The Role Of Telehealth In Emerging Models Of Care
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Pathways to the future The Role of Telehealth in Emerging Models of Care - moving from information exchange to person-centred, technology-enabled care Ross McKenna Portfolio Manager, Health System Infrastructure Information Strategy and Architecture National Health Board Business Unit Ministry of Health HINZ Telehealth Seminar 2009
description
Between 2006 and 2036 the proportion of New Zealand’s population aged 65 or over as a proportion of the working-age population is expected to rise from 18 to 40%,” The number of people over Chronic conditions are estimated to account for 70 percent of health funding and 80 percent of all deaths in New Zealand and health workforce numbers per person are expected to decrease over next 20 years. This presentation explores the potential of Telehealth to address these challenges
Transcript of The Role Of Telehealth In Emerging Models Of Care
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The Role of Telehealth in Emerging Models of Care- moving from information exchange to person-centred, technology-enabled care
Ross McKenna
Portfolio Manager, Health System Infrastructure
Information Strategy and Architecture
National Health Board Business Unit
Ministry of Health
HINZ Telehealth Seminar 2009
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Telehealth - Emerging models of care….
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Summary
Definitions of Telehealth
The potential of Telehealth in the New Zealand Health system
Moving from recipient to participant
Health Social Networking Consumer Personalised Medicine
Going forward
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Recommended definitions
TelehealthProvision of heath care and information at a distance using
Information and Communications Technology
TelemedicineApplication of clinical medicine at at a
distance using Information and Communications Technology
TelecareProvision of health care and support
using Information and Communication Technology to empower people to
remain independent in their own homes
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Health system pressures
Aging population Chronic disease Economic pressures Workforce New technologies and medicines
How can Telehealth help?
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Telehealth – enabling health system change
Workforceeffectiveness
Personalised care
PreventativeCare
Resourceeffectiveness
Connected Health – networks, architecture, standards
Integrated Family Health Centres
TELEMEDICINE TELECARE Chronic conditions Education
Self managementFamily/whänau support
Remote consultations
Video conferencing
Peer review/support
Shared systems
Home Based
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Telecare – evolution from recipient to participant
First Generation User activated alarms Call centre organises a response POTS based dial up serviceSecond Generation Sensors monitor home – smoke, flood, power Sensors monitor vital signs, physiological measures Store and forward POTS, ADSL basedThird Generation Interactive services, part of integrated care Includes Video services – family, care giver support,
doctor or specialist consultations Education, self management Broadband, Internet enabled – home PC, mobile,
wireless
REACTIVE
PREDICTIVE
PREVENTITIVE
Three “generations” based on– Telecare in Scotland, Benchmarking the Present, Embracing the Future, February 2008
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Models of care – moving from recipient to participant
Provider delivered at the hospital
Illness and treatment
Site of care focused
Episodic care
Workforce constrained
Solitary decision making – referral based
Efficiency
Decentralised, independent
Person & whänau involved in the community/home – provider as colleague/advisor
Wellness and informed/responsible/participating/empowered
Continuum of care – home and mobility
Disease prevention and management
Demand managed
Patient involved, collaborative, evidence based decisions – co-diagnosis, co-care
Efficiency and Effectiveness
Coordinated, specialised care
(technology enabled)
MODEL R(ecipient) MODEL P(articipant)CSIP, UK Department of Health “Supporting Long-term Conditions and Disease Management through Telecare and Telehealth: evidence and challenges, January 2008Preparing for Success: Readiness Models for Rural Telehealth Jnl Postgrad Med December 2005Journal of Participatory Medicine
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Moving care closer to home
Early detectionEducation
Community Medicine
AlertsEducationSelf careFeedback loopMonitoringElectronic consultationsSupport – care giver/family/whänau
Home-based Telecare
Home assessmentsElectronic consultationsSharing health recordsBilling/paymentsMonitoring – 24/7Support/adviceEducation
•Consults•Tests•Referral & discharge•Share health records
Hospital/DHB
Peer reviewConsultTrainShare systems & health records
DiagnosticImagingVideoconferencing
Other provider sites
SECONDARY PRIMARY COMMUNITY
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Broadband
Linked to the Primary Care Implementation Plan – IFHCs.
IFHCs supporting the community – enabling services such as: videoconferencing, diagnostic imaging and home based Telecare
EOI selection process informing the roll-out of Broadband
Key steps: November 2009, EOIs selected to proceed to business case December 2009, proposals from potential LFC co-investors.
- Indicate the regions likely to receive the first phase of funding from this initiative. - Ministry of Health will advice on the requirements identified from EOI process to
align, where possible, any plans for fibre deployment.
Early 2010, identify rural schools and hospitals/health sites outside the 75 percent coverage are able to be connected.
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Emerging Telecare models – enabling self care
Increasing Internet access, connectivity and information availability
Developments in care and monitoring devices
Cost and availability of analysis and computing power
Some examples of emerging person-centred models
Health social networking Consumer personalised medicine Self tracking and management
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Health Social Networking
Information and research sharing
Keep updated on latest developments/treatments
Learn and try new approaches – participate in clinical trials
Physician Q&A – free or fee
Social connection and emotional support – “I am not alone”
Track health progress
Source of condition data
E.G Patientslikeme.com 45,000 members, 10% per month growth Free to join 16 conditions Largest dataset on ALS
(Amyotrophic Lateral Sclerosis) Sells data to drug and medical companies
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Consumer personalised medicine
Using individual biological characteristics to tailor therapies and remedies
Combines genetic, blood, biomarker, environment, lifestyle data Personalised genomic information Biomarker/blood testing – blood count, thyroid, lipid, liver, kidneys,
diabetes, etc (see www.directlabs.com) Environment testing – pollutants, pesticides, etc. Blood or hair testing Predictive bio stimulation – project a “virtual” patient (e.g. Entelos)
Quantified self-tracking Implanted and external devices monitor health metrics Current web based services require external input Wearable devices
- Energy expenditure, sleep measurement (www.fitbit.com)
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Going forward…
Recognise the opportunities to drive positive change through new models of technology enabled care – Telemedicine and Telecare
Focus on Telecare services development – person centred, home based
Supporting changes Establishment of IFHC as “technology hubs” and wider broadband deployment Continue development of Connected Health
Supporting information and policy
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QUESTIONS?
Web references
Presentations from the supported self management seminars held in June 2009:http://www.moh.govt.nz/moh.nsf/indexmh/longtermconditions-masterclasses
2007 Synergia Self Care Literature Review http://www.synergia.co.nz/assets/file/Role%20of%20information%20in%20self-care%20July%202007.pdf
Link to Genetic and Bioinformatics resources:http://www.ornl.gov/sci/techresources/Human_Genome/posters/chromosome/tools.shtml
NZ Government Broadband Initiatives – MED sitehttp://www.med.govt.nz/templates/StandardSummary____40551.aspx
