australian telehealth challenges and opportunities
DESCRIPTION
A look at Australian telehealth trends including background on the history of telehealth in ANZ healthcare. The presentation also explores the drivers behind greater adoption of telehealth in healthcare services such as rural population requirements, developments in technology and demographic changes.TRANSCRIPT
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 1 EDCS-962069
Australian Telehealth Challenges and Opportunities
Cisco Health Practice
Dr Brendan Lovelock
Health Practice Lead
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 2 EDCS-962069
Overview
Telehealth
Landscape in
Australia
Solution
Outcomes Challenges for
Telehealth
Drivers for
Telehealth
Practical
People Centered
Transformation of Care
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 3 EDCS-962069
What do we Mean by Telehealth
• It is about creating a clinically productive dialogue between care providers and between care providers and patient
• Integration of data-voice-video: producing an information rich dialogue
• Developed within, between and external to health care facilities
• Australia has been a leader is Telehealth from 1929 RFDS Morse code communications program
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Australia and Telehealth
Date Telehealth Mile-stones
1929 Tele-health program began using a pedal powered wireless and Morse code
Mid 1930s The tele-health program moved to voice radio
1939 The medical chest system was first suggested
1942 The medical chest program began with each component numbered. The ‘where does
it hurt chart’ was introduced
1951 The tele-health program moved to predominantly fixed-line telephone services
1980s Tele-health program incorporated fixed line
1990s Mobile and satellite telephone services with the occasional use of video-conference
facilities
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 5 EDCS-962069
The Clinical Ecosystem
GP
Specialist
Acute
Home
Community
22,471 Specialist
24,029 GPs
736 Public Hospitals
8.5 million
separations
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 6 EDCS-962069
The Clinical Ecosystem
GP
Specialist
Acute
Home
Community
22,471 Specialist
24,029 GPs
736 Public Hospitals
8.5 million
separations
Around 3000 bridging based endpoints
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 7 EDCS-962069
The Clinical Ecosystem
GP
Specialist
Acute
Home
Community
22,471 Specialist
24,029 GPs
736 Public Hospitals
8.5 million
separations
Around 3000 bridging based endpoints
Federal Governments Telehealth Program 495,000 services by end of 2015
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 8 EDCS-962069
The Clinical Ecosystem
GP
Specialist
Acute
Home
Community
22,471 Specialist
24,029 GPs
736 Public Hospitals
8.5 million
separations
Around 3000 bridging based endpoints
Federal Governments Telehealth Program 495,000 services by end of 2015
Leverage Infrastructure and skills
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 9 EDCS-962069
Telehealth Drivers in Australia
• Cost of Care
• Acceleration of healthcare costs as a % of GDP (Currently 9.2% of GDP)
• Equity of care
• How do we more effectively reach and engage consumers: the geographic, cultural and demographic divides
• Resource Availability
• Limited supply of specialist resources facing increasing demand
© 2011 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 10 EDCS-962069
Resource Availability
• Population effect compounded by population density
• 24.3% of rural and remote medical practitioners are over the age of 55.
• Young doctors do not see rural locations as desirable due the
professional and social isolation.
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The Challenges The Healthcare Management Myth
Health is a well disciplined organization ready to immediately obey their leader.
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The Healthcare Management Reality
• Healthcare is a Complex Adaptive System
• Well disciplined agents of comparable authority that interact in often highly nonlinear ways to maximize their individual output. (1,2,3)
• Health evolves as a result of many small innovations leading to a change in the whole system
• This is what fuels change and evolution in healthcare but makes uniform implementation difficult
• Rapid innovation is the opportunity presented to us by the Gov Telehealth Strategy (1) William B. Rouse, Health Care as a Complex Adaptive System, The Bridge, Spring 2008
(2) Sholo m Glouberman, Brenda Zimmerman, Complicated and Complex Systems: What Should Successful Reform of Medicare Look Like,
Commission on the Future of Health Care in Canada, Discussion Paper No2, July 2002
(3) Joseph Tan, Joseph Wen, Healthcare and Services Delivery Systems as Complex Adaptive Systems, Communications of the ACM, May 2005, 48,
5, 38-44
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Challenges: Readiness Spectrum
Specialist General
Practitioner
Acute
Care
Hospital
• Less than 20% practice
computerization
• Low computer literacy
• Little network support
• Low motivation to change
• Greater than 95% practice
computerization
• Moderate computer literacy
• Basic network support
• Moderate motivation to
change
• High level of computerization
• Good computer literacy
• Sophisticated network support
• Existing telehealth
infrastructure
• Existing funding programs
• High motivation to change
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Challenges: General Practitioner Perspective
What do you predict the
take-up to be like for access
to specialist services by
telehealth?
What proportion of your work
could be done by telehealth?
Telehealth Assessment Final Report
28 June 2011 UniQuest Project No: 16807
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Challenges: Specialist Perspective
• Coordination
• Need for high level of support
• Time allotment
• Fit with Current work practices .
• Patient perspective
• Concern with maintaining patient engagement
• Equipment
• Simplicity and cost effectiveness
• Facilities
• Facilities must be fit for purpose
• Education
• Change management is needed
Uniquest Telehealth Review
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Patient Perspective
Affordable, quality, patient centred care
Cisco HealthPresence™ • 99% were satisfied with the experience • 93% would recommend
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External Challenges to Telehealth
• NICTA Telehealth Review
Telemedicine in the context of the National Broadband Network July 25, 2010
Report by NICTA for Department of Broadband, Communications and the Digital Economy
Business Experience
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Telehealth System Requirements
• Integration with the clinical workflow
• Integration with clinical systems and the way care is delivered
• Integration with the business workflow
• Integrating with business systems: availability, booking, billing reporting
• Reducing the complexity of use:
• User interface, Interoperability, reliable access
• Reducing complexity of support
• Easy and cost effective to support
• Linkage with existing telehealth and clinical resources
• Leverage state based, acute care linked telehealth systems
• Systems must be adaptable: One size does not fit all
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Thank you.