2 lewin-telehealth ifa-may_2012

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2 lewin-telehealth ifa-may_2012

  1. 1. Telehealth Monitoring of People with COPD – Are We Fostering SelfManagement or Service Dependency? Gill Lewin Joanna Smith, Kristen De San Miguel, IFA Conference, Prague, May 2012
  2. 2. Background• Silver Chain, WA. Health and community care provider.• 40,000+ clients with 50,000+ hospital admissions annually• Diagnosis of COPD increases risk of admission• Tested telehealth remote monitoring Western Australia• Two trials with people with COPD
  3. 3. Intervention What is Telehealth Self Monitoring?
  4. 4. Daily Measurements
  5. 5. Equipment
  6. 6. Nurse Monitoring
  7. 7. First Study • Randomised controlled trial • Telehealth remote monitoring vs Information only • 40 participants in each group • Monitored for six months • Measured: Health Service Use and Quality of Life • Results promising
  8. 8. Hospital Admissions 30 Hospital Admissions COPD Hospital Admissions Not COPD 25 20 17 Number 15 8 10 5 9 8 0 Telehealth Information Group
  9. 9. Days in Hospital 200 180 Hospital LOS COPD Hospital LOS Not COPD 160 140Number of Days 120 100 162 80 60 85 40 20 21 21 0 Telehealth Information Group
  10. 10. ED Presentations 25 ED Presentations COPD ED Presentations Not COPD 20 15 6 11Number 10 12 5 10 0 Telehealth Information Group
  11. 11. Questions… • Would results be same over winter? • Were people now dependent on ongoing monitoring?
  12. 12. Second StudyCross Over Trial 71 Individuals Telehealth Informationcompleted first study n=36 n=35 Tele-Tele Info-Info69 recruited into 2nd n=18 n=16 study Tele-Info Info-TeleOutcomes monitored for n=17 n=18further 6 months +compared to first 6 months
  13. 13. Mean Change in Hospitalisations 0,8 0,6 0,4 0,3 Mean Change 0,2 0,3 0,3 0,3 0,1 Other Hosp 0,0 -0,1 -0,2 COPD Hops -0,2 -0,5 -0,4 -0,6 INFO-INFO INFO-TELE TELE-INFO TELE-TELE Group
  14. 14. Mean Change in Days in Hospital 5,0 0,8 4,0 3,0 Mean Change 2,0 3,9 Other LOS 1,0 1,9 COPD LOS 0,8 0,4 0,0 -0,3 -0,8 -1,2 -1,0 -2,0 INFO-INFO INFO-TELE TELE-INFO TELE-TELE Group
  15. 15. Mean Change in ED Presentations 0,8 0,6 0,4 0,3Mean Change 0,2 0,4 0,3 0,2 0,1 Other ED 0,0 COPD ED -0,3 -0,2 -0,4 -0,5 -0,4 -0,6 INFO-INFO INFO-TELE TELE-INFO TELE-TELE Group
  16. 16. Cost Difference $8 000 $7 000 $7 466 $6 000 $5 000 Cost Difference $4 000 $3 000 $2 000 $1 000 $1 344 $- -$46 -$1 000 -$1 448 -$2 000 INFO-INFO INFO-TELE TELE-INFO TELE-TELE Group
  17. 17. Conclusions• The benefits of telehealth remote monitoring are evident in all seasons• Telehealth remote monitoring has an impact on all health service use – not just COPD related• The benefits remain even after the monitoring equipment is removed (if the individual has learned to take notice)• Telehealth can result in large cost savings for the health system
  18. 18. Acknowledgements Commonwealth Department of Health and Ageing State Health Research Advisory Council Study Participants Research Colleagues
  19. 19. Contact Details Further information: glewin@silverchain.org.au

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