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Telehealth and Health Informatics - How Should They Work Together?


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Pat Kerr
Principal Consultant
NZ Telehealth Forum
(Wednesday, Telehealth Workshop)

Published in: Health & Medicine
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Telehealth and Health Informatics - How Should They Work Together?

  1. 1. 2012 Telehealth and Health Informatics - How Should They Work Together? Workshop 7 November 2012Workshop Leader – Pat Kerr, Principal Consultant, NZ Telehealth Forum
  2. 2. Today’s Workshop Introduction & NZ telehealth update Arizona Telemedicine Program Knowledge systems framework Discussion 2
  3. 3. Telehealth context eHealthNarrow definition: Telehealthweb based servicesBroader definition:healthcare practicesupported by electronic ... the technology andprocesses & infrastructure that enablescommunication - health healthcare (& relatedinformatics, EHRs, processes) to be delivered PMS, etc at a distance 3
  4. 4. Telehealth – a disruptive force It is not about the technology! It is about enabling changes in clinical practice 4
  5. 5. Telehealth – a disruptive force Used well it can help deliver: • Workforce flexibility • Improved patient services • Improved interventions (LTCs) • Provide services convenient to clinicians and patients, at lower cost 5
  6. 6. Telehealth in NZ –slow progress since early 1990s • Fragmented approach • Clinical awareness & support not cohesive • Strong on innovation (pilots); weak on sustainability • Low priority at funding and planning level – lip service only in most places • Slow uptake, especially for our size and population, compared to other like jurisdictions such as Australia, UK, Alaska, Canada 6
  7. 7. Purpose of the Forum • Promote telehealth as a change agent for health services • Ensure telehealth on agenda for national & regional strategies • Instigate, support & participate in trailblazing telehealth deployments • Maximise Ultrafast & Rural BB • Promote sustainable services (move from pilots to broad deployments) 7
  8. 8. The Forum’s landscape eHealth Telehealth Applications Priorities Support for Telemedicine(interactive / store Telemonitoring • small hospitals and integrated & forward) family health centres (IFHCs) • in home monitoring mHealth Interactive • better quality videoconferencing Portals for clinicians and clinical networks Robotics Help Lines Telecare Standards development /adaptation (alarms) 8
  9. 9. Governance & work programme Governance Workstreams Forum support: planning, QA, mentoring,evaluations NHITBSponsorship and leadership Clinical initiatives (projects) NZTF Chair and ExecutiveStrategy, decision making, commercial Capability Telehealth Leadership Stakeholder building: Group engagement: Advice and execution converting education / barriers to Operations Centre awareness Secretariat, consulting, enablers communications 9
  10. 10. NZ Telehealth activity A broad range across both islands: • Established services • Emerging services • Pilots • Randomised control trials 10
  11. 11. Telemedicine – store & forward Teleradiology imaging and diagnosis - public and private, incl. support for rural centres & out of hours Teledermoscopy imaging and diagnosis • public-private collaboration (Molemap NZ & Waikato DHB) for Virtual Lesion Clinics • private (Molemap)Source: Molemap NZ 11
  12. 12. Telemedicine in NZ – videoconferencing Northland DHB Whangarei to Bay of Islands, Kaitaia Clinics - renal, paediatrics, methadone, nutrition case reviews with ADHB, clinical network meetings Waikato DHB Teledermatology clinics Waikato Hospital to Taranaki DHB (New Plymouth Hospital) Bay of Plenty DHB Speech language therapy Canterbury DHB to West Coast DHB Outpatient clinics - paediatrics, oncology, etc West Coast DHB Outpatient clinics Greymouth to Westport, Haast etc - gen’l surgery, methadone, nutrition, speech therapy etc Ministry & DHBs Education and admin meetings Multi-vendor / network environment emerging for VC 12
  13. 13. Telemedicine in NZ – videoconferencing Multidisciplinary Meetings (MDMs) regional cancer networks and others - multi-point VCs for case management using high spec VC/AV room systems Mobile Health mobile operating theatre, virtual assistance, rural teaching Source: MSS 13
  14. 14. Telemedicine into the home Speech Language Therapy using Skype, Cisco / Jabber & larger enterprise VC network tools for: − therapy with patients in their homes − review, training, multi-disciplinary team evaluation and supervision Telerehabilitation Working Group (mainly SLTs & dieticians) collaborating on technology solutions, protocols, etc 14
  15. 15. Telemonitoring Current focus is on long term conditions e.g. COPD, CVD, diabetes Operational service EasternSource: One News Bay of Plenty, Te Whiringa Ora Trials Taupo / Turangi ASSET (ADHB, Counties Manukau, Ngati Porou) 15
  16. 16. mHealth and interactive Portals 16
  17. 17. Progress on enablers • VC interoperability & standards • VC collaboration tools • Mobile technology • Education / awareness • Resourcng • Professional g’lines • Innovation funding 17
  18. 18. Work in progress & being considered • Northland – Kaitaia (Oncology), Dargaville (ward, maternity, addiction, outpt), ICU • Auckland – strategy + foundation projects + programme mgr • Waitemata – bus case for mobile technology for Community Allied Health • Waikato – bus case for ED services between Waikato and Taumarunui, local telehealth forum and clinical group • Bay of Plenty – outpatient Services (possible trialsDHBs sponsored by MBIE), ED support • Hawkes Bay - teleconsults - hospital to Wairoa • Canterbury / West Coast – continued growth in clinical networks and specialist teleconsultations • Shared Services – scoping for Elective Services, possibly FSAs included • MDMs – Northern Cancer Network 18
  19. 19. Work in progress & being considered • St John and others telemonitoring (adding proactive service to current reactive / responder alarms services) Primary /Community • Community based NGOs many looking at telemonitoring and support for community workforce 19
  20. 20. The Health Informatics link• Value proposition / bus • Operations – patient cases records (shared),• Evidence results of monitoring,• Infrastructure – booking, reporting... technology and tools • Evaluation 20
  21. 21. National Health IT Board’s integrated care initiatives Telehealth touchpoints & enablers Patient Vitals Shared E-events Care Care Plans Decision SupportPhase 2 (5 years)Phase 1 (2 years) Clinical Data Repository Medicine Reconciliation GP2GP Referral Primary - Secondary Continuum of Care National Community - Tertiary Speciality Discharge Systems ePrescribing Clinical content is needed for effective Telehealth 21
  22. 22. Evaluation• Quantitative • Formative (during)• Qualitative • Summative (learnings)Must demonstrate quality of care and sustainability 22
  23. 23. Arizona Telemedicine ProgramSpeaker: Dr Ronald Weinstein, Director 23
  24. 24. Telehealth Knowledge Systems Framework Speaker: Samuel Wong, ProCare Patient 24
  25. 25. Discussion Comments by: Miles Roper, CIO West Coast DHB and Grant Ardern, Chief Architect, Connected Health Developing the framework (planning and operations) Health Informatics – examples and issues? What is needed to make real progress? 25
  26. 26. For more information visit: Or just Google “New Zealand Telehealth Forum”Contacts:Principal Consultant Pat Kerr pat Chair Malcolm Pollock