RDNS and Telehealth. LASA National Congress Mat Tyler Project Manager Telehealth, ehealth

Transcription

1 LASA National Congress 2014 Mat Tyler Project Manager Telehealth, ehealth

2 Today s presentation RDNS in perspective What have we been doing Telehealth Lessons What do we want to do

3 About RDNS Established 1885 in Melbourne NGO Royal District Nursing Service Community healthcare and support Full range of home nursing and support services Delivery of certified and customised education and training Full range of seniors living consultancy services Supported by own Research Institute Fully accredited by Australian Council on Healthcare Standards Wholly owned subsidiaries in New Zealand, Hong Kong and China

4 About RDNS

5 About RDNS AUSTRALIA Melbourne Sydney Brisbane Adelaide Hobart Perth Wollongong Townsville, Hobart, Davenport Port Macquarie NEW ZEALAND Auckland Dunedin Invercargill CHINA Nanjing

6 1. Health Workforce Project 2010 o Remote vital signs monitoring via TeleMedcare and Telephone 2. BEIP Medicines Management VC Project o Remote Medicines Management via Intel Health Guide (VC), supported by Healthe Tech, Care Innovations, Telstra, high speed broadband 3. Integrated Home Telehealth Project (Vic, Tas, NSW) o Remote Nurse care, GP and Care Team via Samsung tablet, supported by Tunstall (VC, vital signs) & Healthe Tech, Telstra, ipad, Tactio and cdmnet electronic care record. 3G/4G, ADSL2+, NBN FTTH, NBN Fixed wireless

7 Medicines Management Video Project (BEIP)

8 User perspective: Video medicines management... Average User (Client) Age: 77 Helped me to manage my medicines Helped me to live independently Was more convenient than home visits Made me feel more confident about taking medicines correctly Pre BEIP Survey How confident are you about using technology such as PCs? Post BEIP Survey I enjoyed using the videoconference unit? 80.7%

9 Conclusion (Australian Institute for Primary Care and Ageing BEIP Evaluation Report) (the) Project demonstrated that medication management by videoconferencing can be an acceptable and effective model of care for appropriate clients

10 The Project won the Outstanding ICT Innovation Award in the Asia Pacific Eldercare Innovation Awards 2013 in Singapore

11 Integrated Home Telehealth project

12 Integrated Home Telehealth project Department of Health (Clth.) $3.3.M funded Collaboration with Precedence Health Care and project partners o o Telstra, Healthe Tech/Tunstall, University of Melbourne, Monash University, Cisco, CSIRO 200+ clients in four (4) distinct cohorts Clients in Victoria, Tasmania and NSW Chronic disease management focus Integrated care team comprising GP, home nurse, virtual nurse and other care team members

13 Integrated Home Telehealth project Four client cohorts 1. Remote monitoring and video support utilising a fully featured solution moderated by RDNS nurse 2. Remote vital sign monitoring and video solution using a lighter solution moderated by RDNS nurse 3. Patient records own data on cdmnet reviewed by GP 4. CSIRO Smarter Safer Homes

14 Meet James

15 Participant profile (Group 1): 68% of participants were 66+ years of age 21% of participants suffered cognitive impairment or STML Chronic condition/illness (most common; diabetes affecting approx 1 in 3) Resided in Victoria, Tasmania or New South Wales Joined the study via RDNS and adv. campaign, GP / medicare local referral Access to NBN (42%), ADSL2+ or 3G/4G (58%) broadband connectivity Received mix of remote and in-home care

16 Project activity snapshot (all groups): Number of participants: n = 204 Number of service delivery days: 390 Number of services provided: 15,206

17 Type of services (all groups): Monitoring of: Blood pressure and pulse, blood glucose, weight, pulse oximetry, spirometry. Videoconferencing associated with care provision (re. monitoring vital signs) Videoconferencing for medicines management Access to cdmnet (electronic care record) Client: Education Planned in-home visits (as applicable) Socialization/phone call(s) Messaging/ Monitoring 15,000+ Services provided

18 Client Health Outcomes (all groups): Older people in the community showed interest in managing their health (participating) Receiving Telehealth outside of RDNS traditional service delivery footprint did not discourage participants Some participants experienced an improvement in their vital signs/wellbeing Other participants found their health conditions stabilized due to actively monitoring and managing their health conditions

19 Client Health Outcomes (all groups) cont... Better recording of vital signs and use of cdmnet led to GPs addressing health issues/lifestyle changes A number of acute conditions were identified In some cases a reduction in: health related anxiety, & social isolation Participants were highly satisfied with their care Service provided was seen as appropriate, safe and high quality.

20 Cost benefit analysis Project identified cost saving in terms of nurse visit time, nurse travel time and fleet costs Offsetting additional costs included on-boarding and support, connectivity costs, IT support costs and decommissioning costs The analysis has helped define a technology hurdle cost This will inform selection of longer term solutions Conclusion = a sustainable model of care

21 The Project s Telehealth Team were finalists in the 2014 HESTA Aged Care awards Team Innovation

22 Pilots have been valuable lessons Practice: Provided learning and experience Necessitated the development and refinement of clinical governance processes for Telehealth Provided insights into acceptance of Telehealth by clients and staff

23 Pilots have been valuable Lessons (cont d) Technology: Enhanced our understanding of Telehealth staff skills (service delivery & technology/troubleshooting) Appreciation of the pros and cons of using particular equipment and connectivity Tested our contact centre and technical capability Informed our thinking about the future sustainability of Telehealth Identified the support model required to effectively deploy Telehealth solutions as BAU

24 Embedding Telehealth successfully: There is NO silver bullet No one solution fits all KISS Preach to all stakeholders: technology is only an enabler Focus on clinical / health outcomes; the technology solution(s) become apparent Research, pilot/test/trial, persevere and stay the course!

25 Embedding Telehealth successfully For Telehealth to be successful; 2 key aspects: Must facilitate suitable health outcomes, & Must be cost effective.

26 Where to from here? Meeting the challenge... Telehealth as an enabler Embedded capability (within organisational Enterprise Architecture), not bolt-on Enhancing accessibility Creating a platform, not service silos

27 The then RDNS Nursing Staff, Melbourne. Almost 130 years in the business of providing home nursing care

28 RDNS Nursing Staff, circa St.Kilda Road Headquarters, Melbourne

29 ... and the now. Almost 130 years in the business of providing home nursing care

30 Mat Tyler M E mtyler@rdns.com.au