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Change of community care funding to CDC is driving community care to now address assistive technology as part of their offerings. In 2014 we will see telehealthcare being delivered at part of community care.Tunstall provides a range of services from project startup, to full or part service implementation.
How many people here recently upgraded their iphone? Had some fun with that?The reality is that sometimes the technology isn’t going to work, blue tooth devices decide to unpair themselves, device errors and user error. It is not always going to work.If the device/s is unplugged from power or batteries go flat things aren’t going to work.If the phone lines, GSM service or internet is down it is not going to work.Surprisingly patients are oftnen pretty ok about troubleshooting themselves or with you over the phone.It is important to have good service support.Video conferencing is an excellent tool to support troubleshooting- help clients change batteries themselves.So it is really, really important that you explain this to your customers upfront so they don’t have an unrealistic expectation of the technology.
I know every project manager bangs on about stake holder engagement. But from first hand experience you will have a project failure if the person or people tasked with implementing the project do not believe in it, are technophobes or have been told they have to do it – the project is doomed, or it is very, very hard and time consuming to bring them around. If for whatever things do go wrong it is important to have good open and honest communications with your stakeholders and work through the issues together.Patients – good training and support, understand why they are on telehealth know their care plan and objectivesGPs are difficult to engage even when you are prepared to pay them – they are busy! But they do like the evidence and information if a patient presents for an intervention.
If I had a dollar for every nurse, GP or community care worker who told me that their 80yo client wouldn’t be able to use technology I could retire earlyNever underestimate the capacity for older people to learn new things, just because they a e old doesn’t mean they are brain dead.Many like the challenge and the experience, and how many of you here have a parent/grandparent who is now a skype monster?General guide: if they can use and ATM or phone text they can use our gear.The older people are if they have had little exposure to computers it does take longer for them to learn and remember how to use the equipment. Allow a couple of weeks of support by phone, vc or even onsite after that they should be right.Technology doesn’t suit everyone and if it is too stressful take them off the program.
Make sure you have clear objective and goals for putting someone on telehealth – what is the care plan. Do you want to track and trend, do you want to stabilise or improve, monitor for exacerbations, medication compliance/titration, or pall care support pain and Qol?Is the patient physically able to use the technology or do they have support from a carer? One armed person will have difficulty using the BP, peripheral vascular disease may not be suitable for SP02, Parkinson's, dementia etc.If patient is a hypochondriac do not put them on telehealth it just encourages the process
Health and community care is elastic – it does take some seed funding to get the program going to reap the longer term benefits.
BP – LesleySelf management – Tas client with COPD presenting 5 times a week to A&EReduction in travel – patient 3 hours from hosp, infection detected remotely, triaged, meds prescribed, hospitalisation avoided. A research project just completed, broad scope for their project generic chronic disease, found that most of the participants lost weight and improved their health condition – in fact many didn’t want to stop.VC – monty drooling and shakingHome Dialysis – have clients show cup size for fluid intake, talk them through using equipment and show them, dietician and psych support etc.
There is a massive amount of evidence around the world that indicates assistive technology can make a difference to the lives of people who wish to live independently and for as long as possible in a place of their choice. Assistive technology is becoming a very important element of healthcare delivery, challenging traditional models of care.The case for New Zealand needs to be made as it plans to meet the many challenges that other countries around the world face in delivering healthcare to their aging population.
The role of assistive technology:
an industry perspective
Business Development Manager, Asia Pacific
Marketing and Strategy Implementation Manager
Tunstall Australasia Pty Ltd
How it all began
56 years ago the first medical
alarm was developed by
Norman Tunstall to support
his elderly mother.
• World’s leading telehealthcare solution
• Global company operating in 46 countries
• 600+ Emergency Response Centres (24/7)
• 2,964 employees
• Assistive Technology Solutions
– Manufacturer to ISO, CE Mark
– Monitoring platform and 24/7 Response
– Software, including vital sign and patient
– GPS tracking devices
– Training, project management, SOP
development and knowledge
4.6 million people
Current Telehealth Projects
Feros Care – Chronic disease and social engagement
TMML – Diabetes
RDNS – Chronic disease and medication compliance
DVA – In-home Telemonitoring for Veterans Trial - COPD, CHF,
Western Health (HUG) – Home Dialysis
Alfred Hospital – Cystic Fibrosis
Integrated Living – Indigenous Healthcare and Social Support
Centacare – Social engagement and medication compliance
Calvary Silver Circle – Transition Care (hospital to the home)
DHHS Tasmania – Remote patient support
LHMA – Residential aged care support
80,000+ telehealth users worldwide
What we have
The good, the bad
and sometimes the
Image courtesy of Warner Home videos
is not infallible and it is not magic
Is it cost-effective?
If structured correctly “Yes”
Program must be targeted
Clear process for off-boarding clients
Effective asset control & equipment recycling
Don’t need all the whizz bang gear
High definition video is nice but standard definition is just as
effective – do you really need video?
Supporting remote areas reducing staff travel
One nurse can support up to 200 patients remotely
Technology costs are reducing
Targeting hospital avoidance
Apps and BYOD are opening up flexibility and will reduce costs in
the near future
Co-payments and private pay are the way forward in community
Patient outcomes we have seen
Stabilisation of BP & BGL
Self management of condition
Reduction in travel for remote patients
Across the board weight loss
– adds value to clinical triage
– patients enjoy the social contact
• Home dialysis
– support dialysis machine use
– monitor fluid intake
– monitor for infections
– Increased compliance and reduced hospitalisation
• Increased access to a range of care solutions
• Increased quality of life and adherence to treatment regimes
• Increased assistance for chronic conditions prevalent with
• Detection of declining health trends (e.g., COPD)
• Viable alternative to outpatient or doctor visits
• Quality of life and peace of mind
Decreased risks associated with predictable factors
Decreased ED visits / potentially preventable hospitalizations
Decreased nursing home admissions (by up to 77%)
Reduced use of patient transport services
Decreased burden on care givers
Decreasing healthcare costs
• Evidence supports telehealth.
• Can be cost-effective.
• Becoming a very important element of
• Challenging traditional models of care.
The case for New Zealand needs to be made as it plans to
meet the many challenges that other countries around the
world face in delivering healthcare to their aging population
General Manager Tunstall New Zealand &
Asia Pacific Business Development Manager
Tunstall Australasia Pty Ltd
306 Cameron Road
New Zealand 3110
+64 7 571 2680
+64 7 571 2685
All slides in this presentation are copyright Tunstall and must only be reproduced with express permission