It will take investment together with changes in the NHS tariff and some smart commissioning of services. It will also take some strong and consistent leadership at local and national level coupled with a real sense of urgency and shared purpose. None of the above is trivial.

I agree with all your points, Jon. I'd develop these a little:

1. It's good news that DH have indicated they are working on a new "year of care" tariff - that will at least provide a currency for future commissioning of telehealth. But this is only a starting point.

2. With investment into central programmes seemingly a thing of the past (with exceptions like Dallas...), the key now lies with persuading commissioners of the business case for new telehealth-enabled services. The WSD results - and other relevant evidence - will need interpreting to help commissioners frame new services and decommission others. In particular, in diverting acute resources into community care.

3. While commissioning at the local level remains in flux, the National Commissioning Board will need to show leadership. What would really drive scale in the market would be some national commissioning of a specific telehealth service. Any ideas?

4. Clinical leadership will be essential. We need to turn enthusiasm at the national level through RCGPs and others into clear endorsement for local GPs to refer patients provided telehealth-enabled services meet key clinical standards. Care pathways incorporating telehealth would bene?t from design and accreditation at a national level.

5. The 3M Lives programme addresses both telehealth and telecare. Some of the user populations are the same and in time, elements may converge. Maybe telehealth can take advantage of some of the existing capabilities around the telecare value chain to help scale up? (eg triage / call centres, installation services, infrastructure).

6. In time, we might expect to see patients themselves driving the uptake of telehealth. Personal health budgets could be the vehicle.

Handbook of Ambient Assisted Living

Technology for Healthcare, Rehabilitation and Well-being

Volume 11 of Ambient Intelligence and Smart

Environments

Covering AAL in the health space; Devices and infrastructure to facilitate AAL; AAL in gerontology; Smart homes as a vehicle for

AAL; Applications of AAL in rehabilitation; AAL initiatives; and finally; and Novel developments and visions for the area.

Blatant plug, as I am editor of a section, but book overall describes what is going on here and elsewhere and may help us to get to the 3mill Lives (before I have to rely on the technologies extensively myself!)

www.iospress.nl www.booksonline.iospress.nl

Telehealth needs to be embedded in national cross-sector policy; GPs need an incentive (as they do for most things) to use the systems/services and there needs to be a local partnership through health and social care providers using dedicated staff and resources with the appropriate level of power (as in, 'do this' not 'please give this a shot') to action. You don't need a coinsultancy (correct spelling?) firm to redesign your pathways as the people that know them the best are the people that actually work within them. You can always find people that want to change the culture; that can see beyond the fire fighting of everyday work and are willing to push themselves to produce real change - not just stick something in as an add-on - a bit like throwing the grenade, turning away with fingers on your ears and hoping nothing comes back to hit you.

How does one embed anything MikeBurton? I agree the 'do this' stance is better than 'please give this a shot'. At the end of the day (?) there needs to be real need out there - that health consumers want the products/services. Maybe they're not aware of them though? (Nice photo by the way) Jean Roberts is obviously very up on all of this but I must say I though Ambient Assisted Living was a concept album by Brian Eno.

i think its all about learning to filter information. data repositeries are proliferating at what seems to be an exponential rate

I find this amazing. £10k gets you in the 'club' of industry suppliers for 3ML - NHS will spend £750million (based on recent overspends this could be far more 5 years down the line) implementing technology for 3ML.

It appears to be a lottery style cost and payout with no fails for suppliers. NHS buys kit; suppliers get paid; NHS deploys kit - or tries to; suppliers still get paid; kit is still in cupboards nationwide - suppliers still get paid. I thnk it is excellent that we are able to look at doing this but I fear it will be industry led just like 6 years ago - but now with ten times the dividend for companies.

I think we should get engaged FIRST before the costly divorce.