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

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 Setting the background

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 Desktop WebRTC

Room Systems

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

Sites on board (4 out of 18) Number

• f

referrals Referrals related to Malnutrition Number of appointments at each site Nyngan 1 1 2 Coonamble 3 1 2 Dunedoo 2 1 1 Collarenebri

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

• 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 – Dietetics – Zara’s Comments

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

Year One June 2015-16 Key platform establishment and starting point models

• New devices
• Initial platform establishment
• Technology training
• Communications Strategy
• Starting point models refined

and implemented

• Additional Models

incrementally established

• Referral pathways and patient

intake integration

12 Month Review

What worked well?

Initial technology & user support platform establishment What worked well?

• Training sessions at handover on

install, follow up, “play” – test site

• Phone directories include all

WNSW other LHD video conference systems

• Applying screen templates with

dialling information

• Health Direct Video Call
• Clinicians applying to the

Telehealth Steering Committee to commence services

• Initial

technology & user support platform establishment What could have worked better?

What could have worked better?

• Health Direct Video Call

– Challenges around internet coverage in communities

• Initial issues with wireless on the

Wireless portable device – Wallie

• Staff change management for

technology

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

June 2016-2017 Widespread adoption of Telehealth Models Across the District

• Initial platform integration
• Ongoing technology

enhancements

• Scheduling solution

development and early roll

• ut phase
• Communications, internet

resources and access portals

• Ongoing reporting and

benefits tracking and service evaluation

• Additional Model ( priorities )
• Referral pathways and

patient intake integration

• Integrated care / virtual

health services

Year Two

2017-2018 Virtual Health Service supporting integration

• f provider Networks

and referral Health Services

Year Three

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