virtual health care
TRANSCRIPT
The Ontario Telemedicine Network:
What is Telemedicine?
Use of information technology
by health care providers:
To deliver care to their
patients;
To engage their patients in
their own health management
and/or:
To collaborate with each other
to improve care delivery
About OTN
An independent not-for-profit corporation
funded by the Government of Ontario
Partners include:
• eHealth Ontario
• OntarioMD
• Canada Health Infoway
• Keewaytinook Okamakanak Tribal Council
Members include:
1,289 health care and education
organizations at more than 1,600
sites
Our vision:
Telemedicine will be a
mainstream channel
for health care
delivery and
education.
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We are in a Virtual
Health Care Revolution …
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The “Virtual Health Care” Transition We Have Been Through Similar Shifts Before…
Inpatient Care
Outpatient Care
Virtual Care
1992… More people leave
hospital after procedure
than remain overnight
202X?… More virtual visits than
physical visits
Each transition involved people,
process, and technology changes.
OTN Telemedicine Services
Clinical Videoconferencing:
Studio-Based Videoconferencing
PC-Based & Mobile
OTN Telemedicine Services
eConsult and Store-Forward:
Teledermatology Teleopthalmology
Telepsychiatry
Generic eConsult (Q & A)
OTN Telemedicine Services
Telehomecare and Consumer
Remote-Monitoring
Nurse Coaching
Patient self-management
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Reduces travel
Improves access to scarce and/or
maldistributed care
Provides urgent access to services
otherwise unavailable
Reduce wait times through
e-consultation
Enables effective chronic disease
self-management
Reduces hospital admissions and
ER visits
Improves patient care
transitions to the community
Access, Quality and Efficiency
Access Rural
Rural and Urban
Better Care for Patients and Better
Value for Money
11
46
61
108
146
$19 $25
$45
60.4
13 17
30
40.2
0
25
50
75
100
125
150
2009-10 2010-11 2011-12 2012-13
Avoided Travel in the North (km) Estimated NHTG Cost Avoidance ($)
Cost Avoidance in Northern Ontario (in
millions)
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Study Outcomes: Telehomecare
72 – 74% reduction in emergency department visits
16 – 33% decrease in number of primary care physician visits
95 – 97% reduction in walk-in clinic visits
64 – 66 % decrease in hospital admissions
High levels of patient and provider satisfaction
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The (Patient) Results Are In …
were satisfied with their telemedicine visit.
indicated they would use it again.
felt as comfortable receiving care through telemedicine as they would have in
person.
saved money using telemedicine, with average savings of $C 242.
Patient survey results – videoconferencing 2012
92%
91%
87%
74%
Personal Videoconferencing
From the hospital to the home
Community 54%
Hospital 27%
Other 5%
Primary Care 14%
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Chronic disease management
is the challenge of our
generation.
It requires a shift towards a
more responsive, patient-
centered system.
Working with Health Links to
embed telemedicine solutions.
Healthcare Transformation
Telemedicine is the key enabler
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Where we are headed …
Self Management & Monitoring Tools
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Where we are headed …
Technology “prescriptions”
Take 2 Apps
and Call Me in
the Morning
Tech Rx Apps Pharmacy not Apps Store
Apps Formulary
AliveCor Cardiac
Withings Blood Pressure
bant Diabetes
Pain Squad Pain Mgmt
MyIBD Crohn’s
Disease
My Health e Network
Log Activity
Education
My Plan
Communication Centre
3 New Messages
Onboard new Patient
Alerts
My Roster (Dashboard)
Calendar
Communication Centre
Flags: 6
9Monday, Sep 92013
Sun Mon Tue Wed Thu Fri Sat
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30
New Patient Case Conference 10AM-12PMJames, Oliver S more…
Weekly Check-in Call 1PM-2PMKripps, Barbara J more…
Priority PatientsID Name Gender Age
947834 Gupta, Harpreet F 89
089564 Herman, Wes M 75
674987 Yip, Sophia F 83
870925 Greene, Gert F 92
937465 Reynolds, James M 68
Welcome Judy Wells
!
My Health e Network
Alerts
My Roster (Dashboard)
Communication Centre
!
Flags: 6
Welcome Dr. Smith
My Watch List
The Care Coordinator View
The Provider View
The Patient View
Where we are headed …
One Tool for Care Coordination
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1
2
3
4
Assess and Categorize Monitor
Understand Risk Factor/Comorbidities
Profile and Readiness for Behavioural
Change
Plan
Target Education to
Support Key Interventions
Responding to Change
(Interventions)
Identifying Change
(Triggers)
Care Coordination
Inter-RAI
LACE +
Predictive Tools
Confirm Diagnosis
e.g. Indicator
Tests
+ PRIMARY CARE
Nutrition
Smoking
Cessation
Medications
Psychosocial/
Mental HealthExercise
Equipment
Condition-Specific
Education
Remote Monitoring
and Self-Management
Coaching
Complementary
Therapies
Caregiver
Support
Telehomecare
Where we are headed …
Integrated Care Pathways Analytics
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What is needed …
“Telemedicine tools will only achieve their full value when they are integrated into a receptive health care system.”