Telehealth in Victoria Andrew M Saunders - Director Digital Health - - PowerPoint PPT Presentation

Andrew M Saunders - Director Digital Health & Health Sector CIO Penelope Watson

• Manager, Telehealth Strategy & Development

Australian Telehealth Conference 2017

Telehealth in Victoria

Topics

• Andrew

Victoria’s Digital Health Strategy & Context for Telehealth

• Penelope

Telehealth in Victoria Past, Present, Future

28 April 2017

Australia’s health system

Public sector health services are provided by all levels of government. Public hospitals are managed by state and territory governments.

Victoria: A snapshot

• Victoria’s population is just over 6 million

(ABS, 2016)

• Just over two thirds of the population (67%)

are aged between 15-64 years

• Nearly 900,000 people are aged 65 years and
• ver (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

Paper based clinical records Network Connectivity & Interoperability below ‘clinical grade’ Integrating Telehealth into ‘clinical workflows’ Change management / Developing clinical expertise Funding Appropriate clinical governance

Challenges to overcome

Priority Use Cases

28 April 2017

Urgent care / unplanned consultations Planned consultation Home & community based care Education & training

Enabling the provision of support and specialist advice during an unplanned medical event. For example, emergency presentation or urgent care. Scheduled consultation that may or may not include a patient and secondary physician. For example, outpatients and MDMs. Providing post-discharge management, community/ home based care delivery (particularly for those with chronic disease), including remote monitoring of patient vital signs. Events focused on education, training and supervision

• purposes. For example, morbidity and mortality meetings.

1 2 3 4

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

39.0% 9.8% 19.5% 26.8% 9.8% 51.2% 70.7% 39.0% 34.1% 5 10 15 20 25 30 35 Lack of clinician engagement and buy-in Lack of executive engagement and buy-in Lack of consumer / patient acceptance Poorly implement and / or managed Lack of overall interest in Telehealth Lack of upfront funding to commence program Lack of sustainable ongoing funding sources Poor infrastructure and / or end user device capability Other Number of HS Metropolitan Melbourne Regional Victoria

The greatest issues in implementing Telehealth programs

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

02

Planned consultations Where required to support patient care, remote specialist clinical advice will be available to patients and treating clinicians irrespective of condition or geographic location.

03

Home and community based care For cohorts at high risk of hospital-based service utilisation, the provision of teleconsultation and monitoring within the community / home environment reduces the burden of disease on the patient and the Government.

The future state

• f telehealth in

Victoria

Urgent care / unplanned consultations In urgent and unplanned events, patients have access to timely expert clinical advice to support their care, irrespective of where they are located in Victoria

04

Training and education All clinicians irrespective of location will have access to certain forms of education and training.

01

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

Application of SIG telehealth expertise Requirements for design of use case

Statewide Telehealth Community of Practice (COP)

Selected Use Case Special Interest Group Development and testing of Model

• f Care for

selected use case by SIG Exemplar site 1 deployment of use case Exemplar site 2/3/4

Statewide Telehealth Capability Program

Revisions and adjustments to Model

• f Care communicated

to SIG for iteration and deployment to Exemplar sites Knowledge gained and resources developed during Model of Care testing and deployment by SIGs and Exemplar sites is collected and stored centrally with COP to ensure shared access to information and learnings

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