Local Health District A Virtual Health Service David Wright: - PowerPoint PPT Presentation

Western NSW Local Health District A Virtual Health Service David Wright: Operational Manager Telehealth Strategy Sharyn Cowie: Telehealth Manager

Setting the background

Setting the background

Setting the background

Respect & Commitment

Setting the background Western NSW Local Health District (WNSWLHD) like all rural LHD’s experiences significant challenges in delivering equitable health services to our diverse widely spread population

Why Telehealth ? • Reduced patient travel • Reduced patient financial / social impact • Increased access to clinical specialities • Medical • Mental Health • Allied Health • Nursing Specialities • Organisational Benefits / Efficiencies • Financial • Productivity

WNSWLHD Telehealth Strategy • 2015 Engaged KPMG Consulting • Conduct a current state review • Pockets of BAU sustainable services • Adhoc clinics • Executive support - ???? • Steering Committee - ???? • Telehealth Manager & Team • Acting eMR Application Support Team Manager

Self Analysis

WNSWLHD Telehealth Strategy • Developed a 3 year Telehealth Strategy • Chief Executive driven • Executive Sponsor – Director Medical Services • Project Manager • Lead the Strategy – Change Management • Clinical Engagement • Team expanded – 2 Support Officers • HWAN & WiFi Roll Out

The End Goal

Starting Models of Care Starting point Models of Care The prioritisation process identified five initiatives to commence first (or key “starting points”) and the potential for subsequent expansion on these foundations . The five starting point Models of Care are: 1. Patient Flow Unit (PFU); 2. Renal Care; 3. Virtual Orthopaedic Clinic; 4. Specialist to GP Collaboration; and 5. Pain Clinic. The detailed Models of Care are provided in Appendix 1 – Detailed Models of Care

Practical - common sense • Worked with people who showed passion • Identified clinical champions • Multidisciplinary / Exec Heavy Steering Committee • Pilot Models of Care (MoC) Implementation Meetings • Use RACI Charts, Flow Charts, controlled hand holding

Tools to Monitor & Support

Current Models of Care (MoC) – Started with 5 MoC – Applications come to the LHD Telehealth Steering Committee – On average 4 applications per month – Now 65 MoC - established, implementation & Parked – financial & staffing

Technology Requirements

Devices CCAS Room Systems Desktop WebRTC Call Centre

Then there’s Wallie & Evie!!!

Marketing • Media Release • District Release • Brochures • Web Page • User Guides • Opportunities to engage staff – Stream meetings, site visits, service gap surveys • Support, support & more support

Web page

Telehealth web page

Progress against the project plan

Virtual Allied Health • Review of Allied Health Services – FTE / service location / work load review – Identified possibility of allocating staff to a virtual service – Virtual Dietetics Service commenced in March 2017 • Malnutrition Screening first step – Zara Codemo – Condobolin – 2 days a week

VAHS - Dietetics Sites on board Number Referrals Number of (4 out of 18) of related to appointments referrals Malnutrition at each site Nyngan 1 1 2 Coonamble 3 1 2 Dunedoo 2 1 1 Collarenebri 0 0 0

VAHS - Dietetics • Length of consult average 40min • All staff have been supportive • Organise appointment & Booking Wallie • Nil issues Kitchen staff and provision of correct diet and oral nutrition supplements for patients.

VAHS - Dietetics • This takes about the same amount of time as doing it in person • 50% of referrals are not related to malnutrition – will require a “launch” or notice to explain purpose of project

VAHS – Dietetics – Zara’s Comments • All the patients & health professionals involved excited and willing to trial virtual dietetic consults. • I’m finding it easy to use the equipment provided to complete a dietetic consult.

VAHS – Dietetics – Zara’s Comments • Working with a client virtually has not limited me in providing dietetic care when compared to an “in - person” appointment. • An initial concern of mine was not being able to develop patient rapport but this hasn’t been the case at all.

VAHS Physiotherapy • Physiotherapy staff conducting pre discharge home assessments. • Use tablets & Health Direct Video Call • Combination of Physio, Physio Aide at patients home and Base Hospital • More time efficient and effective, reduces travel

VAHS - Next • VAHS Steering Committee • Assigning staff to dedicated Telehealth hours • Speech Therapy • Occupational therapy

12 Month Review • New devices Year One • Initial platform establishment June 2015-16 • Technology training • Communications Strategy Key platform • Starting point models refined establishment and implemented and starting • Additional Models point models incrementally established • Referral pathways and patient intake integration

What worked well? • Training sessions at handover on Initial install, follow up, “play” – test site technology & user support • Phone directories include all platform WNSW other LHD video establishment conference systems • Applying screen templates with What worked dialling information well? • Health Direct Video Call • Clinicians applying to the Telehealth Steering Committee to commence services

What could have worked better? • Health Direct Video Call • Initial – Challenges around internet technology & coverage in communities user support • Initial issues with wireless on the platform Wireless portable device – Wallie establishment • Staff change management for technology What could have worked better? Don’t put Wallie in a cupbo board ard or turn him off, he is a virtua tually ly another er valu luable able member ber of your team

Year Two • Initial platform integration • Ongoing technology June 2016-2017 enhancements • Scheduling solution development and early roll Widespread out phase • Communications, internet adoption of resources and access portals • Ongoing reporting and Telehealth benefits tracking and service Models Across evaluation • Additional Model ( priorities ) the District • Referral pathways and patient intake integration • Integrated care / virtual health services

Year Three 2017-2018 Virtual Health Service supporting integration of provider Networks and referral Health Services

Thank you david.wright1@health.nsw.gov.au sharyn.cowie@health.nsw.gov.au Want to know more about Telehealth? https://wnswlhd.health.nsw.gov.au/telehealth