Demystifying the complex: The practical importance of telehealth to - - PowerPoint PPT Presentation

Demystifying the complex:

The practical importance of telehealth to Australian Communities

Kim Casburn, Manager Primary Care, Health and Wellbeing

• The challenge
• RFW – who we are and what we do
• How did we get to where we are
• Traditional telehealth
• Breaking the complex into simple steps
• Building capacity
• What we have learnt
• The future

Overview

• Vulnerability - Children living in remote Australia are twice as likely to be developmentally

vulnerable compared to children living in major cities (AEDC, 2015)

• Indigenous Children
• are twice as likely to be developmentally vulnerable in two or more domains compared to

non-Indigenous children (AEDC, 2015).

• high prevalence of Indigenous youth in Australian prisons which is strongly associated with

hearing loss, speech and language disorders ( Thomson, 2013)

• Workforce gap - the availability of Allied Health professionals ranges from 2.66 per 10,000

people in capital cities to 0.60 per 10,000 in remote areas (NRHA)

• Isolated Practitioners in rural areas have a wide range of clients and clinical

presentations, lack management support incliuding orientation and mentoring (SARRAH)

Percentage of children developmentally vulnerable in 2015 Geography Physical Social Emotional Language Communication Vulnerable 1 Domain Vulnerable 2 Domains Australia 9.7 9.9 8.4 6.5 8.5 22.0 11.1 QLD 12.4 12.4 10.1 8.0 10.5 26.1 14.0 NSW 8.5 9.2 6.8 4.8 8.1 20.2 9.6 Far West 15.8 14.2 8.3 12.7 11.5 33.7 17.4 Coonamble 26.8 28.6 19.6 16.1 8.9 41.1 33.9

Source: Australian Early Development Census (AEDC), 2015 Census

The impact of distance

Royal Far West

The RFW way

Language is important

RFW uses the term ‘telecare’ when describing its technology enabled services. This term is in preference to the more commonly used terms ‘telemedicine’ and ‘telehealth’ in order to reflect the unique nature of RFWs work across the health, education and community sectors. Impact:

• Helped us to better engage the education sector
• Puts ‘care’ at the heart of what we do

Our telecare story

https://www.youtube.com/watch?v=CvMRTbv98jY

2013: BUPA funded pilot (speech) with University of Sydney 2014: Expansion of speech program, delivering tele-OT & telepsychology, delivery into QLD 2015: Telepaediatrics & group programs introduced 2016: Launched Windmill (disability specific program), RFW telecare goes national! 2017: 20 unique telecare services across 7 different disciplines. We support over 1000 children annually, delivering over 10,000 Occasions of Service. We are in 60 schools each term and growing.

Telecare locations: June 15-Dec 16

RFW Telecare Services Speech Pathology Dietetics Paediatrics Psychology Occupational Therapy Psychiatry Practitioner Support

Why telecare?

• Therapy for children unable to access local services
• Provides continuity where outreach and local services are unable

to ‘Right time, right place, right clinician, right frequency’

• Reduce disruption to child’s routines
• Capacity building of staff members within child’s school or

preschool

What parents told us: 57% of parents had previously tried to access services for their children and of these 77% could not receive service because:

• The service was not available
• They had to go on long waiting lists
• The services were too far away
• The cost of services was too much

Moving beyond traditional telehealth

Traditional telehealth in our Paediatric setting:

• ‘Child & Therapist’ consultation
• Basic speech, language 1:1 approach

Evolved to include:

• Remote triage & stepped care
• Interactive play therapy
• Group therapy with children

with similar needs

• Capacity building (adults take
• n active therapy aide lead)
• Real time feedback to teachers

regarding individual and ‘whole of class’ strategies

Capacity Building

It underpins all we do:

• complement existing local services
• leverage community capabilities
• sustainable model

“When I said to the teacher ‘he’s got significant language difficulties’…his teacher came and observed a session and then there’s that carry over now into the classroom. So she may, instead of giving him a set of three instructions in a row, she might be limiting them to just one instruction at a time’ Therapy aide working with RFW to deliver group therapy in a NSW school

Case study: Early intervention in regional QLD

Design and implement a complementary and integrated sustainable Paediatric Early Intervention Allied Health service model delivered by telecare. Working with early educators to identify and support children aged 4-5 so that they are school ready: Pathway 1: Screening Pathway 2: Specialised Assessment Pathway 3: Individual Therapy Pathway 4: Group Therapy Pathway 5: Capacity Building

“Our families have been extremely happy with the progress their children are making due to being able to access allied health services while their children are in care. Lots

• f positive feedback

received from families and educators within the service” Early educator

What we have learnt

• Culture (clinicians and recipient of service)
• Hype vs practical
• Funding sustainability & Advocacy
• Make the complex simple but don’t underestimate the

time and commitment it takes to support people.

• Technology runs ahead of people and systems
• Co designing the solutions
• EVIDENCE

Future Directions

• National Centre for Child Health and

Learning

• Servicing all states in the country
• Reaching most marginalized

communities - strengths based approach

• 12,000 kids reached annually by

2020

• Increase capacity building services =

sustainability in community

• Expansion of Disability services

(NDIS)

• Multi modal approaches

Telecare is changing lives

“By helping these kids to receive the therapy they need, you are not only helping them to find their voice. You are helping them grow into more confident, happier kids. You are giving them an opportunity to learn new skills, build stronger relationships and hopefully achieve all their hopes and dreams!.” Teacher, QLD “At first I was a little sceptical about how the children participating in the program would be able to achieve their individual goals/learning outcomes but after supporting and guiding these groups I have seen significant growth in the overall development of each and every child.” Therapy aide working with RFW to deliver group therapy in a NSW school “When my anxious child says I don’t want to go to sleep. I used to say ‘Don’t worry go to sleep’. Now I ask; ‘Why are you feeling this way? What can we do? How can I make her feel like I understand’?” Parent, telepaediatrics program