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Tag Archives: telehealth

Addressing the Barriers of Telehealth Adoption

In a recent article from ehi ehealth insider (http://www.ehi.co.uk/news/EHI/8728/telehealth-doesn%27t-improve-self-care) a “Whole System Demonstrator” programme revealed that telehealth doesn’t improve patients’ self-care behavior. The randomized control trial by the Department of Health was attempting to find evidence to support the use of telehealth and telecare technologies.

A major finding was that the patient outcome pathway was rarely discussed when talking about telehealth. The article goes on to say that “behavior change is the only way to deliver telehealth. We need a new telehealth delivery model to achieve sustained improvement”.

Whilst there is some conflicting research about the cost effectiveness of telehealth, and the improvements in the quality of life for patients, I would suggest that further research is warranted to better define telehealth and determine it’s true effectiveness at delivering positive patient and fiscal outcomes.

There is no doubt that there are many barriers to the adoption of telehealth and telecare. As this article suggests, most of the barriers are to do with integration. In my view, the following activities need to be undertaken to reduce these barriers:

  • Definition of a clear scope of what telehealth is and isn’t. Rather than have a broad high level definition of telehealth, develop an accurate and detailed picture of the processes and technology involved in delivering telehealth.
  • Service delivery models need to be developed that support the process change for telehealth. Telehealth should not be provisioned just because we think that e-health is the way to go.
  • Telehealth needs to be thoroughly considered and tested from a client, safety, financial, benefit, and process perspective.
  • Telehealth needs to be carefully planned to ensure the service delivery models, processes and practices are in place to support the change in service delivery. Staff buy-in is paramount, particularly as it relates to the change to the way care is delivered.
  • The client needs to be involved in the telehealth journey, to facilitate input, feedback, buy-in, etc
  • Organisations need to understand the integration challenges in telehealth. This is from a technology perspective as well as a service delivery model perspective. Integration in relation to data, systems and infrastructure is as important as the integration in relation to service delivery, processes and change. Addressing one component without the other will result in poor outcomes.

The article goes on to say that “there’s no literature about the difficulties of integrating telehealth and telecare and no evidence that there is an awareness of this issue at policy level”. This is somewhat concerning given the push to implement telehealth (and many other ehealth initiatives) in the interest of improved client outcomes, care provision and financial efficiencies.

 
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Posted by on July 16, 2013 in e-health, telehealth

 

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Time to introduce Videoconferencing into Community Health ?

One of the most effective ways for healthcare providers to improve service delivery is by enhancing the level of collaboration between different stakeholders using videoconferencing, according to a recent report by independent analyst firm Ovum.

Putting dedicated telehealth and telemonitoring solutions to one side for the moment, both home grade and enterprise videoconferencing solutions can be used to improve service delivery outcomes, enhance collaboration and communication between patients and practitioners, and provide more equitable healthcare – particularly to those in rural and remote areas.

Clinicians’ and care workers who provide care for patients in their homes can use videoconferencing tools on tablet or laptop devices:

  • for Occupational Therapy reviews, particularly to review and monitor client equipment usage or risks in the home
  • to link with a physiotherapist to review a patients home exercise program
  • to link with wound assessment or diabetes management experts
  • to liaise with the palliative care team for communication and triage
  • for patient social isolation prevention

Whilst there are many more usage senarios, the main point is that we have the technology available today (eg laptop/tablet & skype) to deliver improved outcomes by using this readily available technology. Unfortunately many (dare I say “most”) community healthcare providers are not using it in this manner.

So, why are some/many community healthcare organisations not using videoconferencing ?

  • Culture and process change – using videoconferencing in the clients home requires change in process, documentation and culture. It needs to be driven proactively by organisational leaders, and requires consultation and buy-in from field staff (and patients).
  • Perceived cost – the purchase of laptops/tablets, monthly data plans and systems (corporate systems give the best experience but come at a price). There is also the cost of change and training. A business case is essential in justifying the return on investment and benefits to patients/staff.
  • Lack of connectivity in remote areas – unfortunately many rural pockets of Australia do not have broadband connectivity, and many areas struggle with cellular 3G connectivity.

To have the best chance of success, the above issues need to be addressed, or mitigated as much as possible. Also, video-conferencing solutions must be tailored to various usage scenarios, so having a clear picture of how the technology will be used is very important. Health related video conferencing initiatives must align with, and be included within an over arching e-health strategy.

With the continual improvements in fixed and mobile broadband connectivity, improvements in equipment interoperability, and relatively low cost entry, video-conferencing in healthcare has a lot of potential now and in the future.

