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