The TQG has been active in numerous events, a sample of which is given below. These are in addition to the organisation’s ongoing work for the European Commission through the PROGRESSIVE Project on ‘Standards for ICT and Active and Healthy Ageing’ (see www.progressivestandards.org) and for the Pobal, Irish Government agency (see www.pobal.ie). Notable also is the work that TQG has undertaken and continues to undertake in promoting new visions and approaches for telehealth – including those embedded within the International Code of Practice for Telehealth Services (downloadable from this website). A feature on this website points to the consumer perspective taken by the International Code, key elements of which are ‘captured’ in the pointers to strengthened content in three areas (for the 2018/19 Edition) viz.

The Push for Interoperability:

“Greater interoperability means greater choice.”

Openness for Performance Measures:

“Openness with performance measures means greater accountability.”

More Attention to Cybersecurity:

“More attention to cybersecurity means the greater trust.”    

The TQG has worked (and continues to work) with or present to organisations such as NHS Shared Business Services; the Scottish Local Government Digital Office; and CEN, the European standards body. There is an ongoing dialogue with Standards Australia and TQG Directors have presented, with a focus on standards, at key events from Sydney and Brisbane to Bristol and Brussels.


The TQG partnered with Standards Norway in Oslo for a 2017 workshop to examine the challenges to standards arising from ongoing changes in technologies and the ways that people access telecare and telehealth services. Presentations include Lars Dahle, CEO of Dignio, a leading Norwegian service provider and TQG member. See http://www.standard.no/kurs-og-arrangementer/arrangement-standard-norge-og-nek/standard-morgen1/standards-morning-telecare-and-telehealth/


TQG was a key partner and had a stand at Medetel 2017 in Luxembourg. Frederic Lievens was focal to the event’s organisation. The TQG ran a session on ‘User Perspectives and Awareness’. Dr Malcolm Fisk explored standards for telehealth and featured the TQG International Code. Other presentations included Robert and Donna Floyd (Crag Business Group) addressing the perspectives of health professionals. See  https://www.medetel.eu/?rub=educational_program&page=program


In Ashton-under-Lyne (November 2016) the TQG partnered with Contour Homes and UK Telehealthcare for a ‘North-West’ Telecare Forum. Presentations by Dr Kevin Doughty and Dr Malcolm Fisk respectively set out the technological changes that are impacting on telecare services; and the way that the TQG International Code of Practice for Telehealth Services enabled such change to be accommodated.


In Manchester (June 2016) the TQG held its first major conference on ‘New Routes to Integrated Care: The Challenge of Assistive Technologies, Telehealth and Telecare’. Over 100 participants were treated to challenging presentations relating to innovative developments and practice initiatives in different parts of the UK (notably Scotland) and Canada! Details and slides are available on this website. See http://www.telehealth.global/events/431/


In Luxembourg (April 2016) the TQG were key exhibitors and participants at Medetel. Frederic Lievens was key to the event’s organisation. Dr Drago Rudel and Dr Malcolm Fisk respectively explored an intervention for people with chronic heart failure and set out some of the emerging evidence base supporting telehealth. Other presentations, workshops and panel discussions related to a fully international perspective stretching from Brazil to Bratislava! See    https://www.medetel.eu/?rub=knowledge_resources&page=evidence




The 2017 version of the TQG’s acclaimed International Code of Practice for Telehealth Services has been released. It continues to set the pace for flexible and innovative service standards.

Since its conception as a European Code in 2014, the International Code has set out to help transform digital health and care services – so that they are more and more responsive to service users … whether the user is a 26 year old self-managing her diabetes or an 86 year old being supported with his dementia.

The International Code has rejected any rigid ‘this is how you must do it’ approach. Instead it has recognised from the ‘get go’ that service users must be empowered and even liberated by the technologies that they use. They must not be thought of or treated as the victims of narrow ‘old style’ health and care regimes.

