Making Connections: A transatlantic exchange to support the adoption of digital health between the US VHA and England’s NHS

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John Cruickshank, Joanne Harding, Jon Paxman & Charlotte Morris

With forewords by Dr Robert Petzel, Dr Adam Darkins, Miles Ayling & Stephen Johnson

In January 2012 2020health published a short report ‘Telehealth: What can the NHS learn from experience at the US Veterans Health Administration?’ which looked at what the NHS could learn from the largest implementation of telehealth anywhere in the world. Our research found that telehealth represents a vital element in the shift towards more home-based care and benefits patients with long term conditions as it enables the coordination of care services.

A year later in England, we are at a crossroads in the delivery of healthcare. New technologies mean that we have the potential to deliver complex care in patients’ homes, which the rising number of those living longer, with long term conditions requires. At the same time, the current economic climate means there is virtually no budget growth. It is important that action to remodel health services in England is taken soon, before the quality of care is jeopardized and funds are wasted through current inefficient and inadequate services.

This second report builds on the first, adding much greater depth to our findings and recommendations. It not only reflects on the impressive use of technology currently provided by the VHA, but also draws on the innovative progress that has been made in the NHS through their experience of telehealth. We draw lessons learnt from both sides of the Atlantic and make recommendations for both organisations.

This report was funded by an unrestricted educational grant from NHS 3millionlives and Robert Bosch, which gave us the freedom to draw our own conclusions. We are indebted to all our sponsors.

“The report was a work of art. I really appreciate the quality and thorough presentation of the facts”

M. Ileana Welte, Divisional Director – UK Region, Robert Bosch Healthcare

The aim of the research:

Developing the findings of our 2012 Telehealth report, this research in partnership with the UK Department of Health and the US Department of Veteran’s Affairs (VA) reflects in depth on the use of technology in the US by the VA’s Health Administration and the telehealth developments being made here in the UK by the NHS.


  • Publication was launched at the 2013 Innovation Expo and is the ‘text book’ for the Leadership Exchange Programme being facilitated by 2020health in partnership with NHS England and the VA.
  • 50 clinicians, NHS England staff and Local Authority directors have visited the VA and work on implementation in the NHS is underway.
  • Programme being supported by NHS England Directors Dr Robert Harris and Dr Martin McShane (Domain 2 Lead).
  • John Cruickshank, Consultant Director, 2020health and co-author of the report says: “Whilst successful use of technology has been a key enabler to success in making digital health the first route for delivering a service, it is the underlying culture, leadership, processes and training that have been paramount to the VHA’s success.”

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