ICT in Health: Improving Health Outcomes, Reducing Costs


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AHIA 2011 Conference presnetation by Dr David Hansen from the Australian e-Health Research Centre

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ICT in Health: Improving Health Outcomes, Reducing Costs

  1. 1. Using ICT to Improve Health OutcomesDavid Hansen, CEO, Australian e-Health Research Centre
  2. 2. ICT enabled health service• W e are recommending a transforming e-health agenda to drive improved quality, safety and efficiency of health care. A Healthier Future For All Australians National Health and Hospital Reform Commission June 2009
  3. 3. Australian e-Health Research Centre >6500 Staff Information & Communication Technology Division (~250) Joint Venture formed 2003Researchareas Health Health Tele- Advanced Surgical Service Informatics medicine imaging simulation Delivery
  4. 4. The Australian e-Health Research CentreAeHRC is the leading national eHealth research group in Australiacurrently 60-70 staff, students, visiting researchersFunding from • CSIRO • Qld Govt - DEEDI, Queensland Health • engagement partners • revenueInvestment into research programsNational reach - Brisbane HQ, smaller teams nationally - NSW, Victoria, SA, and now WA, and through CSIRO in Tasmania and ACTSuccess built on partnering - Government, clinicians, industry • Local engagement to drive national benefit
  5. 5. AEHRC CapabilitiesHealth Data Management and Semantics Biomedical Imaging Colon Cancer Project DeceasedPersons PatientProce ProcedureBy Query dureQuery EventQuery BHospPerson BHospProce BHospEvent Details dure Procedure Custodial Data BHospPerson BHospProce BHospEvent Details dure Procedure Procedure Person Details Event Mobile and Tele-health Forecasting and Scheduling Agent Representing Agent ORMIS Representing Supervisor Charge Agent Nurse Representing Director of Surgery Agent Regular Representing Anaesthetic Communication Charge Nurse Agent Representing And Director of Negotiation Anaesthesia Agent Representing Agent Theatre Representing Manager Bookings Supervisor
  6. 6. Tele and Mobile Health:Improving access of healthcare services Care Assessment Platform Partners: Prince Charles Hospital, Metro North Community Services
  7. 7. Hospital-Based Cardiac RehabilitationReferral: < 11% of patients across Australia(D.L.Walters et.al. “Variation in the application of cardiac care in Australia” MJA 2008; 188(4))Uptake and Completion QLD: 16% of all eligible patients (I.A.Scott et.al. “Utilisation of outpatient cardiac rehabilitation in Queensland”, MJA 2003; 179(7) USA: 18.7% of the eligible patients participate in rehabilitation programs. Suaya JA et al. (2007) Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation 116: 1653–1662
  8. 8. Mobile Phone based Cardiac Rehabilitation Program Service Provider Wellness Diary Connected Measurement Health Diary data data Reports Educational Discussion, material messaging Community Care TeamPatient in the Community
  9. 9. Educational multimedia material on the phone© Multi-ed Medical Inc.
  10. 10. Mobile phone software toolsWellness Diary – health entries Nokia N96 handset with a built-in motion sensorStep Counter – walking activity
  11. 11. WellnessDiary Connected web service Mentoring and self- management tool• End User View • Dashboard: a single view to all user data • Four central concepts in the feedback and motivation: • traffic light indicators • a simple measure of physical activity • goal setting • verbal feed back• Professional View, interface for Mentors, Functionalities: • managing groups • patient monitoring and analysis • news postings, system wide messaging with attachments. • create questionnaires • access the users’ data• Administrator View • creation and managing user groups • providing admin rights
  12. 12. CAP
  13. 13. Outcome measures• Main outcome measure: • % Uptake and completion of CR program• Other measures: • Adherence to physical activity guidelines (30 mins moderate level activity each day) • Patient satisfaction: is this technology and home-based process the preferred means by patients? • Quality of life. • Risk factors: BMI, blood pressure, lipids, smoking, alcohol, diabetes • Diet/ nutrition status • Costs • Return to work rate • Readmission rate, deaths • Psychosocial status • Pharmacological management
  14. 14. Trial status April 2011 Total recruited n=107 IT Group Traditional n=52 n=55Withdrawn Still enrolled/ Withdrawn Still enrolled/ n=13 completed n=23 completed 25% n=39 42% n=32
  15. 15. Uptake of WD entries on mobile phone (n=16) Entries per health factor 160% 140% 120% 100% Percentage 80% 60% 40% 20% 0% alcohol blood eating exercise fat sleeping smoking steps stress weight
  16. 16. Uptake of WD entries on mobile phone (n=16) Maunal entry of at least one WD entry per day for each week 100.00% 90.00% 80.00% 70.00% % patients 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% 1 2 3 4 5 6 CR program week no.
  17. 17. Tele and Mobile Health:Improving access of healthcare services ManUpPartners: Health Promotion Qld, Central Queensland University, University of Western Sydney, CSIRO Food and Nutrition
  18. 18. Health Promotion Queensland: ManUp project Information updates Mobile Website Handset• Access health information • Self monitoring of PA and• Self monitoring of PA and nutrition behaviours nutrition behaviours • Feedback on PA and• Feedback on PA and nutrition behaviours nutrition behaviours • Reminders/Prompts for PA• Participate in challenges and nutrition behaviours• Network with ‘mates’ Participant
  19. 19. Tele and Mobile Health:Improving access of healthcare services Pilbara Tele-ophthalmologyPartners: Health Promotion Qld, Central Queensland University, University of Western Sydney, CSIRO Food and Nutrition
  20. 20. The Eye is the Window to the Body
  21. 21. Remote Tele-ophthalmology: Pilbara Pilot • Eye images taken at Pilbara Hospital • 8 images – 2.3MB per image • New methodologies being explored – video and 3D viewing of the retinal • Images uploaded to web EMR for viewing in Perth by Specialist • On-going monitoring and diagnosis for diabetic retinopathy, glaucoma and other eye disease • Follow-up where necessary • Earlier diagnosis • Primarily aimed at providing vision care for the children in the region • Video conferencing – such as the RIDES system – will then become vitalCSIRO. Innovation in a Broadband World
  22. 22. Monitoring longitudinal change A retinal image A retinal image taken 1-year later
  23. 23. Monitoring longitudinal change A retinal image Image flickering Image subtraction
  24. 24. Remote-I Being Used in Pilbara Region to Prevent Blindness1. Port Hedland Hospital,2. OPSM shop in Karratha
  25. 25. Data and Information
  26. 26. Patient Admission Prediction ToolFor Emergency Departments For Inpatient Beds:
  27. 27. The Australian e-Health Research CentreDr David Hansen - CEODavid Hansen@csiro.auThank you Contact Us Phone: 1300 363 400 or +61 3 9545 2176 Email: Enquiries@csiro.au Web: www.csiro.au