Australian Telehealth Conference 2017 Telehealth in Victoria Andrew M Saunders - Director Digital Health & Health Sector CIO Penelope Watson - Manager, Telehealth Strategy & Development
Topics Victoria’s Digital • Andrew Health Strategy & Context for Telehealth Telehealth in Victoria • Penelope Past, Present, Future 28 April 2017
Australia’s health system Victoria: A snapshot Public sector health services are provided by • Victoria’s population is just over 6 million all levels of government. (ABS, 2016) • Just over two thirds of the population (67%) Public hospitals are managed by state and territory governments. are aged between 15-64 years • Nearly 900,000 people are aged 65 years and over (15%) • Total health expenditure in Victoria by Government in 2014-15 was $39 billion (AIHW 2016) – Community Health ($817 million – 2%) – Primary health ($13.5 billion – 35%) – Public hospitals ($11.358 billion – 29%) • Victoria’s health services devolved governance model
Pressures on Victoria’s health sector
Connected health in the future: moving to a person-centric model of care
Telehealth is not a stand alone clinical workflow system – It is part of a Digital Health eco-system Telehealth Clinical Workflow Processes
Challenges to overcome Paper based clinical records Network Connectivity & Interoperability below ‘clinical grade’ Integrating Telehealth into ‘clinical workflows’ Change management / Developing clinical expertise Funding Appropriate clinical governance
Priority Use Cases Urgent care / Enabling the provision of support and specialist advice during an unplanned medical event. For example, 1 unplanned emergency presentation or urgent care. consultations Scheduled consultation that may or may not include a Planned 2 patient and secondary physician. For example, outpatients consultation and MDMs. Home & community Providing post-discharge management, community/ home 3 based care delivery (particularly for those with chronic based care disease), including remote monitoring of patient vital signs. Education & Events focused on education, training and supervision 4 training purposes. For example, morbidity and mortality meetings. 28 April 2017
Telehealth in Victoria Past, Present, Future April 2017 Penelope Watson Manager, Telehealth Strategy & Development
Vision The cornerstone of the department’s telehealth vision is that, where clinically appropriate, it must be seen as a routine method of delivering clinical care, and a viable and reliable alternative to face to face consultations.
The Past 2013 • Telehealth Unit established • 2013 Health Innovation Reform Council developed a telehealth paper & recommended a number of projects be funded 2013-2015 • $8.72 million funding for telehealth projects (27) • Resources developed: • Critical Success Factors for Telehealth Implementation • Medico-Legal Aspects of Telehealth Services for Victorian Public Health Services • Various toolkits from telehealth projects • Audit of Network Capacity completed
Present 2016 • $5 million allocated to support adoption and increase of telehealth in public specialist outpatient clinics • 16 trojects across 15 health services received funding • Better Care Victoria funded $4.1 million across 6 telehealth projects • Health Services provided access to Healthdirect Video Call (at this stage primarily to projects but is available to any Victorian publically funded health service) • PwC engaged to complete: • Telehealth Strategic Options Assessment - Current and Future State, and Roadmap • Business Case to support State-Wide Telehealth Capability
Telehealth Strategic Options Assessment – Survey • Surveyed 86 Health Services on their understanding of telehealth use (RR 60%) • The survey focused on the four user cases Telehealth frequency
Survey Responses Existence of a telehealth strategy within the Health Service
Survey Responses Telehealth activities included within ICT strategy (for those answering no)
Survey Responses The greatest issues in implementing Telehealth programs Other 34.1% Poor infrastructure and / or end user device capability 39.0% Lack of sustainable ongoing funding sources 70.7% Lack of upfront funding to commence program 51.2% Lack of overall interest in Telehealth 9.8% Poorly implement and / or managed 26.8% Lack of consumer / patient acceptance 19.5% Lack of executive engagement and buy-in 9.8% Lack of clinician engagement and buy-in 39.0% 0 5 10 15 20 25 30 35 Number of HS Metropolitan Melbourne Regional Victoria
Future Directions for Telehealth in Victoria Strategic Plan: Enabling better care for Victorians, Telehealth in Victoria, May 2016 • The report describes a future vision for a state-wide telehealth capability which will enable telehealth to be scaled up and utilised for planned and unplanned care, home and community based care, and education and training • The capability will include the policy and governance structures, people and process, and supporting technology
Future Vision The future vision for Telehealth in Victoria 01 02 Urgent care / unplanned Planned consultations consultations Where required to support patient In urgent and unplanned events, care, remote specialist clinical advice patients have access to timely expert will be available to patients and clinical advice to support their care, treating clinicians irrespective of The future state irrespective of where they are located condition or geographic location. in Victoria of telehealth in 03 04 Victoria Home and community based care For cohorts at high risk of hospital-based Training and education service utilisation, the provision of All clinicians irrespective of location teleconsultation and monitoring within will have access to certain forms of the community / home environment education and training. reduces the burden of disease on the patient and the Government.
Future State Delivery • Partnership Delivery Model requiring a staged approach over 4 years • A blend of key capabilities between DHHS and Health Services • Centralisation of key activities i.e. strategic direction and policy, aligning funding arrangements, promotion of standardisation etc. • Health Services continue to build on their experiences in telehealth • State-wide Telehealth Community of Practice & Special Interest Groups for each Use Case
Proposed Delivery Framework Statewide Telehealth Community of Practice (COP) Selected Use Case Special Interest Group Application of SIG Requirements for telehealth expertise design of use case during Model of Care testing and deployment Knowledge gained and resources developed Development and stored centrally with COP to ensure shared by SIGs and Exemplar sites is collected and testing of Model of Care for access to information and learnings selected use case by SIG Revisions and adjustments to Model of Care communicated to SIG for iteration and deployment to Exemplar site 1 Exemplar sites deployment of use case Exemplar site 2/3/4 Statewide Telehealth Capability Program
Where to Now? • Another funding round for telehealth projects 2017/18 • Explore use cases further • Work with Victorian Telehealth Community of Practice (2016/17 funded project) Join at: http://tinyurl.com/telehealthvic • Seek funding to support State-wide telehealth capability • Strengthen data collection - VINAH
Questions? Email: Penelope.Watson@dhhs.vic.gov.au
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