telehealth in the ed and improving partnerships with community healthcare providers
TRANSCRIPT
EMET and Telehealth
-Build it and they will come
-Emergency Medicine Education & Training EMET
-Technology is the tool
-Telehealth
EMET Enhance standard of regional emergency care
Build a credentialed regional workforce
Reinforcement of relationships within local health network
Improve remote clinical advice and support
Professional development of existing staff at BH
Weekly • Echuca
Fortnightly • Swan Hill
Monthly • Castlemaine
Other
• Charlton • Inglewood • Kyneton • Heathcote • Rochester • Kerang
2
5
1 1
5
2
Swan Hill (12)Echuca (22)Castlemaine (6)GP (2)EMC Candidates (36)Other (GP Workshop & SES Training Day)
last 6/12 - average 76 days providing training and education in
the region for the region
EMC/D
2012 2013 2014 2015 2016
new 4 8 4 6 2 24
pass 3 7 4 1 3 18
EMC/EMD accreditation RACGP accreditation
STP ED registrars - rural & remote
STP GP registrars STP Anaesthetic & ICU
Rotations
Use of technology
www.edcentral.com.au
ISimulate FACEM chat groups/teaching chat groups Teleconferencing and Telehealth
Victorian ED Data set 2015-16
Assessment, Evaluation or Treatment
provided through Telehealth by Doctor or
Nurse on unplanned emergency patients in
region in acute healthcare facility
Quality healthcare- 7 rights
Right care
Right patient
Right provider
Right place
Right time
Right outcome
Right cost
Duty Consultant
hotline 8104 managing sickest patients
overseeing rest (48,000 /year)
teaching on run (junior docs and students)
counsel roster
relationships right safe and secure
(and happy)
Results
58 Consults
Triage
3 cat 1
15 cat 2
25 cat 3
15 cat 4&5
- 48 captured by tool
- 12 avoid transfer
+ 6 optimised transfer
“The telehealth system increases the senior
medical leadership and experience in our
local ED significantly by bringing the
Bendigo Duty Consultants into the room
with us.”
“Telehealth has prevented the need for
transfer of some patients, whilst for
others has expedited the transfer with
arrangements being made by the Duty
Consultant.”
“This program has been very useful for
us…. especially with a patient with no
advance care directive …input from them
to discuss options was very beneficial …
following up with the family to discuss
the options for them to decide on.”
“Thank you for taking time to speak with
me this morning….. for people who are
not able to access the ED or even a GP
easily….like my son…..telehealth is the
answer. Instead of calling police,
ambulance and his carer to sedate and
bring him to you….this is easy.”
Emergency Physicians
“You gather so much more information by
seeing the patient and the surrounds”
“We should do telehealth before we take any
transfers. We can support and give advice and
keep some of these patients treated locally.
Those that come can benefit from having
access to our skillset earlier. “
Learnings Improves relationships
Improves quality care and transfer
Optimisation of regional points of care
Improves local hospital profile
Improves patient and staff satisfaction
-New skill set
-Time & Reliable network
-Unintended consequences
Cornerstone for clinical & educational EM outreach services provided in country by the country -available to all healthcare providers -encompass deficiencies in community for chronic as well as acute and emergency healthcare provision -wherever they are located -wherever they are sent -funded -activity counted