Dr Laurie Wilson, CSIRO Computational Informatics - Telehealth Beyond Video-Conferencing
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Transcript of Dr Laurie Wilson, CSIRO Computational Informatics - Telehealth Beyond Video-Conferencing
Telehealth Beyond Videoconferencing Laurie Wilson Honorary Fellow, CSIRO Computational Informatics Adjunct Professor, University of Western Sydney Honorary Secretary, Australasian Telehealth Society
CSIRO COMPUTATIONAL INFORMATICS
Outline
• Telehealth Today • Potential restricted
• Lagging behind other ICT applications
• Potential Evolution • CSIRO study
• Models for telehealth evolution
• Examples • Telehealth to the patient
• Multisite high-care teams
• The need for a national strategy
Telehealth is booming!
0
5000
10000
15000
20000
25000
30000
Telehealth Medicare
Claims
But technology is slow to change
• To most users, telehealth=videoconference
• Consultation rather than service delivery
• Not at point of care
• Restricted data access
• Telephone with pictures
Telepresence & mobile media
•Healthcare (as usual!) slow to adopt new technologies •But telehealth must change to achieve its potential
Health systems are in crisis Can telehealth play a role?
http://www.health.gov.au/internet/yourhealth/publishing.nsf/Content/report-redbook/$File/HRT_report3.pdf
Health budget as percent of
total expenditure
Bandwidth will cease to be a barrier
Image: NBNCo
Only the most remote users may be limited by •Latency •Bandwidth •Symmetry
Even truncated NBN will free healthcare from bandwidth limitations
CSIRO Study
• How can we “future-proof” infrastructure such as the NBN?
• How will telehealth evolve over the lifetime of such infrastructure?
• Can telehealth evolve to meet the challenges?
• Literature search • Telehealth literature
• Computer Supported Cooperative Work (CSCW) literature
• CSIRO Broadband Pilots
• Interviews with panel of thought leaders
Analysis
Telehealth literature
CSCW literature
CeNTIE pilots
Expert panel
Analyse for trends
Analyse for trends
Analyse for trends
Analyse for trends
Meta-analyse for trends
Conclusions
Research questions
Patient centricity
Universal access
Networked caregivers
Ubiquity
Quality of service
Adaptability
eHealth integration
Smarts
Care models
Future trends
Technology Clinical applications
Aged & chronic
Point of care critical
Mental
Wellness & prevention
Care models → Patient centricity
• Both a driver and beneficiary of telehealth evolution • Key technologies
• Home-based systems
• Mobile applications
• Personal health records
• Implies ubiquity of access • Also includes such issues as
• Human factors/culture and
• Process change
• Policy/regulation
• Business model, funding
• Implementation and sustainability
• Legal/liability issues.
Personalised
information
Interactive
technology
Personal health
record
GP
CSIRO NBN Telehealth Trial
6 Sites • Townsville • Penrith • Greater Western Sydney • Canberra and ACT • Ballarat and the Grampians • Launceston / Northern Tasmania
• Number of patients at each site • 25 Test Patients • 50 Control Patients
• Total • 150 Test patients • 300 Control Patients
• Trial Design • Case Matched controls • Before-After-Control-Impact (BACI)
High-end & point-of-care systems Evidence base
ViCCU - Emergency
ECHONET – Intensive care
RIDES – Paediatric post-surgery
Three advanced telehealth systems trialled in the CSIRO CeNTIE program
LS Wilson, DR Stevenson & PC Cregan, Telehealth on Advanced Networks, Telemedicine & eHealth 16, pp 69-79 (2010).
Care models
Technology Clinical
applications
Telehealth evolution
Complexity
Simple, low bandwidth
Multichannel, broadband
Tertiary referral hospitals
Primary care
Home & mobile
Early systems
Future advanced systems
?
Current advanced systems
Current advanced systems
Publication
J.Li and L.S.Wilson. Telehealth trends and the challenge for infrastructure. Telemedicine and eHealth, 19, pp 772-779 (2013).
Challenges for telehealth 1
• Achieve economies of scale • Beyond pilots
• Facilitate structural and changes in healthcare delivery
• Make best use of technology • Telepresence – as good as being there
• Multimedia
– Multicamera
– Images
– Sounds
– Touch
– Data, vital signs
• Integrate with eHealth
• Wider range of clinical applications
• Bandwidth no longer a problem
Challenges for telehealth 2
• Human factors • Ease of use
• Process change
• Integration into workflow
• Point of care => patient not tech focus
• Economics • What is the value of telehealth?
• Business models for telehealth implementation, esp home-based
• Cost-benefit
Need for a National Strategy
• Advocated by HISA and more recently, Australasian Telehealth Society.
• High level guidance of process change
• More patient centred delivery of healthcare
• Removal of social and organisational barriers
• Achieve economies of scale
|
•Only organisation specifically addressing the needs of the Australian and New Zealand Telehealth communities •Over 300 members •Has run four internationally-recognised national and international conferences •A forum for all those involved in telehealth •Actively promoting telehealth with Government and other decision-makers
www.aths.org.au