The Ontario Telemedicine Network (OTN) provides telemedicine services across Ontario. It aims to use technology to improve access to healthcare, especially for rural communities. OTN offers clinical videoconferencing, eConsultations, telehomecare/remote patient monitoring. Studies show telemedicine reduces costs by lowering travel needs, ER visits, and hospital admissions while improving access to care. OTN is working to integrate telemedicine into healthcare to support chronic disease management and shift towards more patient-centered care coordination. The goal is to use digital tools and analytics to better monitor patients and support self-management.

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.”