staying strong with technology 1.0march 2014 indra arunachalam – strategic projects manager
TRANSCRIPT
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Staying Strong with Technology
March 2014
Indra Arunachalam – Strategic Projects Manager
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Bringing Technology into Care
Objectives:
• Use scarce resources to service increasing demand
• Find alternative ways of delivering services to rural
and remote communities
• Building capacity in consumers to be techno-savvy
• Increase productivity and efficiency
March 2014 Slide 2
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Two Pilot Project
• iPad for regional Carers – reducing social
isolation
• Staying Strong – Telehealth Monitoring for
older Aboriginal and Torres Strait Islanders
March 2014 Slide 3
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iPad for Carers Project
• Pilot project funding from QLD
Department of Communities
• 20 carers participating – iPad + 4G Wi-Fi
each
• Regional Central QLD – 100 to 300 kms
from Rockhampton
• Over 3 months in 2013March 2014 Slide 4
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Why Carers?
• Carers experience the lowest collective wellbeing
- social isolation is a contributing factor
• Carers experience financial challenges
- more than half are on a pension or allowance
• With the ageing population, more Australians will
take on caring roles
• More people want to stay at in their own home
March 2014 Slide 5
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How was it implemented?
• Carer Support Officer trained on use of iPad
• CSO provided one-on-one training to Carers
• One group of 4 Carers opted for group training
• Followed by informal model driven by inquiry and
learning – with CSO and within Carer network
• Carer needs drove iPad usage – email/Skype CSO,
Carer’s facebook forum, useful external links
March 2014 Slide 6
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Evaluation Question
• Did the iPad device assist Carers in regional areas
to reduce social isolation?
March 2014 Slide 7
Very low
Low
Moderate
High
Very high
0% 10% 20% 30% 40% 50%
Post-trainingPre-training
• ‘we can connect to our son in Afghanistan’• ‘it goes everywhere with me’• ‘shortens miles between people’• ‘let’s Skype with a cuppa tea’• ‘can use it for research’
• 92% had positive impressions• 62% made them feel more connected• 93% used it for social network +
entertainment
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Suggestions for Future
• Carers be assessed for indicators of social isolation
– pre and post project
• Ensure internet coverage is not a barrier
• Consider iPad use for both Carer and Care Recipient
• Secure forum to address security concerns
• Access to integratedliving sites – newsletter, policies, training
• Adequate ongoing support to maximise benefits e.g. helpdesk
• Staged capacity building in Carers
March 2014 Slide 8
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Staying Strong Project
Objective: Improve the health and wellbeing of
Aboriginal and Torres Strait Islanders by:
• supporting older Aboriginal and Torres Strait Islanders
access telehealth monitoring at their home or a hub
• developing and implementing cultural activities that
connect older Aboriginal and Torres Strait Islander
Australians with younger people to raise cultural
awareness and respect Indigenous history and heritage
March 2014 Slide 9
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Benefits of Telehealth
• Reduce emergency hospitalisations
• More accurate and timely diagnosis
• Increase awareness of own health conditions
• Increase independence and self-management
• Reduce need for GP home visits
• Peace of mind for older person and family
March 2014 Slide 10
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Telehealth Service Model
• Individualised monitoring plan with relevant vital health sign parameters, acceptable margins and frequency
• Monitor temperature, blood pressure, weight, pulse, oxygen levels, blood glucose levels and/or peak flow rate
• Measure at home or at telehealth services hub and transmitted to central location for triage management
• RN triages and responds to out-of-margin readings
• Provide vital health sign readings to participants/GPs to support diagnoses
March 2014 Slide 11
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Project Participants
Eligibility criteria:
• Identify as Aboriginal and Torres Strait Islander
• Aged over 50 years
• Live in project trial site
Current trial locations:
• Armidale, NSW
• Coffs Harbour, NSW
• Goodna, QLD
• Toowoomba, QLD
March 2014 Slide 12
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Project Evaluation
• Did it improve provision of health services?
• Did it empower people to better manage own health?
• What were the supporting and inhibiting factors in the uptake of telehealth among Aboriginal and Torres Strait Islanders?
• Did it reduce number of hospitalisation/length of time in hospital?
• Did the cultural activities improve the older person’s social connectedness?
• Did it enhance cultural awareness and respect for indigenous history and heritage?
• Did the project improve people’s quality of life (wellbeing index)?
