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The Ontario Telemedicine Network:
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
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
Our vision:
Telemedicine will be a
mainstream channel
for health care
delivery and
education.
5
We are in a Virtual
Health Care Revolution …
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.
OTN Telemedicine Services
Clinical
Videoconferencing:
Studio-Based
Videoconferencing
PC-Based &
Mobile
OTN Telemedicine Services
eConsult and
Store-Forward:
Teledermatology
Teleopthalmology
Telepsychiatry
Generic eConsult
(Q & A)
OTN Telemedicine Services
Telehomecare
and Consumer
Remote-Monitoring
Nurse Coaching
Patient self-
management
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
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
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
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%
Personal Videoconferencing
From the hospital to the home
Community
54%
Hospital
27%
Other
5%
Primary
Care
14%
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
Where we are headed …
Self Management & Monitoring Tools
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
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
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
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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Virtual Health Care

  • 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.
  • 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.”