Background
Mersey Care Trust serves a diverse population of more than 1.4 million, of whom 35% live in deprivation, across Cheshire and Merseyside. In 2011/12 Mersey Care rolled out a telehealth service to support the care of people with long-term physical health conditions. This service has supported around 40,000 patients, including 22,000 patients with Chronic Obstructive Pulmonary Disease, Heart Failure and Diabetes. The service is provided in patient’s homes, using a computer app called ‘Doc@home’ and devices that help to monitor health conditions. The aim is to help patients manage their conditions themselves and to prevent them needing to be admitted to hospital. Many health care systems are considering introducing telehealth services, and extending this to new groups of patients with, for example, mental health conditions. Before expanding the service, we need to know whether a telehealth service provides effective care that meets the needs of all patients.

Our approach
We will answer four important questions about the Mersey Care telehealth service:
• Question 1 – Does the service prevent unplanned hospital/doctor visits, and does this vary by social group and health condition?
• Question 2 – Do patients using the service report better quality of life, mental health and wellbeing and does this vary by social group and health condition?
• Question 3 – What makes it harder or easier for a hospital to use telehealth?
• Question 4 – Does telehealth save the NHS money?
We will use routine health and social care records, surveys, and telephone interviews (with patients and healthcare staff) to answer these questions. The survey will ask new telehealth patients how confident they are in using technology. We will explore whether attitudes to telehealth are changing over time and examine differences between groups (e.g. sex, age, ethnicity). We will look at the costs of telehealth and emergency services (with and without telehealth) and compare this to patients’ outcomes to understand the cost-effectiveness of the service. We will estimate the costs of the Mersey Care Telehealth service during our study, and the next ten years.

Involving patients and the public
Two public advisors act as equal team members alongside academic and clinical researchers. They attend project meetings and will co-produce plain language information including patient-facing research material. They will also advise on how best to recruit patients for interviews, contribute to the interpretation of findings and assess the health inequalities approach within the study.

Sharing our results
We will publish results and share them with Mersey Care boards and Integrated Care Board remote monitoring, clinical and digital groups. We will also share results using plain language summaries, and a workshop involving local and national stakeholders to inform future policy, practice and service development.

This project is funded by the NIHR’s Research for Patient Benefit Programme.