Telehealth Beyond Videoconferencing Australian Telehealth Conference
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1 Telehealth Beyond Videoconferencing Australian Telehealth Conference Dr Sarah Dods Research Theme Leader, Health Services March 2014 DIGITAL PRODUCTIVITY AND SERVICES FLAGSHIP
2 Overview CSIRO & Health Services research Context: Australia s looming health crisis A little of what s possible Smarter Safer Homes - demonstration Things to think about
3 CSIRO Snapshot Darwin People 6550 Locations 57 Alice Springs Cairns Atherton Townsville 2 sites Rockhampton Budget $1B+ Partners Infra $3.5bn Patents Top 1% of global research institutions in 14 of 22 research fields Top 0.1% in 4 research fields Highest number of citations per scientist in Australia Perth 3 sites Murchison Bakers Hill 62% of our people hold university degrees 2000 doctorates 500 masters Adelaide 2 sites Belmont Geelong Toowoomba Gatton Myall Vale Narrabri Parkes Wodonga Werribee Mopra Griffith Hobart Sandy Bay Newcastle Armidale 2 sites Brisbane 6 sites Sydney 5 sites Canberra 7 sites Melbourne 6 sites CSIRO undertakes $~500M of externally funded R&D each year Work with partners in over 80 countries
4 Health Services Research Broadband Health What: Improving access to services & management of chronic diseases How: Service delivery models utilising telehealth, mobile health & remote monitoring Data-enabled Health Productivity What: Improving health system performance & productivity How: Leveraging operational & clinical data through analytics, modelling, decision support & automation Intelligent Health Information What: Realising value embedded in electronic health & medical records How: Meaningful interoperability for decision support & reporting Clinically partnered, digitally enabled, services focussed
5 The Australian e-health Research Centre Partnered for success Australia s leading national ehealth research centre staff, students, visiting researchers Embedded in RBWH Funding from CSIRO Queensland Health Engagement partners Success built on partnering - Government, clinicians, industry
6 Australia s Looming Health Crisis
7 Health Costs are Rising Unsustainably
8 We are staying alive longer, but not well Chronic disease, new treatments Ageing population
9 Bad things happen in overcrowded hospitals Adverse Events/day 4 Overcrowding impacts safety 3.5 Eg 650-bed metro hospital 3 1 year of severe adverse 2.5 events vs occupancy 2 Type of event vs Occupancy 1.5 Probability of event-free day: 1 88% for 80% occupancy % for 95% occupancy Clinical Management Falls 60% for 110% occupancy Medications Hospital Occupancy (midnight census) Predicted Counts by Type Probability of SAC1/SAC2 Incident Probability of Severe Adverse Event vs Occupancy (midnight census) Occupancy Predicted Probabilities No event/day 1 event/day 2 events/day 3 events/day Boyle J, Zeitz K, Hoffman R, Khanna S, Beltrame J. Probability of severe adverse events as a function of hospital occupancy. IEEE J Biomed Health Inform Jan;18(1):15-20
10 Population Futures for Australia: the Policy Alternatives, Professor Peter McDonald, Rebecca Kippen, Social Policy Group 12 October 1999 Ageing population health double whammy Shrinking Workforce Reduced tax base Retiring health workers Less access to services Growing Demands More patients Increased costs More chronic disease Higher expectations
11 Poor access has consequences Health Professionals, per 100,000 Major Cities Very remote GPs Registered Nurses Allied Health Source: National Strategic Framework for Rural and Remote Health 2012, AIHW (20109,, National Rural Health Alliance Fact Sheet 23
12 Productivity Choices Increase capacity (or live with less) More hospitals Effectiveness & efficiency Sweat the assets (the data, not the people) Old things in new ways Service delivery Entirely new things in new ways Rethink into wellness
13 Telehealth Teasers: a little of what is possible
14 Access to Services with a little extra help
15 Rich longitudinal data: Wound Care
16 Rural ED Clinical Summaries
17 From etours to erounds Remote workforce development Developed for education Health training applications Single guide / trainer Unlimited participants Independent view selection for each.
18 Smarter Safer Homes Sensor Networks User Interface design & Interaction ICT in Health & Biomedical Engineering Psychology & Perception
19 Bringing home the virtual world: Community Care through Smarter Safer Homes Platform: Consumer-driven Daily living Community and family Sensors in the home
20 to digitally support independent living Family/Relatives Self-Mgmt Nursing Service Doctor/Clinical Emergency
21 Our Approach: Monitor places, infer people Motion sensor Power meter Temperature Humidity Accelerometer Reed switch Acoustic sensor Motion sensor Power meter Temperature Humidity Accelerometer Reed switch Acoustic sensor
22 Pilot Study 14 independent living homes - 30 sensors + medical devices, Fast broadband Usability & Acceptability Psychological and physiological well-being Quality of Life
23 Demo
24 Example: Pilot study data Motion Sensor only M T W Th F Sa Su
25 Things to think about: the four Es in Telehealth Effectiveness Quality, carer and client satisfaction, health and social outcomes Efficiency Cost per service, direct and indirect Equity Access, appropriate to need, rural and remote targeting Evidence For objective decision making by patients, clinicians and government
26 From information to business services Continuous monitoring of Activities of Daily Living (ADL) Activity Evidence Confidence And more c = 2.3
27 Videoconferencing is the tip of the iceberg Aligning Safety & Quality with Flow, Oct 2013
28 Gentlemen, we have run out of money. It is time to start thinking. Winston Churchill, UK Prime Minister Thank you Sarah Dods Health Services Research Theme Leader t e sarah.dods@csiro.au w DIGITAL PRODUCTIVITY AND SERVICES FLAGSHIP
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