This document proposes a randomized controlled trial to implement a nationally coordinated home health monitoring program for patients with long-term conditions using telemedicine. The objectives are to improve patient outcomes, reduce need for secondary care, and provide a more efficient model of care. The trial would include 400 participants across four regions and assess various health, quality of life, and utilization outcomes. It would also explore regulatory issues, costs, workforce impacts, and technology requirements of integrating telemedicine into care for long-term conditions.

2. Malcolm Pollock Director National Institute for Health Innovation Auckland University Programme Director for ASSET Gayl Humphrey Manager Planning and Funding ADHB

3. To implement a nationally coordinated home health monitoring programme for patients with Long Terms Conditions through the introduction of telemedicine to assess impacts on health outcomes and costs of care provision as a precursor for a full clinical trial.

5. Objectives To improve patient health outcomes To reduce need for secondary care (incl admissions) Increase the health related quality of life (HRQoL) for patients and family / whänau; Maximise clinical treatment opportunity Provide an economically more efficient model of care Be feasible and acceptable to patients and health care professionals Be an enabler for the integration of health services

6. Randomised Controlled Trial (1:1) Inclusion: Long term condition (Heart Failure, COPD, non-disease specific) Sample size : 400 Implement home telecare monitoring systems in participants homes or a local centre (hub) Participants and carer/s to be trained in utilisation of equipment to measure biometrics (relevant to condition) Incorporated supported self management options Care team will remotely monitor, review and respond according to individual setting protocols Methodology

7. ADHB: Congestive Heart Failure CMDHB : Chronic Obstructive Pulmonary Disease CDHB : Chronic Obstructive Pulmonary Disease Tairawhiti : Non-disease specific long term conditions in geographically remote communities Study Partners and Patient Cohort

8. Assess the impact of the programme on: Patients’ health related quality of life Patients self management and personal health outcomes Caregiver sense of burden/support Health care utilisation –ED attendance rates, hospital admission rates and length of stay, GP and allied primary care utilisation Assess usability of the telecare products for all stakeholders Outcome measures (1)

9. Explore the regulatory issues and costs Identify the key elements and factors necessary for integration into existing or future health IT systems Identify the changes in terms of workforce, care practices Examine the implications of the change in the model of care e.g. medico-legal Examine the levels of technology and support required Outcome measures (2)

10. Acknowledgements Thank you