Leading the telehealth revolution

With financial incentives from Medicare available since July, 2012 could be the year that telehealth is widely implemented in nursing homes – vastly improving residents’ access to specialist nursing, medical and allied health expertise.

Above: Professor Len Gray and a nursing home resident speak with another doctor using the University of Queensland’s ‘virtual presence’ video conferencing device during a previous demonstration (image: UQ Centre for Online Health). The technology is now in being used for a clinical trial at Masonic Care Sandgate.

By Stephen Easton

A video conferencing service could enable nursing home residents greatly improved access to GPs, specialists and allied health professionals as early as next year, thanks to a cutting-edge pilot project due to be completed at the end of this year.

The clinical trial began in July at a large facility near Brisbane, Masonic Care Sandgate, and is being conducted by a team of three reserachers led by Professor Len Gray, director of the University of Queensland Centre for Online Health.

Professor Gray has successfully used video conferencing technology, developed at the leading telehealth research centre, to conduct weekly rounds of Toowoomba Hospital’s geriatric ward for the past four years.

Hospital staff simply wheel his ‘virtual presence’ from bed to bed, using a specialised trolley equipped with high-grade video and broadband technology.

“We’re pretty much at the cutting edge in terms of doing this,” Professor Gray said.

“The proof will be whether facilities decide to invest in the equipment to do this in the new year. We’re very likely to offer a service to nursing homes in the new year.”

Prof Gray said the aims of the trial included needs assessment, demonstrating the technology and establishing ‘proof of concept’, and developing protocols for how it could be used in residential care facilities.

“It’s not as simple as just buying some gear,” he said. “What we’re trying to do is set up a service – so the nursing home comes to the service and it organises everything. Our idea is to have a panel of specialists available and to grow that panel over time.”

Consultations with various types of experts are being trialled, on referral from a GP, including specialists like geriatricians, nurses with expertise in wound care, dermatologists, speech pathologists, physiotherapists and psychiatrists.

“We’re trying out all sorts of things – firstly, to see what works and is useful and secondly, if it appears useful, to work out protocols for preparing cases and providing advice,” Prof Gray said.

“To develop a different way of doing things, you need to get the protocols worked out – so you can do it efficiently and effectively.”

Financial support for residential aged care facilities is already available from Medicare to help with implementing this kind of technology – including a one-off $6,000 payment for facilities who set up video conferencing facilities, and $60 for each time they host a telehealth service. Similar payments also give practioners a fincancial incentive to be involved.

Joyce Stephan, Masonic Care Queensland’s Regional Manager, Central and Southern Region, said the trial had impressed staff, residents and residents’ relatives at the host facility, and that the organisation was considering wider implementation.

“The pilot program has proven to be very beneficial and we have had positive responses from residents and their families,” Ms Stephan said. “In consultation with Prof Gray and his team, we will certainly be looking at possible sustainable ways of implementing the program into the future.”

Perhaps the “biggest and best benefit” of video conferencing, according to Prof Gray, is the preparation it requires on the part of nurses and care assistants at the facility end, an effect he said had caused the standard of care to go up after the introduction of remote consultations in the Queensland hospital system.

“The video is just part of it,” said Prof Gray. “What’s important about this is firstly, case preparation – collecting all the relevant information at the facility to make sure that when the specialist does a consultation, they have everything organised and available. 

“The staff at the video end get better and better at preparing the cases; they get easier as we go along. You get this diffusion of knowledge throughout the different levels of aged care staff.

“It gives the staff at the aged care facility access to the ‘specialist’s world’ – hospitals have good access but nursing homes don’t, so I think that’s one of the big advantages this provides.

“We think [nursing home residents] are just as entitled to specialist care as anyone else in the community – their disadvantage is they can’t get to the specialist.”

Click here for detailed information on eligibility requirements for Medicare incentive payments available to residential aged care facilities for hosting telehealth consultations, and practitioners who provide telehealth consultations.

Tags: allied-health, doctors, general-practice, gp, masonic-care-queensland, medicare, residential-aged-care, technology, telehealth, university-of-queensland, video-conferencing,

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