The context is clear. The emergence of telehealth, assisted by the array of technologies that are increasingly accessible to all, is an opportunity to transform the way we think about our health and wellbeing. It is no longer so much about health ‘interventions’ – but it is about how people access services to help them maintain appropriate lifestyles and manage any health conditions. Telehealth services … from telecare to mHealth must see themselves, therefore, within a new landscape. The International Code of Practice for Telehealth Services points the way.


Some Telehealth Service Domains

Health and motivational coaching and advice

Activity and lifestyle monitoring

Safeguarding and monitoring in care settings

Gait, seizure and falls prediction / management

Vital signs monitoring

Telecare and social alarms (PRS)

Mobile health technology systems (e.g. apps)

Medication or therapy adherence

Rehabilitation and (re)ablement

Tele-consultation and virtual presence

Key facets of the International Code include:

Incorporation of ISO/TS 13131 Health Informatics – Quality Planning Guidelines for Telehealth Services

Download a copy from this website and consider what it means for you … whether a

  • Strategist or Planner

Build the International Code into your planning.

  • Commissioner or Procurer

Make the International Code a requirement when procuring services.

  • Service Provider

The International Code is your benchmark. Become certified to it.

  • User

Expect your service to know about and use the International Code.






The Telehealth Quality Group (TQG) is one of the ten partners funded by the European Commission to undertake research into standards and standardisation around ICT for Active and Healthy Ageing. The project lasts until September 2018. It is led by De Montfort University (Leicester). It links the TQG with other high-profile European and international partners. The partner list is set out below.

The PROGRESSIVE project will set in place a ‘dynamic and sustainable framework where the contribution of standards and standardisation for ICT can be maximised for Active and Healthy Ageing (AHA).’ The TQG role includes ensuring that the project maintains a strong ethical foundation that will determine how good practice in standards and the standardisation process is recognised. Needless to say the TQG role will also include strong inputs around telehealth (and telecare) as well as contributing to ‘deliverables’ around smart homes, age-friendly designs and interoperability.

The ICT issues for telehealth are, of course, highly visible. We have, for instance, many opportunities and some challenges that arise from new technologies and the increasing capacity of communications media. The ‘Active and Healthy’ ageing agenda is, however, less well considered. It is, nevertheless, highly important to telehealth services because it helps us to turn away from what can be over-clinically driven approaches (focused on one-way service ‘delivery’ for dependent older people) towards approaches concerned with wider well-being and service ‘provision’ (focused on engaging with and empowering older people). The latter approaches, it is considered, can often meet, in more flexible ways, the needs and choices of service users. They can also help build levels of knowledge, skills and capacities so that older people are better able to make choices about their lifestyles (in work or retirement) and to self-manage in relation to any health conditions. The project will, in fact, be considering how older people can be engaged in the standardisation process so that their voice is reflected in the content of standards that are intended to benefit them. Exciting and important developments in standards and the standardisation process are, therefore, envisaged!

The partner list is as follows. More detail will be available in the New Year on the project website.

  • De Montfort University (UK, Lead Partner)
  • The Open University (UK)
  • Telehealth Quality Group (UK)
  • Age Platform Europe
  • EHTEL (the European Health Telematics Association)
  • Consiglio Nazionale delle Ricerche (Italy)
  • Stichting Nederlands Normalisatie – Instituut, NEN (Netherlands)
  • Deutsches Institut fuer Normung E.V, DIN (Germany)
  • Associazione di Normazione Informatica, UNINFO (Italy) and
  • Asociacion Española de Normalizacion y Certificacion, AENOR (Spain)

The project carries the support from, amongst others,

  • European Committee for Standardisation, CEN
  • European Consumer Voice in Standardisation, ANEC
  • British Standards Institute, BSI (UK)
  • International Society for Telemedicine and eHealth, ISfTeH
  • UC Leuven Limburg (BE)
  • CRETECS Centre of Expertise in Care Technology (BE) and
  • European Association of Service Providers for People with Disabilities, EASPD





The Telehealth Quality Group has been commissioned to undertake a review of the ‘Operation and Delivery Model’ of the Seniors Alert Scheme that operates throughout the Republic of Ireland utilising community support as a model for identification of those in need.

