CONNECTING PATIENTS TO CARE, ALL ACROSS ONTARIOOntario Telemedicine Network

Melody King-SmillieKathy Morris Nov 5 2009

Objectives

• Provide an overview of the Ontario

Telemedicine Network (OTN)• Describe the components of Telehomecare Phase

One Program• Discuss findings of THC Phase One Program

What is OTN?

• The Ontario Telemedicine Network (OTN) is one of the largest Telemedicine networks in world, helping to deliver clinical care and professional education among health care providers and patients. An independent, not-for-profit organization, OTN is funded by the Government of Ontario.

• Programs and services are delivered in over 660 sites across the province

Our Mission and Vision

Vision: • For telemedicine to become a mainstream channel for

health care delivery and education

Mission: • To develop and support telemedicine solutions that

enhance access and quality of health care in Ontario, and inspire adoption by health care providers, organizations, and the public

Uses of OTN

Utilization By Event Type 2008/09 fiscal

Clinical Events 53,745Educational Events 9,230Administrative Events 9,794Total Events 72,769

Utilization By Therapeutic Area of Care 2008/09 Fiscal

Telemedicine Site Locations

• Hospitals• First Nations Communities• Medical and Nursing Schools• Cancer Centres• Psychiatric Hospitals• Air Ambulance Program (ORNGE) • Cancer Care Ontario• Professional Associations (OMA,

OHA, RNAO, CPSO)• CIHI, HIROC• Public Health Units• LHIN Offices• Long-Term Care Homes

• Community Mental Health Facilities

• Community Care Access Centres• Community Living Centres• Addiction Treatment Centres• Eating Disorder Clinics• Cardiac Rehab Centre• Family Health Teams• Rural Nurse Practitioners• Specialists’ Offices and Homes• MOHLTC Emergency Management

Unit

Active Sites By Health Care Setting2008/09 Fiscal

Enablers Supporting Telemedicine

• CMPA

• CPSO

• OHIP Billing

• PHIPA

10

Telehomecare

Leonard H. McCoy: The Final FrontierStarfleet Chief Medical Officer, U.S.S. Enterprise

To boldly go…..

What is Telehomecare?

• Telehomecare is more than just the use of technology to link patients and practitioners. Telehomecare involves the use of health informatics, telehealth and disease management to enhance care and case management. The reason for doing this is to change the location of care and to make the right care at the right time accessible to patients in their own homes and local communities

(Dr. Adam Darkins, VHA).

• Telehomecare is a service that gives the clinician the ability to monitor and measure patient health data and information over geographic, social, and cultural distances

(ATA).

Telehomecare in Ontario

New Programming:Telehomecare & Chronic Disease Management

• In 2007, OTN launched a Phase One Telehomecare Program,

• Phase One of this program (March 2007 – Dec. 08) will be delivered to 600 patients in six Family Health Teams (FHTs)

• Funded by Canada Health Infoway and the Ministry of Health and Long-Term Care

• OTN is the Project Manager • Program evaluation

Education & Self-Management

From Enrollment to Discharge: Patient referral THCS meets with patient

obtains patient consent care plan based on patient goals installation of remote home-monitoring

Daily readings teaching and coaching based on

patient data, expressed goals & needs Patient discharged

ongoing support from primary care providers, caregivers and community resources

Telehomecare Architecture

FHT

FHT

PH I FHTPH I

PH I

Support Center/Service Desk

Home Monitoring Unit

Key Findings • Positive impacts on patient quality of life…

• Enhanced patient ability to self-manage their condition.

• FHT staff believed the program provided great benefits to their patients

• OTN successfully delivered the Phase One Program…

• Reductions in hospital admissions were observed…

• Family Health Teams are still developmental as a primary healthcare delivery model within Ontario, it is important to recognize that introducing more change into such systems will present challenges.

Integration & Change

Change Management & Adoption

Change management is about helping people through change…

Health Care Utilization

67.7%

Average number of Emergency Department visits per patient/month

DE

CR

EA

SE

63.6%

Average number of hospital admissions per

patient/month from baseline to discharge

DE

CR

EA

SE

46.8%

Hospital length of stay from baseline to

discharge

DE

CR

EA

SE

Health Care Utilization:

Patient Benefits

• Greater sense of security

• Improved knowledge of condition

• Enhanced family involvement in chronic disease management

• Greater independence

• More physical activity

Patient Survey ResultsOverall patient satisfaction with telehomecare

100%

were satisfied with the telehomecare program

98%were satisfied with the information they received about their health condition

97% felt that the remote monitor equipment was easy to use

100%

felt that their condition was well monitored with telehomecare

Where do we go from here?

Next Steps • Expand THC to those diseases that have the

greatest burden on the health care system • Investigate different models of telehomecare• Offer a variety of CDMS products • Interoperability between the CDMS and

EMRs and other applications• Provide a strong clinical function• Administrative and logistics support

Thank youFor additional information about OTN, please visit

www.otn.caMelody King-Smillie mkingsmillie@otn.ca

Kathy Morris kmorris@otn.ca