king smillie & morris telemedicine
TRANSCRIPT
CONNECTING PATIENTS TO CARE, ALL ACROSS ONTARIOOntario Telemedicine Network
Melody King-SmillieKathy Morris Nov 5 2009
Objectives
• Provide an overview of the Ontario
Telemedicine Network (OTN)• Describe the components of Telehomecare Phase
One Program• Discuss findings of THC Phase One Program
What is OTN?
• The Ontario Telemedicine Network (OTN) is one of the largest Telemedicine networks in world, helping to deliver clinical care and professional education among health care providers and patients. An independent, not-for-profit organization, OTN is funded by the Government of Ontario.
• Programs and services are delivered in over 660 sites across the province
Our Mission and Vision
Vision: • For telemedicine to become a mainstream channel for
health care delivery and education
Mission: • To develop and support telemedicine solutions that
enhance access and quality of health care in Ontario, and inspire adoption by health care providers, organizations, and the public
Uses of OTN
Utilization By Event Type 2008/09 fiscal
Clinical Events 53,745Educational Events 9,230Administrative Events 9,794Total Events 72,769
Utilization By Therapeutic Area of Care 2008/09 Fiscal
Telemedicine Site Locations
• Hospitals• First Nations Communities• Medical and Nursing Schools• Cancer Centres• Psychiatric Hospitals• Air Ambulance Program (ORNGE) • Cancer Care Ontario• Professional Associations (OMA,
OHA, RNAO, CPSO)• CIHI, HIROC• Public Health Units• LHIN Offices• Long-Term Care Homes
• Community Mental Health Facilities
• Community Care Access Centres• Community Living Centres• Addiction Treatment Centres• Eating Disorder Clinics• Cardiac Rehab Centre• Family Health Teams• Rural Nurse Practitioners• Specialists’ Offices and Homes• MOHLTC Emergency Management
Unit
Active Sites By Health Care Setting2008/09 Fiscal
Enablers Supporting Telemedicine
• CMPA
• CPSO
• OHIP Billing
• PHIPA
10
Telehomecare
Leonard H. McCoy: The Final FrontierStarfleet Chief Medical Officer, U.S.S. Enterprise
To boldly go…..
What is Telehomecare?
• Telehomecare is more than just the use of technology to link patients and practitioners. Telehomecare involves the use of health informatics, telehealth and disease management to enhance care and case management. The reason for doing this is to change the location of care and to make the right care at the right time accessible to patients in their own homes and local communities
(Dr. Adam Darkins, VHA).
• Telehomecare is a service that gives the clinician the ability to monitor and measure patient health data and information over geographic, social, and cultural distances
(ATA).
Telehomecare in Ontario
New Programming:Telehomecare & Chronic Disease Management
• In 2007, OTN launched a Phase One Telehomecare Program,
• Phase One of this program (March 2007 – Dec. 08) will be delivered to 600 patients in six Family Health Teams (FHTs)
• Funded by Canada Health Infoway and the Ministry of Health and Long-Term Care
• OTN is the Project Manager • Program evaluation
Education & Self-Management
From Enrollment to Discharge: Patient referral THCS meets with patient
obtains patient consent care plan based on patient goals installation of remote home-monitoring
Daily readings teaching and coaching based on
patient data, expressed goals & needs Patient discharged
ongoing support from primary care providers, caregivers and community resources
Telehomecare Architecture
FHT
FHT
PH I FHTPH I
PH I
Support Center/Service Desk
Home Monitoring Unit
Key Findings • Positive impacts on patient quality of life…
• Enhanced patient ability to self-manage their condition.
• FHT staff believed the program provided great benefits to their patients
• OTN successfully delivered the Phase One Program…
• Reductions in hospital admissions were observed…
• Family Health Teams are still developmental as a primary healthcare delivery model within Ontario, it is important to recognize that introducing more change into such systems will present challenges.
Integration & Change
Change Management & Adoption
Change management is about helping people through change…
Health Care Utilization
67.7%
Average number of Emergency Department visits per patient/month
DE
CR
EA
SE
63.6%
Average number of hospital admissions per
patient/month from baseline to discharge
DE
CR
EA
SE
46.8%
Hospital length of stay from baseline to
discharge
DE
CR
EA
SE
Health Care Utilization:
Patient Benefits
• Greater sense of security
• Improved knowledge of condition
• Enhanced family involvement in chronic disease management
• Greater independence
• More physical activity
Patient Survey ResultsOverall patient satisfaction with telehomecare
100%
were satisfied with the telehomecare program
98%were satisfied with the information they received about their health condition
97% felt that the remote monitor equipment was easy to use
100%
felt that their condition was well monitored with telehomecare
Where do we go from here?
Next Steps • Expand THC to those diseases that have the
greatest burden on the health care system • Investigate different models of telehomecare• Offer a variety of CDMS products • Interoperability between the CDMS and
EMRs and other applications• Provide a strong clinical function• Administrative and logistics support
Thank youFor additional information about OTN, please visit
www.otn.caMelody King-Smillie [email protected]
Kathy Morris [email protected]