1 / 31

Enhancing Access by Bridging the Distance

Enhancing Access by Bridging the Distance. The New Brunswick Telehealth Experience. February 2007. The New Brunswick Context. New Brunswick is a rural province with a geographically dispersed population We are required by law to offer health services in two official languages

jimmiec
Download Presentation

Enhancing Access by Bridging the Distance

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Enhancing Access by Bridging the Distance The New Brunswick Telehealth Experience February 2007

  2. The New Brunswick Context • New Brunswick is a rural province with a geographically dispersed population • We are required by law to offer health services in two official languages • Tertiary services are concentrated in NB’s 3 largest cities in the south: Moncton, Saint John & Fredericton

  3. Challenges and Creativity Geography Access Population concentration Wait time Location of services Telehealth Creative service delivery approaches utilizing technology to improve access and wait times.

  4. NB - Early Innovator in Telehealth “Imagination is more important than knowledge.”

  5. Telehealth Definition “The use of information and communication technology to deliver health services, expertise and information over distance.”

  6. Telehealth in NB Bridging distances by bringing quality health services and information to all New Brunswickers.

  7. VISION Independent of the location of patient and providers, telehealth will: • Empower consumers and communities • Improve access to needed services and expert resources • Decrease wait times for health services • Maximize opportunities for self-care and compliance to treatment plans • Mobilize new opportunities for patients, families and communities to prevent illness and promote wellness

  8. Guiding Principles • Alignment with the provincial health plan • Improve access/wait times • Clinical programs, not technology, drive priorities • Provides value for client, provider and funder • Respect for preference of language, culture, location of service • Integration with clinical programs & EHR • Respect for privacy & confidentiality • Ease of use • Adopt standards of best practice

  9. Matapedia, PQ Regional Centres TeleCare Hospital/ CHC Montague, Souris, Summerside, Charlottetown, PEI TeleOncology TeleMental Health TeleCardiology TeleNephrology TeleRehabilitation TelePaediatrics TeleHomeCare Teleneurosurgery TeleEducation Amherst, NS TeleGenetics IWK Halifax, NS TeleNutrition QEII Halifax, NS Telehealth Infrastructure Caraquet Dalhousie Lamèque Campbellton St-Quentin Tracadie-Sheila Edmundston Bathurst Miramichi Grand Falls Plaster Rock Doaktown Perth Bath Ste-Anne-de-Kent Woodstock Minto Moncton (Dumont) Moncton (City) Fredericton Oromocto Sackville Sussex Harvey Albert McAdam Saint John (St. Joe’s) Saint John St. Stephen Black’s Harbour Deer Island Campobello Island Grand Manan

  10. Telei4 PACS Connections Other DI Connections Provincial and Atlantic Network Connection Halifax NS QEII Hospital DI Infrastructure Caraquet Dalhousie Lamèque Campbellton St-Quentin Tracadie-Sheila Edmundston Bathurst Miramichi Regional Centres Grand Falls Plaster Rock Hospital Perth Bath Ste-Anne-de-Kent Woodstock Minto Moncton (Dumont) Moncton (The) Fredericton Oromocto Sackville Sussex Harvey Albert McAdam Saint John (St. Jos) Saint John St. Stephen Black’s Harbour Grand Manan

  11. Enhancing Access “Taking the hype out of Telehealth and utilizing available technology, allows us as health care providers to seize opportunities to increase access to quality holistic health care. We are limited only by our imagination”. Krisan Palmer, Manager, Telehealth Department, Atlantic Health Sciences Corporation

  12. New Brunswick Heart Centre • The New Brunswick Heart Centre (NBHC) provides tertiary cardiac care to the province of New Brunswick • Initiated telehealth service in the 90s as a result of issues relating to access and continuity of care • As a result of this and other program improvements, currently • 96% of all coronary artery bypass surgeries are completed within 182 days

