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Virtual Health Care

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  • 1. The Ontario Telemedicine Network:
  • 2. What is Telemedicine? Use of information technology by health care providers: To deliver care to their patients; To engage their patients in their own health management and/or: To collaborate with each other to improve care delivery
  • 3. About OTN An independent not- for-profit corporation funded by the Government of Ontario Partners include: • eHealth Ontario • OntarioMD • Canada Health Infoway • Keewaytinook Okamakanak Tribal Council Members include: 1,289 health care and education organizations at more than 1,600 sites
  • 4. Our vision: Telemedicine will be a mainstream channel for health care delivery and education.
  • 5. 5 We are in a Virtual Health Care Revolution …
  • 6. 6 The “Virtual Health Care” Transition We Have Been Through Similar Shifts Before… Inpatient Care Outpatient Care Virtual Care 1992… More people leave hospital after procedure than remain overnight 202X?… More virtual visits than physical visits Each transition involved people, process, and technology changes.
  • 7. OTN Telemedicine Services Clinical Videoconferencing: Studio-Based Videoconferencing PC-Based & Mobile
  • 8. OTN Telemedicine Services eConsult and Store-Forward: Teledermatology Teleopthalmology Telepsychiatry Generic eConsult (Q & A)
  • 9. OTN Telemedicine Services Telehomecare and Consumer Remote-Monitoring Nurse Coaching Patient self- management
  • 10. 10 Reduces travel Improves access to scarce and/or maldistributed care Provides urgent access to services otherwise unavailable Reduce wait times through e-consultation Enables effective chronic disease self-management Reduces hospital admissions and ER visits Improves patient care transitions to the community Access, Quality and Efficiency AccessRural Rural and Urban Better Care for Patients and Better Value for Money
  • 11. 11 46 61 108 146 $19 $25 $45 60.4 13 17 30 40.2 0 25 50 75 100 125 150 2009-10 2010-11 2011-12 2012-13 Avoided Travel in the North (km) Estimated NHTG Cost Avoidance ($) Cost Avoidance in Northern Ontario (in millions)
  • 12. 12 Study Outcomes: Telehomecare 72 – 74% reduction in emergency department visits 16 – 33% decrease in number of primary care physician visits 95 – 97% reduction in walk-in clinic visits 64 – 66 % decrease in hospital admissions High levels of patient and provider satisfaction
  • 13. 13 The (Patient) Results Are In … were satisfied with their telemedicine visit. indicated they would use it again. felt as comfortable receiving care through telemedicine as they would have in person. saved money using telemedicine, with average savings of $C 242. Patient survey results – videoconferencing 2012 92% 91% 87% 74%
  • 14. Personal Videoconferencing From the hospital to the home Community 54% Hospital 27% Other 5% Primary Care 14%
  • 15. 15 Chronic disease management is the challenge of our generation. It requires a shift towards a more responsive, patient- centered system. Working with Health Links to embed telemedicine solutions. Healthcare Transformation Telemedicine is the key enabler
  • 16. 16 Where we are headed … Self Management & Monitoring Tools
  • 17. 17 Where we are headed … Technology “prescriptions” Take 2 Apps and Call Me in the Morning Tech Rx Apps Pharmacy not Apps Store Apps Formulary AliveCor Cardiac Withings Blood Pressure bant Diabetes Pain Squad Pain Mgmt MyIBD Crohn’s Disease
  • 18. MyHealtheNetwork LogActivity Education MyPlan CommunicationCentre 3 New Messages Onboard new Patient Alerts MyRoster (Dashboard) Calendar Communication Centre Flags:6 9 Monday, Sep 9 2013 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 New Patient Case Conference 10AM-12PM James, Oliver S more… Weekly Check-in Call 1PM-2PM Kripps, Barbara J more… Priority Patients ID Name Gender Age 947834 Gupta, Harpreet F 89 089564 Herman, Wes M 75 674987 Yip, Sophia F 83 870925 Greene, Gert F 92 937465 Reynolds, James M 68 Welcome Judy Wells ! MyHealtheNetwork Alerts MyRoster(Dashboard) CommunicationCentre ! Flags:6 Welcome Dr.Smith MyWatchList The Care Coordinator View The Provider View The Patient View Where we are headed … One Tool for Care Coordination
  • 19. 19 1 2 3 4 Assess and Categorize Monitor Understand Risk Factor/Comorbidities Profile and Readiness for Behavioural Change Plan Target Education to Support Key Interventions Responding to Change (Interventions) Identifying Change (Triggers) Care Coordination Inter-RAI LACE + Predictive Tools Confirm Diagnosis e.g. Indicator Tests + PRIMARY CARE Nutrition Smoking Cessation Medications Psychosocial/ Mental Health Exercise Equipment Condition-Specific Education Remote Monitoring and Self-Management Coaching Complementary Therapies Caregiver Support Telehomecare Where we are headed … Integrated Care Pathways Analytics
  • 20. 20 What is needed … “Telemedicine tools will only achieve their full value when they are integrated into a receptive health care system.”

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