Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Telehealth in New BrunswickThe 5WH’s

by Valerie Hagerman

Senior Business Systems AnalystDepartment of Health and Community

ServicesProvince of New Brunswick

September 30, 1999

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Objectives

This presentation will:

Introduce Telehealth as one component of NB’s Health Infostructure

Explain New Brunswick’s approach to telehealth planning and implementation.

Summarize what has been accomplished

Discuss what is left to do

And , if time permits, introduce you to the Canadian Society of Telehealth.

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Consumer Information/

Empowerment

Electronic Patient Record Information

Management

TelehealthDisease

Monitoring/ Surveillance

Privacy

Program Management/Monitoring

Telehealth: A Key Component of the New Brunswick Health Infostructure

Standards/Interoperability

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Eliminate redundancies Eliminate redundancies Shorten the time to do the work Shorten the time to do the work Improve healthcare quality and Improve healthcare quality and outcomes outcomes Improve productivity and effectiveness Improve productivity and effectiveness Improve communications Improve communications Contain/reduce costs Contain/reduce costs Increase accessibility to health Increase accessibility to health services services Facilitate easier administration Facilitate easier administration managementmanagement of program areas of program areas

The success of NB Health Infostructure (and its different components) will be measured by the extent they can:

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Shifting from the Physical Movement of Shifting from the Physical Movement of Patients and/or Providers to the Virtual Patients and/or Providers to the Virtual

Movement of Information.Movement of Information.

PhysicalPhysical

VirtualVirtual

PatientPatient ProviderProvider

In a nut-shell telehealth is:

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Administrative/Management

Patient Information/

Education

Clinical

•Tele-monitoring of vital signs•Telephone triage•Compliance Monitoring•Remote diagnosis•Remote treatment

• Electronic case management• Electronic records database• Remote access to records• Care integration/coordination

• Self-care• Health promotion• Disease prevention• Disease management• Caregiver education

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Provincial Telehealth Provincial Telehealth Planning Cycle Planning Cycle

StartStart

Vision,Goals,Vision,Goals,PrinciplesPrinciples

Strategic Strategic ObjectivesObjectives

OutcomeOutcome((PerformancePerformance)) MeasuresMeasures

StrategicStrategic PrioritiesPriorities

ImplementatioImplementationn

PerformancePerformance FeedbackFeedback

Plan ToPlan To PlanPlan

External External NeedsNeeds AssessmentAssessment

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

DHCS / RHC’s• Shared vision• Definition• Goals/ priorities• Success Indicators

PTCC RHC’sHCIT• Telehealth Champions• Education• Networking• Communication• Barriers• Links to EDT/• Business• New funding opportunities

• Application • development• Research/• evaluation• Strategic partnerships

• IT/IS solutions group• Provincial strategic information and IT plan• Interoperability/ integration

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Telecare Telephone triage

Expert decision support software

Poison Control

Private-public partnership (DHCS-Clinidata)

Export /economic opportunities

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Tele-nephrology -Region 1 Beauséjour

Remote monitoring of patients undergoing renal dialysis: 4 unique settings

Distance Education: Diabetes Education and Prevention

Telematics: Wireless Point of Care EPR Integrated With Meditech Record

PACS and Data Repository

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

•A scalable solution was required to improve the reach and efficiency of New Brunswick’s centre of excellence for cardiac care

•A provincial infrastructure was created using a range of network platforms that improved access to and utilization of scarce specialized services

•Hospital network for remote patient referrals,assessments and post op monitoring direct to patients’ homes

Building the virtual hospital

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Remote cardiac triage management

Remote cardiac catheterization assessment

Post cardiac surgery assessment

Remote home monitoring

Tele-cardiology

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Tele-radiology Mixture of

technologies/locations -point to point

Integration/Standardization: Sterling (Agpha)Direct Radiography-Regions 1,2,3,7.

Discussions for province-wide emergency room linkages.

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Tele-rehabilitation

Access to specialized physiatry and OT/speech/physiotherapy services-(Regions 3, 6, 1SE)

Remote monitoring/assessment/education over secure Internet connections-Assistive Devices-(Region 3)

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Tele-psychiatry

New project in Region 2[Off the ground fast-most of therequired infrastructure in place.]

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Distance Education

Multi-point video-conferencing (35+units)

Virtual Campus and Tele-education

CBT: Community access centers

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Partnerships with Nova Scotia

• Pediatrics:Maritime Telehealth Network-IWK Grace: Regions 2,6,3 +

• Oncology- Tumor Rounds

• CME-Dalhousie medical School

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Review of Accomplishments:

1996-99:

A great deal of innovation and an increasein telehealth applications under the umbrella of aprovincial vision/strategic plan versus one provincial implementation plan/project.

PTCC believes it has accomplished the goals set out forit to do in respect to raising awareness, providing a forum to open up communication among regions/DHCS,offering recommendations on issues related to reimbursement, and telehealth standards.

Telehealth funding has come from a variety of sources: DHCS, EDCT, CANARIE, Health Canada, Foundations, RHCs.

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

Next Steps: 1999-2000 +What is the NB telehealth community saying ?

Acceleration of telehealth implementation agenda

Measures to sustain and expand programs

Business plan to move from pilots to a sustainable provincial telehealth program

Increased funding

More human resource support at local and provincial levels

Explore, based on pilot results/experiences,what else telehealth could do for NB in 21st Century.

Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia

DiscussionQuestions