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Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Telehealth in New BrunswickThe 5WH’s
by Valerie Hagerman
Senior Business Systems AnalystDepartment of Health and Community
ServicesProvince of New Brunswick
September 30, 1999
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Objectives
This presentation will:
Introduce Telehealth as one component of NB’s Health Infostructure
Explain New Brunswick’s approach to telehealth planning and implementation.
Summarize what has been accomplished
Discuss what is left to do
And , if time permits, introduce you to the Canadian Society of Telehealth.
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Consumer Information/
Empowerment
Electronic Patient Record Information
Management
TelehealthDisease
Monitoring/ Surveillance
Privacy
Program Management/Monitoring
Telehealth: A Key Component of the New Brunswick Health Infostructure
Standards/Interoperability
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Eliminate redundancies Eliminate redundancies Shorten the time to do the work Shorten the time to do the work Improve healthcare quality and Improve healthcare quality and outcomes outcomes Improve productivity and effectiveness Improve productivity and effectiveness Improve communications Improve communications Contain/reduce costs Contain/reduce costs Increase accessibility to health Increase accessibility to health services services Facilitate easier administration Facilitate easier administration managementmanagement of program areas of program areas
The success of NB Health Infostructure (and its different components) will be measured by the extent they can:
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Shifting from the Physical Movement of Shifting from the Physical Movement of Patients and/or Providers to the Virtual Patients and/or Providers to the Virtual
Movement of Information.Movement of Information.
PhysicalPhysical
VirtualVirtual
PatientPatient ProviderProvider
In a nut-shell telehealth is:
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Administrative/Management
Patient Information/
Education
Clinical
•Tele-monitoring of vital signs•Telephone triage•Compliance Monitoring•Remote diagnosis•Remote treatment
• Electronic case management• Electronic records database• Remote access to records• Care integration/coordination
• Self-care• Health promotion• Disease prevention• Disease management• Caregiver education
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Provincial Telehealth Provincial Telehealth Planning Cycle Planning Cycle
StartStart
Vision,Goals,Vision,Goals,PrinciplesPrinciples
Strategic Strategic ObjectivesObjectives
OutcomeOutcome((PerformancePerformance)) MeasuresMeasures
StrategicStrategic PrioritiesPriorities
ImplementatioImplementationn
PerformancePerformance FeedbackFeedback
Plan ToPlan To PlanPlan
External External NeedsNeeds AssessmentAssessment
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
DHCS / RHC’s• Shared vision• Definition• Goals/ priorities• Success Indicators
PTCC RHC’sHCIT• Telehealth Champions• Education• Networking• Communication• Barriers• Links to EDT/• Business• New funding opportunities
• Application • development• Research/• evaluation• Strategic partnerships
• IT/IS solutions group• Provincial strategic information and IT plan• Interoperability/ integration
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Telecare Telephone triage
Expert decision support software
Poison Control
Private-public partnership (DHCS-Clinidata)
Export /economic opportunities
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Tele-nephrology -Region 1 Beauséjour
Remote monitoring of patients undergoing renal dialysis: 4 unique settings
Distance Education: Diabetes Education and Prevention
Telematics: Wireless Point of Care EPR Integrated With Meditech Record
PACS and Data Repository
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
•A scalable solution was required to improve the reach and efficiency of New Brunswick’s centre of excellence for cardiac care
•A provincial infrastructure was created using a range of network platforms that improved access to and utilization of scarce specialized services
•Hospital network for remote patient referrals,assessments and post op monitoring direct to patients’ homes
Building the virtual hospital
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Remote cardiac triage management
Remote cardiac catheterization assessment
Post cardiac surgery assessment
Remote home monitoring
Tele-cardiology
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Tele-radiology Mixture of
technologies/locations -point to point
Integration/Standardization: Sterling (Agpha)Direct Radiography-Regions 1,2,3,7.
Discussions for province-wide emergency room linkages.
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Tele-rehabilitation
Access to specialized physiatry and OT/speech/physiotherapy services-(Regions 3, 6, 1SE)
Remote monitoring/assessment/education over secure Internet connections-Assistive Devices-(Region 3)
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Tele-psychiatry
New project in Region 2[Off the ground fast-most of therequired infrastructure in place.]
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Distance Education
Multi-point video-conferencing (35+units)
Virtual Campus and Tele-education
CBT: Community access centers
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Partnerships with Nova Scotia
• Pediatrics:Maritime Telehealth Network-IWK Grace: Regions 2,6,3 +
• Oncology- Tumor Rounds
• CME-Dalhousie medical School
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Review of Accomplishments:
1996-99:
A great deal of innovation and an increasein telehealth applications under the umbrella of aprovincial vision/strategic plan versus one provincial implementation plan/project.
PTCC believes it has accomplished the goals set out forit to do in respect to raising awareness, providing a forum to open up communication among regions/DHCS,offering recommendations on issues related to reimbursement, and telehealth standards.
Telehealth funding has come from a variety of sources: DHCS, EDCT, CANARIE, Health Canada, Foundations, RHCs.
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
Next Steps: 1999-2000 +What is the NB telehealth community saying ?
Acceleration of telehealth implementation agenda
Measures to sustain and expand programs
Business plan to move from pilots to a sustainable provincial telehealth program
Increased funding
More human resource support at local and provincial levels
Explore, based on pilot results/experiences,what else telehealth could do for NB in 21st Century.
Valerie Hagerman, Province of New Brunswick, ACHI Conference ,Nova Scotia
DiscussionQuestions