Role of Telehealth in Role of Telehealth in Organising Our Organising Our

Resources Around the Resources Around the Person’s Needs Person’s Needs

Kate LivockProject Manager Unscheduled Care

NHS Grampian

TelehealthTelehealth

““The provision of health services The provision of health services at a distance using a range of at a distance using a range of

digital and mobile technologies digital and mobile technologies ““

The National Telehealth and Telecare Delivery Plan for Scotland to The National Telehealth and Telecare Delivery Plan for Scotland to 20152015

Components of TelehealthComponents of Telehealth

CommunicationsTechnology

Diagnostics Technology

Bringing the Hospital to the PatientBringing the Hospital to the Patient

Communications Communications TechnologyTechnology

• Telephone / Text.

• Wi-Fi.

• Blue tooth.

• Satellite.

• E-mail.

• Video Conferencing.

• Web and Digital television

• Know Who To Turn Know Who To Turn To.To.

• No Delays. No Delays.

•Zero Delays.Zero Delays.

•Living it Up - MorayLiving it Up - Moray

Telehealth supporting NHS Grampian’s New Approach to Unscheduled Telehealth supporting NHS Grampian’s New Approach to Unscheduled CareCare

•Clinical Decision Clinical Decision support Service support Service launched Sept 13launched Sept 13• North of Scotland North of Scotland Paediatric Pilot Paediatric Pilot underwayunderway• Clinical Guidance Clinical Guidance Intranet (CGI) Intranet (CGI) launched Sept 2013launched Sept 2013• Working with Working with Samsung to test a Samsung to test a tablet device to tablet device to provide information provide information @ the point of @ the point of contactcontact

•Extension of remote Extension of remote access for the access for the multidisciplinary multidisciplinary workforceworkforce•Working with Working with partners to include partners to include telehealth in cross telehealth in cross system working.system working.•Provision of Provision of workforce training in workforce training in the use of telehealth the use of telehealth equipment.equipment.•Support for Support for workforce in workforce in embracing the embracing the cultural change cultural change

• eBooking of eBooking of appointments – MIU & appointments – MIU & others in developmentothers in development

• Automated Vehicle Automated Vehicle Location System piloted in Location System piloted in

AberdeenAberdeen

• Near Patient Troponin Near Patient Troponin Testing Pilot commencing Testing Pilot commencing

April 2014April 2014

•Use of Telehealth Use of Telehealth in the provision of in the provision of remote support for remote support for Mental Health Mental Health patients in the patients in the islandsislands

•Piloting remote Piloting remote rehabilitation using rehabilitation using VC for patients VC for patients with COPD.with COPD.

11/11/13

Aims of Clinical Aims of Clinical Decision Support Decision Support

ServiceService

• To provide high quality clinical decision support to professionals across Unscheduled Care in Grampian.

• To deliver excellence by organising our resources

around a person’s needs.

• To bring structure and efficiency to every Unscheduled Care patient journey.

Decision SupportDecision Support

• Operational Mon – Fri08.00 – 14.00.

• Tel: 01224 558002.

• Co-located in Operations hub with G Med & NHS 24.

• Currently staffed by ED Consultants.

• Over 1000 calls to date.te.

Two

Paramedic Case Study - Paramedic Case Study - PeterheadPeterhead• 22 month old child (female)

• 36 hr history of raised temperature (as high as 40c) and intermittent vomiting.

• On examination -Temp 39.9c -Nasal congestion

-No signs of resp distress -No evidence of rash

• Given Calpol 120mg

• Child fully clothed with heating on in house.

• Requires further assessment.

• Discuss with Decision Support

Patient PathwayPatient PathwayTraditional Pathway Traditional Pathway

V V

• Patient taken by SAS to RACH Emergency Dept.

• Pt assessed, treated and discharged.

• Parents required to arrange return transport to Peterhead in a taxi at a cost in excess of £50.

Decision Support Decision Support PathwayPathway

• Paramedic contacts Decision Service by telephone.

• Full clinical assessment of pt relayed to DS clinician

• DS clinician discusses with patients GP.

• Pts GP agrees to further assess child at P’head MIU adjacent to Health Centre

• Crew transfer pt to P’head MIU ( 3minutes away) where they are expected.

• Pt discharged home.• No transport costs incurred.

Diagnostics TechnologyDiagnostics Technology• Near Patient Testing – Troponin / LactatesNear Patient Testing – Troponin / Lactates

• TelemetryTelemetry

• Digital ImagingDigital Imaging

• UltrasoundUltrasound

• Video ConferencingVideo Conferencing

• Text or E-mailing of Digital Images to support Text or E-mailing of Digital Images to support diagnosisdiagnosis

Benefits of Telehealth Benefits of Telehealth for:for:PatientsPatientsPatient Centred Care with improved patient Patient Centred Care with improved patient

experience, patient safety & outcomes.experience, patient safety & outcomes.

– By ensuring the right care is provided to the patient, first time through prompt assessment supported by telehealth.

– By introducing an enhanced level of assessment at an earlier point in the patients Unscheduled episode of care using diagnostic telehealth.

– Increased reassurance for patients and carers by easy access via telehealth to diagnostics and senior decision making advice.

– Reduced requirement for patients to travel e.g. 1 hr journey for 10min Outpatient appointment

– Ensures the transfer of patients is the most appropriate place at the most appropriate time.

Benefits of Telehealth Benefits of Telehealth for:for:StaffStaff

• Ability to provide reassurance to patients and carers.

• Increased awareness of colleagues skills leading to confidence in the skill set of all members of a team.

• Reduction in the duplication of activities and patients handoff’s between different parts of the service.

• More efficient use of professionals time

• Enhanced integration of professionals across Health & Social care providing greater support for Unscheduled Care services.

Benefits of Telehealth Benefits of Telehealth for:for:NHS Grampian and the NHS Grampian and the Public SectorPublic Sector

• Improved Governance and safety.

• More effective and efficient use of limited resources e.g. people, transport (SAS), infrastructure etc.

• Supports joined up high quality health and care.

• Supports a number of the government standards.