 
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Posted by on September 12, 2012 in e-health, videoconferencing

 

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Videoconferencing in health – the need for skype

Videoconferencing and telepresence have significantly matured over the last few years. Consumers love the video/chat experience and ease-of-use that Skype brings to the table, and in the enterprise space we have familiar solutions from Microsoft and Cisco, and a plethora of other players such as Lifesize, vidyo and ooVoo steadily gaining market share.

Videoconferencing is increasingly common on smartphones and tablets with Skype, Apple Facetime, and Google Hangouts available for consumers, and  Microsoft Lync, Cisco Jabber, Citrix GoToMeeting and a handful of others available on smartphones and tablets for the enterprise. Use of video communication for consumers and business is only going to increase with the introduction of the NBN, improved cellular networks (4G), more choice and improved affordability (many are free). Our appetite for video collaboration is showing no signs of slowing.

For healthcare organisations, there are many opportunities to leverage videoconferencing to improve client outcomes, particularly now that videoconferencing solutions are well and truly mobile. A few examples…

  • Social isolation prevention –  eg, clients keeping in contact with family via skype
  • Field workers attending clients in their home – videoconferencing with colleagues or specialists to provide holistic care or get a second opinion about a particular issue
  • Remote doctor-client communications, where clients in areas with scarce medical resources receive treatment and consultations through videoconferencing.

For organisations undertaking videoconferencing initiatives, consideration must also be given to other uses of videoconferencing within the organisation, to ensure any investment is well leveraged.  A common example is videoconferencing between various branches/offices and staff, either through desktop conferencing or room-based conferencing. Delivering education or presentations to remote staff using videoconferencing tools is a common requirement. Increasingly there are requirements for videoconferencing consultations between staff and clients or colleagues, who are external to the organisation.

Whilst there are an array of choice to satisfy consumer videoconferencing requirements, and a range of good options to satisfy the enterprise, the challenge comes when emphasis is placed on the requirement for videoconferencing with those external to your organisation. This could be clients, contractors, consultants, universities, government agencies, competitors, etc.  Whether we like it or not, the best chance of videoconferencing with these entities is likely to be via Skype.  Microsoft acquired Skype in May 2011, and as of September 2011 had 663 million registered users.

Organisations wishing to satisfy all videoconferencing requirements listed above may need to consider a hybrid approach – an enterprise tool and a consumer tool(s).  The choice of enterprise solution would depend on many factors including user/business requirements, and existing investments in telephony, infrastructure and systems.  However, to accommodate the requirement to videoconference with say, a client in their home, or a colleague who is out of the office, there is no getting away from a consumer solution such as Skype, unless you are willing to talk them in to installing product x on their device, which is not always an option.

I.T. and business leaders need to consider the challenges of not only introducing consumer videoconferencing into the organisation (think security, management, support, etc), but also the challenges that a hybrid approach would bring in terms of support, licensing and maintenance. Something has to give – either the suite/scope of requirements needs to be refined, or budgets increased to accommodate the scope.

 
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Posted by on August 13, 2012 in e-health, videoconferencing

 

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Consumerisation of Telehealth

According to a 2010 study by Access Economics, Telehealth is a subset of e-health that includes the application of IT and telecommunications for diagnostic and treatment services, educational and support services and the organisation and management of health services.

Looking at this wide definition, it is interesting to examine the consumerisation of telehealth, and the role being played within the mobile applications space for every-day users. According to MobiHealthNews latest report, there are more than 10,000 “medical” apps available for iPhones, Android, Blackberry, Nokia, Palm, etc. Whilst the largest group of consumer health apps are cardio fitness apps, there are also thousands more apps that fit into the “health & fitness” category that are not actually health, medical or fitness related. Despite this, the quantity of health apps for consumers is growing at a steady rate.

Popular health apps are used for counting calories, gauging nutrition, tracking workouts, calculating body mass index and quitting smoking. Our humble smartphone device offers a relatively low-cost and real-time method to assess disease, movement, images, behaviour, social interactions, and a host of other health related information. Much like the consumerisation of smartphones into businesses, there is also a gradual consumerisation of telehealth via smartphones.

There is significant further potential in using smartphones to improve the health and wellbeing of clients. Remote monitoring, at home triage services, teleconsultations, medication management, outpatient services – could all contribute to improving health related outcomes.

Unfortunately there are still many obstacles in the way that is preventing higher penetration and enhanced mobile application services to clients. Cost, usability, security, privacy all play a role, however the role of mobile apps in healthcare isn’t set to disappear any time soon, so it may pay to embrace this technology and plan it’s place in your strategy, rather than hoping for a fast exit.

 
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Posted by on August 2, 2012 in Uncategorized

 

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