Pobal (www.pobal.ie), the commissioning agency, acts as an intermediary for Irish Government and the European Commission programmes. It works closely with different stakeholders – with a focus on improving outcomes, especially for people who experience disadvantage or social exclusion.

The Seniors Alert Scheme has operated in the Republic of Ireland for 20 years. Social alarm services in the country date back to the early 1980s. The scheme has an interesting genesis concerned not just with the way that older people obtain help but also with fostering neighbourliness and community support. This is achieved through the involvement of neighbourhood watch groups and other local organisations.

With the wider range of technologies now available, the review is well-timed. Consultations are taking place with key stakeholders during September and October 2016. Those interested in expressing their views or making suggestions about the scheme are invited to get in touch.

The TQG work on this important review is being undertaken by Dr Malcolm Fisk (malcolm.fisk@dmu.ac.uk) and Dr Kevin Doughty (dr.k.doughty@btinternet.com ) . The review’s recommendations will be provided to the Department of Housing, Planning, Community and Local Government later in 2016.







The Foreword aptly describes this volume as an ‘immensely practical book cum workbook’. It fulfils this role well – in a context of rapid technological change where the imperatives that drive moves towards more integrated service frameworks in the UK are clearly recognised.

Half the book comprises chapters on topics from telecare and telehealth to apps and social media. The other chapters address such matters as the challenges of overcoming barriers to change, improving uptake and undertaking service evaluations. Overall, therefore, as well as providing a practical guide (for professionals or practitioners) the book offers an ‘eye-opener’ on current developments for a wider readership. But be warned that, as perhaps befits a book that arrives at a time of rapid change, there remain some questions that could have justified a wider airing – the most notable of which relates to the way in which health and personal data can and will be safeguarded in our new world of ‘digital healthcare’.

Arguably the first and clearest ‘positive’ is the book’s exposition of the merits of different telehealth initiatives. Most notably these relate to apps and the laudable contribution that ‘Flo’ is making within an increasing number of UK telehealth and telecare services. Flo is the telehealth text messaging service that gives support to and helps people to take a fuller role in the management of their long-term conditions. There are several pointers in the book to the benefits of Flo in terms of individual well-being and cost savings to the NHS. The implied message is that, in the context of change for our health service frameworks, we overlook the potential of such technologies at our peril!

A second positive relates to the adoption, by the book, of a people (or patient)-driven, rather than technology-driven, perspective. This recognises the imperative for us all, regardless of our age, around the responsibility we must take to be better, and more informed, partners in our health. It is pleasing to note, in this context, the nod to the Telehealth Quality Group’s ‘International Code of Practice for Telehealth Services’ as a reference point and a benchmark for the telehealth services with which the book is concerned.

A further positive is the book’s inclusion of or pointers to and inclusion of a substantial range of resources (practice examples, case studies and the ‘dos and don’ts’ of digital health). The message is that there is ample information ‘out there’ about the benefits of different kinds of telehealth (and telecare related) interventions and that we must re-double our efforts to overcome the barriers that thwart or constrain service changes and developments.

It is of some disappointment (but not detracting from the positives noted above) that the book doesn’t take a clear position on the overlapping definitions around telehealth, eHealth, telecare and digital health. Rather, it chooses to use the term TECS (Technology Enabled Care Services) as a ‘catch-all’ – that maybe should have been in the title.

Overall, therefore, a practical and worthwhile book that is very relevant to the world of TECS in England, offers lessons for a wider readership, and will help in setting the direction of telehealth and related services.

Dr Malcolm J Fisk – August 2016

Manchester, UK June 21st 2016


One of the biggest challenges for our services. The first major UK conference of the Telehealth Quality Group tackled the issue of integrated care. Over 100 people participated in this successful event – including strategists, commissioners, service providers, and manufacturers, carer and user focused organisations. The exhibitors featured and many of the presentations are available through following the links below.

Exhibitor list

Programme and Presentations