved patient outcomes;
• Access to treatment not otherwise available (for example there are not enough therapists in the UK to provide the amount of treatment to enable all stroke victims to recover their speech and language abilities fully, whereas computers can do much of the ‘heavy lifting’).
There are similarities here with the benefits of telemedicine described earlier. Whilst it is important to recognise that there are two importantly different elements – the doctor online, and the delivery of machine-based care – there is a continuum between them.
Technology
Examples of remote advice include:
• The wealth of advice available on NHS Choices;
• Other online patient medical information services;
• Symptom checkers that identify common illnesses and conditions and suggest care plans for them
Examples of remote treatment include
• Stroke rehabilitation for example using computer-based SALT (speech and language therapy) routines (which are especially appropriate for technology delivery as computers can identify tiny improvements in speech) or using connected fitness equipment (so a therapist can run a physical movement class remotely, receiving signals for example from connected static bicycles of the state of each patient’s abilities;
• Behaviour change coaching, alluded to under vital signs monitoring ((1) above) whereby the controller delivers advice and guidance, either autonomously, or with greater or lesser human health coaching engagement, to secure a desired behaviour change;
• Worth a specific mention is mental health where many practitioners claim a better online cure rate than for face-to-face consultations8;
• Apps that train users no longer to be affected by physical symptoms such as severe pain;
• Electronic game playing which has been shown to be effective for treating a wide range of conditions including smoking cessation, depression and weight loss.
Examples of remote advice and treatment include:
• Online GP services which use a computer front end to triage patients and to provide advice and then can either complete the consultation electronically or transfer the patient to a doctor online; they can even dispense prescriptions.
Note that virtually all the above are accessible or downloadable on to a PC, tablet and/or mobile phone.
