Session 3: Optimising ehealth: Strategy, Technology, Mangement
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1 Session 3: Optimising ehealth: Strategy, Technology, Mangement Telemedicine John Wilson Alfred Hospital & Monash University, Melbourne Australia
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5 Telemedicine in Aged Care
6 Age of disability
7 Disability Disadvantage Physical incapacity Distance Psycho-social (volitional) limitation Socio-economic compromise
8 Stakeholders Community Healthcare workers Vendors Health Insurers Medical Insurers Institutions Government
9 Perceived benefits of ehealth implementations to healthcare workers and patients Hannah Ambrose Maxine Braithwaite John Wilson Alfred Hospital & Monash University, Melbourne Australia Ambrose et al, Telecom J Aust 2011;61:43
10 Results: Top 5 Perceived Barriers to Implementation: Staff Barriers Staff (n=137) (Mean ± SD) Patients (n=130) (Mean ± SD) p Value Lack of funding 5.76 ± ± 2.60 <0.01 Slow or inadequate internet access The age of the computer or hardware Lack of training/personal support 5.53 ± ± ± ± ± ± 2.63 <0.01 Time required to learn how to use the technology 4.61 ± ± 3.00 <0.01
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13 Telemedicine Video-conferencing Home environment assessment Home monitoring Multi-disciplinary team meetings Skill enhancement / medical assisting Store and forward image analysis
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15 ewing Early discharge Chronic disease monitoring Triage / RVA ED Critical Care Palliative Care Psychiatry Dermatology
16 CP review potential telemedicine
17 CP review potential telemedicine Actual 112 claims 2011 NSW VIC QLD SA WA TAS ACT NT ,
18 Optimizing telemedicine use Vision for the future Reliable product Community demand Pathway to achieve Sustainable operating frame Performance indicators for success Responsible governance & review
19 Monash Alliance Solution Convergent technologies Clinician-led Cost-effective Low-risk Public / Private Hospitals/ Medicare Locals / GPs
20 Monash Alliance concept Pilot To-Be State Alfred (CF) Peninsula (Cancer) MMC (Renal) Cross discipline Skill and datasharing CF Diab Renal Epworth Monash Alliance BHH Monash Alliance (Renal) (Sleep) Renal Sleep Primary Care Cabrini (Cancer) Cancer
21 Patient centric, not patient dependent Current State To-Be State Data Data Physio Data Physio Data GP Psychol GP Psychol Data Data ED Data Data Rehab Xray ED Xray Data Surgery Data Data Data Pharmacy Surgery Data
22 fev1pp_us Convergent technologies EHR Telemedicine Home monitoring FEV1 %Predicted, Males years Australian Cystic Fibrosis Data Registry Annotations below: * less than 90% reported 10 WES MMC RAH* JHA* ALF* SCG PCH MAH TAA GCA Major adult excludes outside values excludes outside values Risk management Clinical KPIs
23 Rollout & Knowledge Transfer Pilot To-Be State Monash Alliance Pen MMC BHH Cab Epw Alfred Viral growth Monash Alliance Peninsula (Cancer) MMC (Renal) BHH (Sleep) Cabrini (Cancer) Epworth (Renal) Alfred (CF) Cancer Renal Renal CF Sleep Renal CF Sleep Cancer Diab Sleep Renal Cancer Diab CF Renal Cancer Diab CF Sleep Renal Cancer Diab CF Sleep Diab CF Sleep Cancer Diab Monash Alliance Peninsula (Cancer) MMC (Renal) BHH (Sleep) Cabrini (Cancer) Primary Care Epworth (Renal) Alfred (CF)
24 Implementation plan Proof of concept best possible product Targeted project studies use population Identify minimum requirements for success (drivers and barriers) Generate competition all sectors Foster opinion leaders national / international Promote early wins Audit performance
25 Summary Telemedicine has potential to improve care Covergent technology will magnify gains Professionals see few barriers Advantages come with low risk Integrated solution via collaboration
26 Thank You! John Wilson, Head, Cystic Fibrosis Service Alfred Hospital & Monash University, Melbourne
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28 Optimizing the system - Biotech Vision for the future...biotech industry Identifiable product...vaccine, antibiotics, insulin Community demand...healthcare needs, CHF Pathway to achieve...concept, research, trials, market Sustainable operating frame...professional standards, PBAC Performance indicators...clinical trials, ADRAC Governance & review...nhmrc, ARC, Medicines Aust,
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