  13. Clinical Issues Prompting System Changes Cardiac Triage • No objective, systematic approach in referrals or prioritization • Loss of patient data • Inequities Following surgery • 32.3% reaccess rate to local emergency • 54% of those readmitted • No communication to the Heart Centre • Inappropriate case management

  14. Objectives for Telehealth Use • Objective, systematic approach to cardiac triaging • Increase access to specialized scarce resources and reduce wait times • Increase quality and continuity of care • Extend the hospital into the home • Decrease reaccess, readmission rates • Eliminate geography

  15. Cardiac Triage - Teleconsultation • Contact system through remote terminal at any time of day • Data stored on server at the Heart Centre • Maintain list of all patients and provide feedback to referring centres re: where patients are on the list • Utilization of an acuity/priority scoring system to objectively rank patients for transfer

  16. Post Surgery – Hospital to Home Monitoring • Real-time interactive clinical monitoring system (ECG, NIBP,SP02) • Fully interactive audio and video • Wound Management • Works on standard phone line (POTS)

  17. Results -Quality • Ease of access to expert advice improved quality of care, and reduced reaccess rates by study patients during immediate post discharge period • Clinically valuable, treatment of symptoms before emergent

  18. Results -Acceptability • Patient satisfaction – 80 – 100% • Clinician satisfaction – 80 – 100% • Technology Performance 91 - 100% Peripherals 92 - 99%

  19. Overall Evaluation • Determined clinically equivalent • Improved access/wait times • Enhanced capacity • Cost of access to care is significantly reduced for patients and their families

  20. Testimonials • “It is an excellent program, easy to use.We feel really secure knowing we are being monitored daily by our nurse. It lessens our fear of something happening.” –patient • “It’s facilitates great collaboration with the specialists at the heart centre”- remote MD • “You are angels in a suitcase!!”-patient

  21. Telehealth and the New Brunswick Heart Centre • An integral component of the New Brunswick Heart Center • Teleconsultation and home monitoring are key components for appropriate access and wait times • Home monitoring provides service to over 450 patients a year • Has undergone planning for technology enhancement and incorporation of all information collected into the Region’s Clinical information System

  22. Outpatient • Clinics • Real-time interactive • audio and video • Data channel allows auscultation of heart and lung sounds • Wound management • Echocardiograms, • X-rays

  23. Provincial Telehomecare demonstrator initiative • New approach to care of patients with a chronic care disease • 85% decrease in hospital admissions for patients • 55% decrease in emergency room visits • 96% - overall patient satisfaction with service • 95% - recommend to others • 93% - better knowledge of health condition • Overall, improved access to appropriate care when required resulted in enhanced patient outcomes, decreased utilization of hospital care and therefore enhanced capacity for hospital based services. Telehomecare EMPcare@home

  24. And there are many other examples… • Telemental health – provision of emergency mental health services and consultation services in areas without this expertise. Increased access to specialty services and reduced wait times. • Oncology services –provision of education and information from a provincial cancer centre to the northern regions. Increased access to specialty services and reduced wait times.

  25. Nephrology • Satellite Dialysis Unit • Access to EHR • Physician order entry • Review of diagnostics • Wound Management • Overall improved access to • services and greatly reduced • patient travel.

  26. Summary Telehealth can be a positive enabler for enhancing access, reducing wait times and increasing capacity when…. • It is embedded in the model for service delivery • It is program driven not technology driven • There has been effective change management and support in place

  27. Telehealth, a NB success story as defined by… • Enhanced access • Reduced wait times • Increased capacity • Patient and provider satisfaction • Quality care/outcomes • Patient efficacy/self management • Knowledge transfer/education • Patient support/holistic care • Innovation/technology performance • Cost • Attitude changes – “Just the normal way we do business”

  28. Success…as acknowledged by others

  29. Thank YouEnhancing Access by Bridging the DistanceThe New Brunswick Telehealth Experience

More Related