National Rural Health Conference Expanding Rural Service Delivery through Emerging Technologies Karen Dixon, CHSALHN Friday 28 April 2017

Technology and Health

SA Health

The next 20 minutes!

> Rationale for virtual services

> Key factors necessary for successful implementation of technology-enabled health services in country South Australia

> Examples of technology-enabled health services in Country Health SA Local Health Network

> Challenges and opportunities

> SA’s largest geographical health service

> 64 hospitals, 220 locations

> 8,000 staff, 470,000 people over approx. 1 million square kilometres

CHSALHN Regions

SA Health

Why do we need Virtual Services?

Virtual Services enable rural health services to expand reach and improve access in a resource poor environment across vast distances

SA Health

Benefits of Virtual Services

> Expand availability of services provided in local community

> Reduced transfers and trips to larger centres or cities for patients requiring specialised intervention

> Early detection and management, potentially preventing hospitalisation

> More appropriate utilisation of health services

> Improvements in safety and quality, and accessibility and efficiency

SA Health

Key Factors for Technology-enabled health service models

> Strategic Vision, intent and context

> Cultural change and bold leadership

> Foundation on which technology is built

> Consumer, community, service need driving change

> Embedding technology into service models

> Digital intelligence and access

SA Health

Strategic Vision, intent and context

SA Health - Transforming Health Increased access to services for country residents by:

> Continuing to provide services as close to home as possible, reducing need for travel

> Proactively facilitating timely transfer from Adelaide back to country S.A.

> Increasing use of videoconferencing through DTN as an alternative to face to face

> Utilising other emerging technologies to support country patients, eg home monitoring for people with chronic disease

SA Health

eHealth Clinical Services Strategy

> Supports our work to be the best rural health service by creating an integrated, patient-centric, technology-enabled health service for country South Australia.

> CHSALHN Transforming through Technology - eHealth Clinical Services Strategy provides an overarching framework to guide current and future eHealth initiatives within CHSALHN.

SA Health

Vision

> Providing quality, patient-centred effective

services utilising technology at every level

of care with reliable, timely, interconnected,

mobile and robust systems

SA Health

Cultural change and bold leadership

“Your proposal is innovative. Unfortunately we won’t be able to use it as we have never tried something like this before.”

SA Health

CHSA’s Foundation for Technology

> Existing workforce willing to embrace technology and overcome challenges

> Networked and responsive local country health services

> Digital Telehealth Network (DTN)

> Integrated Cardiovascular Clinical Network (iCCnet) – Point of care testing, cardiovascular clinical network, accessible clinical data, Integrated Point of Clinical Care System (iPOCCS)

Digital Telehealth Network (DTN)

> Provides more than 230 video conferencing units in country and metropolitan health sites

> 100 additional DTN clients

> Used in mental health, psychology, oncology, cardiology, renal, burns and rehab

SA Health

Examples of consumer, community, service need driving change

Country Access to Cardiac Health (CATCH)

> 3 major components of this initiative

• Referral pathway for all residents of country South Australia to cardiac rehabilitation including automated referrals from metropolitan hospitals

• Developed a database and booking/information system for cardiac rehabilitation – used across SA

• Implemented a telephone cardiac rehabilitation program

SA Health

Achievements for CATCH > Telephone cardiac rehabilitation service

successfully implemented including 6 and 12-month follow-ups

> A comprehensive referrals database has been developed – collection of clinical information during and post cardiac rehabilitation

> Referrals database now used across all country and metropolitan providers both public and private

> Telephone cardiac rehabilitation now available for all country residents in addition to face to face services

CATCH Outcomes

VCC

> ADD photo of consumer

Virtual Clinical Care (VCC)

SA Health

Virtual Clinical Care – Home Tele-monitoring (Implementation phase April - October 2015)

> 81 patients supported across country SA who have COPD, Cardiac Failure, Diabetes, Hypertension or a combination of these conditions

> Patient set up at home with devices to take daily measurements with results linked to a database accessible to members of the healthcare team

> Results outside ‘normal’ range for that patient triggers a response from healthcare team

> VCC is facilitated by a collaboration between iCCnet (CHSA) and nurses and allied health involved in the provision of services for people with chronic disease(s) in country SA

SA Health

VCC – innovation in action

Patient feedback

“I would never have known I had BP issues without the trial. I often felt really ‘crappy’ and didn’t know why. I now know it is because of my high BP and am starting to get on top of it with my GP. So I

think the VCC is wonderful.”

SAVES – SA Virtual Emergency Service

SA Health

Other technology-enabled initiatives

> Digital 3-D foot scanning and custom footwear production

> Use of floor, bed and chair sensor mats and door sensor beams for early notification – falls prevention

> Tele-rehabilitation – linking clinicians with patients remotely to support ambulatory and home-based rehabilitation

SA Health

Embedding technology into service models

SA Health

Digital Intelligence and Access

> Limitations of mobile network coverage

> Bandwidth challenges

> Socio-economic divide re access to multiple devices/media

> Varying levels of health literacy with the additional layer of digital intelligence

SA Health

Future State

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SA Health

Opportunities for the Future

> Embedding technology into all service delivery models as a viable alternative to face-to-face

> Continuing to seek innovative solutions to access issues

> Public/private partnerships to address the challenge of public health staying abreast with technological advances

> National approaches to telehealth where appropriate eg stroke telehealth