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Expanding Rural Service Delivery through Emerging Technologies · SA Health Key Factors for...
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National Rural Health Conference Expanding Rural Service Delivery through Emerging Technologies Karen Dixon, CHSALHN Friday 28 April 2017
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Technology and Health
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SA Health
The next 20 minutes!
> Rationale for virtual services
> Key factors necessary for successful implementation of technology-enabled health services in country South Australia
> Examples of technology-enabled health services in Country Health SA Local Health Network
> Challenges and opportunities
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> SA’s largest geographical health service
> 64 hospitals, 220 locations
> 8,000 staff, 470,000 people over approx. 1 million square kilometres
CHSALHN Regions
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SA Health
Why do we need Virtual Services?
Virtual Services enable rural health services to expand reach and improve access in a resource poor environment across vast distances
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SA Health
Benefits of Virtual Services
> Expand availability of services provided in local community
> Reduced transfers and trips to larger centres or cities for patients requiring specialised intervention
> Early detection and management, potentially preventing hospitalisation
> More appropriate utilisation of health services
> Improvements in safety and quality, and accessibility and efficiency
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SA Health
Key Factors for Technology-enabled health service models
> Strategic Vision, intent and context
> Cultural change and bold leadership
> Foundation on which technology is built
> Consumer, community, service need driving change
> Embedding technology into service models
> Digital intelligence and access
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SA Health
Strategic Vision, intent and context
SA Health - Transforming Health Increased access to services for country residents by:
> Continuing to provide services as close to home as possible, reducing need for travel
> Proactively facilitating timely transfer from Adelaide back to country S.A.
> Increasing use of videoconferencing through DTN as an alternative to face to face
> Utilising other emerging technologies to support country patients, eg home monitoring for people with chronic disease
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SA Health
eHealth Clinical Services Strategy
> Supports our work to be the best rural health service by creating an integrated, patient-centric, technology-enabled health service for country South Australia.
> CHSALHN Transforming through Technology - eHealth Clinical Services Strategy provides an overarching framework to guide current and future eHealth initiatives within CHSALHN.
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SA Health
Vision
> Providing quality, patient-centred effective
services utilising technology at every level
of care with reliable, timely, interconnected,
mobile and robust systems
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SA Health
Cultural change and bold leadership
“Your proposal is innovative. Unfortunately we won’t be able to use it as we have never tried something like this before.”
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SA Health
CHSA’s Foundation for Technology
> Existing workforce willing to embrace technology and overcome challenges
> Networked and responsive local country health services
> Digital Telehealth Network (DTN)
> Integrated Cardiovascular Clinical Network (iCCnet) – Point of care testing, cardiovascular clinical network, accessible clinical data, Integrated Point of Clinical Care System (iPOCCS)
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Digital Telehealth Network (DTN)
> Provides more than 230 video conferencing units in country and metropolitan health sites
> 100 additional DTN clients
> Used in mental health, psychology, oncology, cardiology, renal, burns and rehab
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SA Health
Examples of consumer, community, service need driving change
Country Access to Cardiac Health (CATCH)
> 3 major components of this initiative
• Referral pathway for all residents of country South Australia to cardiac rehabilitation including automated referrals from metropolitan hospitals
• Developed a database and booking/information system for cardiac rehabilitation – used across SA
• Implemented a telephone cardiac rehabilitation program
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SA Health
Achievements for CATCH > Telephone cardiac rehabilitation service
successfully implemented including 6 and 12-month follow-ups
> A comprehensive referrals database has been developed – collection of clinical information during and post cardiac rehabilitation
> Referrals database now used across all country and metropolitan providers both public and private
> Telephone cardiac rehabilitation now available for all country residents in addition to face to face services
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CATCH Outcomes
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VCC
> ADD photo of consumer
Virtual Clinical Care (VCC)
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SA Health
Virtual Clinical Care – Home Tele-monitoring (Implementation phase April - October 2015)
> 81 patients supported across country SA who have COPD, Cardiac Failure, Diabetes, Hypertension or a combination of these conditions
> Patient set up at home with devices to take daily measurements with results linked to a database accessible to members of the healthcare team
> Results outside ‘normal’ range for that patient triggers a response from healthcare team
> VCC is facilitated by a collaboration between iCCnet (CHSA) and nurses and allied health involved in the provision of services for people with chronic disease(s) in country SA
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SA Health
VCC – innovation in action
Patient feedback
“I would never have known I had BP issues without the trial. I often felt really ‘crappy’ and didn’t know why. I now know it is because of my high BP and am starting to get on top of it with my GP. So I
think the VCC is wonderful.”
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SAVES – SA Virtual Emergency Service
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SA Health
Other technology-enabled initiatives
> Digital 3-D foot scanning and custom footwear production
> Use of floor, bed and chair sensor mats and door sensor beams for early notification – falls prevention
> Tele-rehabilitation – linking clinicians with patients remotely to support ambulatory and home-based rehabilitation
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SA Health
Embedding technology into service models
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SA Health
Digital Intelligence and Access
> Limitations of mobile network coverage
> Bandwidth challenges
> Socio-economic divide re access to multiple devices/media
> Varying levels of health literacy with the additional layer of digital intelligence
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SA Health
Future State
(
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SA Health
Opportunities for the Future
> Embedding technology into all service delivery models as a viable alternative to face-to-face
> Continuing to seek innovative solutions to access issues
> Public/private partnerships to address the challenge of public health staying abreast with technological advances
> National approaches to telehealth where appropriate eg stroke telehealth
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