March 2014 Slide 13
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Evaluation Methodology
• Baseline and Follow-up surveys– Personal Wellbeing Index
– Attitude to Technology
– Social Connectedness
• Yarning Circles with participants
• In-depth interviews with
– 8 project participants
– 4 key stakeholders
– Staying Strong registered nurses and project team
March 2014 Slide 14
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Participant Profile
• Currently 89 people receiving telehealth services
• Average age: 62 years
• Mostly female (70%)
• 33% single and 30% married
• 69% living with spouse and/or other family members
• 66% lived in a house; 34% in a flat or unit
• 38% had a primary (non-professional) carer
March 2014 Slide 15
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Conditions Affecting Participants
Diagnosis % of cases*
High blood pressure 67
Type 2 diabetes 48
High blood cholesterol
40
Asthma 28
Angina 17
Heart attack 12
Emphysema 11
Chronic bronchitis 7
March 2014 Slide 16
*Participants may have more than one condition so numbers do not add up to total number of participants
67% have 3 or more
health conditions
At least 30% have
been hospitalised once in
the last year
50% who have high
blood cholesterol also have high blood pressure
80% who have
angina also have high blood pressure
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Baseline Personal Wellbeing Index
March 2014 Slide 17
The normative range for Australians is 73.4 to 76.4 points
Spirituality/Religion
Future Security
Community Connectedness
Safety
Relationships
Achieving in Life
Health
Standard of Living
0 10 20 30 40 50 60 70 80 90 100
Staying Strong BCS Transition Care
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Baseline Attitude to Technology
March 2014 Slide 18
I was completely comfortable with the idea of using Telehealth in my home
I would find Telehealth easy to use
It would be easy for me to become skilful at using Telehealth
My interaction with Telehealth would be clear and understandable
Learning to operate Telehealth would be easy for me
Telehealth useful in my regular testing
Telehealth would save me time in having regular testing
Telehealth would make it easier to do regular testing
Telehealth would improve my access to regular testing of my health condition
- 10 20 30 40 50 60 70 80 90 100 Staying Strong BCS Transition Care
Staying Strong participants reported greater confidence with technology
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Project Challenges
• Project timeframes
• National Broadband rollout
• Recruitment of telehealth nurses
• Stakeholder engagement
• Participant recruitment
March 2014 Slide 19
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Stakeholder Engagement- What Worked
• Early consultation
• Investment of time
• Responsive communications
• Partnership Agreements
• Working groups and involvement in project activities
• Awareness of local politics
March 2014 Slide 20
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Participant Recruitment- What Worked
• ‘Cups of tea’ and a yarn
• Culturally appropriate communications collateral
• Referral pathways involving Aboriginal and Torres Strait Islander organisations/people
• Support of local Elders/bush telegraph
• Awareness of local politics
• Promise of on-going supportMarch 2014 Slide 21
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Project Successes
• Expansion of integratedliving presence and partnership development at trial sites
• Organisational experience in the delivery of telehealth services
• Probable aversion of heart attack/reduction in hospitalisation
• Supplementary nursing support
March 2014 Slide 22
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Lessons Learnt
• Community engagement with Aboriginal and Torres Strait Islanders takes time
• Remote telehealth monitoring for Indigenous communities needs to be complemented with face-to-face contact
• Clinical Management of Telehealth RN
• GP involvement is important
• Asset Register for telehealth equipment and peripherals
• Strong internet connection is neededMarch 2014 Slide 23
Funding bodies should take this into consideration
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Strategic Partnerships
March 2014 Slide 24
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Final Evaluation Report
• Completed by June 2014
• Acquitted by September 2014
• What are the enablers and barriers to older Aboriginal and Torres Strait Islanders using telehealth?
• Did telehealth deliver better health outcomes?
• Did it improve their quality of life?March 2014 Slide 25
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Bringing Technology into Care
Objectives:
• Use scarce resources to service increasing demand
✔
• Find alternative ways of delivering services to rural
and remote communities ✔
• Building capacity in consumers to be techno-savvy
✔
• Increase productivity and efficiency – many learnings
March 2014 Slide 26
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Contact Details
Indra Arunachalam
0437 900 237
References:• Cartwright C, Wade R, Shaw K: The Impact of Telehealth and Telecare on
Clients of the Transition Care Program (TCP), May 2011
March 2014 Slide 27