The Future of Telehealth in NZ. Craig Lett Head of Innovation Triton Hearing

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1 The Future of Telehealth in NZ Craig Lett Head of Innovation Triton Hearing

2 Overview Background Why consider telehealth? Population trends Benefits of telehealth Case study 1: TeleAudiology Case study 2: Mobile TeleAudiology

3 Triton Hearing TeleAudiology Launched our TeleAudiology initiative in tiers mhealth (ipad and online hearing screening) Clinic-based TeleAudiology Mobile TeleAudiology

4 160 ipad Screening Kiosks around New Zealand 1 in Niue Foou Hospital

5 2 hub sites with 4 control rooms - Auckland - Christchurch 10 remote sites and 1 mobile clinic - Cambridge - Tauranga - Whakatane - New Plymouth - Johnsonville - Timaru - Dunedin - Queenstown - Gore - Invercargill

6 39180 ipad SCREENING TESTS 612 REMOTE CONSULTATIONS 553 HOURS TELEAUDIOLOGY 3902 MOBILE KILOMETERS TRAVELLED 421 TELEAUDIOLOGY CLIENTS 113 REMOTELY-FIT HEARING AIDS 6 MARAE VISITED 275 REMOTE HEARING TESTS

7 Patients Local Community MAKING CONNECTIONS Health Care Providers Technology Health Decisions

8 Percentage increase from now Trends in Ageing Population 140% Population change by age group 120% 100% 80% 60% Under and older Significant increase in 65 and older population group 40% 20% 0% next 10 years next 20 years next 40 years Source: (2018)

9 Trends in Ageing Population Approximately 1 in 3 people over the age of 65 will fall in any one year. Source: healthnavigator.org.nz Older drivers with a history of falling are 40% more likely to be involved in a crash than their peers. Source: NHTSA General Estimates Systems (GES)

10 Difference from Adult Drivers (%) Trends in Ageing Population Comparison of Older and Younger Drivers in Terms of Risk, Frequency on the Road, and Fragility Younger drivers Significantly higher risk of fatality on the road in older population group 200 Older drivers Riskiness Relative frequency on the road Relative probability of fatal injury Source: Loughran, D.S., Seabury, S.A., Zakaras, L. (2007) What risks do older drivers posse to traffic safety?. Santa Monica CA: RAND Corporation.

11 Source: GOBankingRates.com 28% of People Over 55 Have No Retirement Savings

12 The global impact of dementia Around the world, there will be 9.9 million new cases of dementia in 2015, one every 3 seconds US$ 818 BILLION 2015 US$ 1 TRILLION 2018 The total estimated worldwide cost of dementia in 2015 is US$818 billion. By 2018, dementia will become a trillion dollar disease, rising to US$ 2 trillion by million people worldwide are living with dementia in This number will almost double every 20 years million 74.7 million million If global dementia care were a country, it would be the 18th largest economy in the world, exceeding the market values of companies such as Apple and Google Apple $742 billion Google $368 billion Dementia $818 billion Source: The World Alzheimer Report 2015

13 Trends in Ageing Population Modifiable Risk Factors of Dementia 35% of Dementia is Preventable 1. Hearing Loss 9% 2. Less education 7% 3. Smoking 5% 4. Depression 4% 5. Physical inactivity 3% 6. Hypertension 2% 7. Social isolation 2% 8. Obesity 1% 9. Diabetes 1% Source: Lancet Commission Report, 2017

14 Trends in Ageing Population Hearing Loss is independently associated dementia, with risk associated with degree of loss 2x 3x Mild hearing loss Moderate hearing loss 5x Severe hearing loss Source: Lin et al (2011)

15 Trends for Consumers The way we access products and services is changing Convenience access through conversational interfaces E-commerce Click-and-collect Empowerment of the end-user

16 Why consider Telehealth? What are the healthcare challenges the world is facing? Access Cost-effectiveness Equity Quality How can we keep healthcare costs down when we have a growing older population who are increasingly less mobile? Source: WHO, 2010

17 Benefits of Telehealth Improved Access to Care Cost Efficiencies Improved quality of care Patient demand Increase Reach and Operational Efficiencies

18 CASE STUDY 1: TELEAUDIOLOGY

19 The Problem Globally, 97% of people have no access to hearing healthcare Increased individual recognition of hearing healthcare Ageing populations Shortage of clinicians, challenges of geography

20 Trends in Audiology What s Happening to all of the Audiologists? Significant growth of the older patient population will see rapidly increasing demands for audiology services. In 25 years, the number of Audiologists will have needed to rise by 50% in addition to lowering the attrition rate to 20% (currently at 40%) Source: Windmill, I & Freeman, B. Demand for audiology services: 30-year projections and impact on academic programs. Journal of the American Academy of Audiology, 24:5, 1 May 2013, pp (10)

21 Hearing Loss in NZ: the numbers 1 in 6 3 in 5 $4.9b $5556 1/3 NZers are affected by hearing loss. People over the age of 60 are affected by hearing loss. The amount hearing loss costs NZ annually. The annual financial & well-being costs for a person with hearing loss. Of all people acquire hearing loss through preventable means. Source: ListenHear! Social and Economic Costs of Hearing Loss in New Zealand (2017)

22 CMS Patient Audiology Equipment Computer MNZAS Audiologist TA Clinical Assistant Teleconferencing System Teleconferencing System Host Site Remote Site

23 Launch of TeleAudiology in NZ

24 Current Services ipad and online screening Puretone audiometry Hearing screenings Hearing aid fittings Hearing aid follow ups Immittance testing Speech testing Speech in noise testing Video otoscopy Hearing needs assessments Counselling Tinnitus counselling

25 Future Services In-home hearing aid adjustments Cochlear Implant adjustments Paediatric testing TeleTherapy services Vestibular consultations Increased services to under-served communities Consultation services to other healthcare providers Provision of network to other healthcare providers

26 CASE STUDY 2: MOBILE TELEAUDIOLOGY

27 Mobile TeleAudiology Need to deliver hearing care to under-served communities Equipment and sound-environment constraints Client-friendly experience

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29 Te Waka Awhina

30 Thank you. Craig Lett