The increasing number of aged people will place unsustainable stress on established healthcare services and will result in increasing deficits in clinical human resources, the expansion of disease management programs and patient demand for greater self-management.
Despite a significant focus and investment on developing ehealth standards and infrastructure, very little policy work has been done in Australia to deploy telehealth as a solution to the increasing demands and costs of managing chronic disease. In contrast, the first report from Britain's Department of Health on this subject was published in 2000. This since has been followed by many other studies such as their Preventative Technology Grant of 2006-08 which provided £80 million ($132.4m) to local authorities and their partners for investment in assistive technology and, most recently, £31m of funding for a Whole System Demonstrator program which noted telehealth as integral for the management of long-term conditions.
As noted in the Australasian Telehealth Society's Strategy, Australia is faced with many challenges to the large-scale deployment of these services, such as a necessity of cultural change in clinicians, a lack of integration of telehealth services with care planning, and little collaboration between players to address the issue in the healthcare industry. Also important is the lack of federal funding for telehealth services delivered into the home.
Although Medicare recently introduced financial incentives to encourage videoconferencing between specialists and patients under strictly controlled conditions, this does not yet exist for home telemonitoring services.
To tackle this challenge, CSIRO recently began a $5.47m pilot to report on the deployment, operation and evaluation of an NBN-enabled telehealth system for home monitoring of patients with chronic disease. As one of the most comprehensive scientific studies of its kind attempted in Australia, we have identified six different clinical models of care for the management of chronic disease in the community, ranging from community-based, nurse-led programs to a hospital-focused, chronic-disease management program supported by highly trained doctors and specialist nurses.
The pilot will introduce telehealth services and observe how each test site integrates these into their established models of care. We will study a wide range of variables, including healthcare outcomes, changes in patterns of utilisation of GP and other healthcare services, socio-economic costs of delivering care, impact on clinical workforce, patient and clinician acceptance of the service and the organisational change management that was required to influence and change established workplace cultures.
Based on results from similar international studies such as the Litan report, we expect that when it is finished the pilot will show significant reductions in unscheduled admissions to hospitals, depending on the existing baseline model of care, and a high level of patient and clinician satisfaction with the at home telemonitoring services. We also expect patients will develop significantly more insight into their own chronic condition and will learn to better self-manage their condition to avoid unnecessary hospitalisation.
Advanced data analytics together with clinical decision support will allow telehealth to be deployed in very large numbers nationally without placing an excessive workload on the monitoring facility or the patient's own clinicians.
This data will have the potential to help to set policy frameworks and lead to funding packages which will assist in finally progressing large-scale national deployment of telehealth services in Australia.
---
Autor(en)/Author(s): Branko Celler
Quelle/Source: The Australian, 03.07.2013
Bitte besuchen Sie/Please visit:
