western nsw local health district · •organise appointment & booking wallie •nil issues...
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Western NSW
Local Health District
A Virtual Health Service
David Wright: Operational Manager Telehealth Strategy
Sharyn Cowie: Telehealth Manager
Setting the background
Setting the background
Setting the background
Respect & Commitment
Western NSW Local Health District
(WNSWLHD) like all rural LHD’s
experiences significant challenges in
delivering equitable health services to our
diverse widely spread population
Setting the background
Why Telehealth ?
• Reduced patient travel
• Reduced patient financial / social impact
• Increased access to clinical specialities
• Medical
• Mental Health
• Allied Health
• Nursing Specialities
• Organisational Benefits / Efficiencies
• Financial
• Productivity
WNSWLHD Telehealth Strategy
• 2015 Engaged KPMG Consulting
• Conduct a current state review
• Pockets of BAU sustainable services
• Adhoc clinics
• Executive support - ????
• Steering Committee - ????
• Telehealth Manager & Team
• Acting eMR Application Support Team
Manager
Self Analysis
WNSWLHD Telehealth Strategy
• Developed a 3 year Telehealth Strategy
• Chief Executive driven
• Executive Sponsor – Director Medical
Services
• Project Manager
• Lead the Strategy – Change Management
• Clinical Engagement
• Team expanded – 2 Support Officers
• HWAN & WiFi Roll Out
The End Goal
Starting Models of Care
Starting point Models of
Care
The prioritisation process
identified five initiatives to
commence first (or key “starting
points”) and the potential for
subsequent expansion on these
foundations.
The five starting point Models of
Care are:
1. Patient Flow Unit
(PFU);
2. Renal Care;
3. Virtual Orthopaedic
Clinic;
4. Specialist to GP
Collaboration; and
5. Pain Clinic.
The detailed Models of Care are
provided in Appendix 1 –
Detailed Models of Care
Practical - common sense
• Worked with people who showed passion
• Identified clinical champions
• Multidisciplinary / Exec Heavy Steering
Committee
• Pilot Models of Care (MoC) Implementation
Meetings
• Use RACI Charts, Flow Charts, controlled hand
holding
Tools to Monitor & Support
Current Models of Care (MoC)
– Started with 5 MoC
– Applications come to the LHD Telehealth
Steering Committee
– On average 4 applications per month
– Now 65 MoC - established, implementation
& Parked – financial & staffing
Technology Requirements
Devices
CCAS
Desktop WebRTCRoom Systems
Call Centre
Then there’s Wallie & Evie!!!
Marketing
• Media Release
• District Release
• Brochures
• Web Page
• User Guides
• Opportunities to engage staff – Stream
meetings, site visits, service gap surveys
• Support, support & more support
Web page
Telehealth web page
Progress against the project plan
Virtual Allied Health
• Review of Allied Health Services
– FTE / service location / work load review
– Identified possibility of allocating staff to a virtual service
– Virtual Dietetics Service commenced in March 2017
• Malnutrition Screening first step
–Zara Codemo – Condobolin
– 2 days a week
Sites on board (4 out of 18)
Number
of referrals
Referrals
related to Malnutrition
Number of
appointments at each site
Nyngan 1 1 2
Coonamble 3 1 2
Dunedoo 2 1 1
Collarenebri 0 0 0
VAHS - Dietetics
• Length of consult average 40min
• All staff have been supportive
• Organise appointment & Booking Wallie
•Nil issues Kitchen staff and provision of
correct diet and oral nutrition supplements for
patients.
VAHS - Dietetics
• This takes about the same amount of time
as doing it in person
• 50% of referrals are not related to
malnutrition – will require a “launch” or
notice to explain purpose of project
VAHS - Dietetics
• All the patients & health professionals
involved excited and willing to trial
virtual dietetic consults.
• I’m finding it easy to use the
equipment provided to complete a
dietetic consult.
VAHS – Dietetics – Zara’s Comments
• Working with a client virtually has not
limited me in providing dietetic care
when compared to an “in-person”
appointment.
• An initial concern of mine was not being
able to develop patient rapport but this
hasn’t been the case at all.
VAHS – Dietetics – Zara’s Comments
VAHS Physiotherapy
• Physiotherapy staff conducting pre
discharge home assessments.
• Use tablets & Health Direct Video Call
• Combination of Physio, Physio Aide at
patients home and Base Hospital
• More time efficient and effective,
reduces travel
VAHS - Next
• VAHS Steering Committee
• Assigning staff to dedicated Telehealth
hours
• Speech Therapy
• Occupational therapy
Year One
June 2015-16
Key platform
establishment
and starting
point models
• New devices
• Initial platform establishment
• Technology training
• Communications Strategy
• Starting point models refined
and implemented
• Additional Models
incrementally established
• Referral pathways and patient
intake integration
12 Month Review
What worked well?
Initial technology & user support
platform establishment
What worked well?
• Training sessions at handover on
install, follow up, “play” – test site
• Phone directories include all
WNSW other LHD video
conference systems
• Applying screen templates with
dialling information
• Health Direct Video Call
• Clinicians applying to the
Telehealth Steering Committee to
commence services
• Initial technology & user support platform establishment
What could have worked better?
What could have worked better?
• Health Direct Video Call
– Challenges around internet
coverage in communities
• Initial issues with wireless on the
Wireless portable device – Wallie
• Staff change management for
technology
Don’t put Wallie in a cupboard or turn him off, he is a virtually another valuable member of your team
June 2016-2017
Widespread
adoption of
Telehealth
Models Across
the District
• Initial platform integration
• Ongoing technology
enhancements
• Scheduling solution
development and early roll
out phase
• Communications, internet
resources and access portals
• Ongoing reporting and
benefits tracking and service
evaluation
• Additional Model ( priorities )
• Referral pathways and
patient intake integration
• Integrated care / virtual
health services
Year Two
2017-2018
Virtual Health Service supporting integration of provider Networks
and referral Health Services
Year Three
Thank you
Want to know more about Telehealth?
https://wnswlhd.health.nsw.gov.au/telehealth