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Role of Telehealth in Organising Our Resources Around the Person’s Needs Kate Livock Project Manager Unscheduled Care NHS Grampian
Telehealth “The provision of health services at a distance using a range of digital and mobile technologies “ The National Telehealth and Telecare Delivery Plan for Scotland to 2015
Components of Telehealth Communications Technology Diagnostics Technology Bringing the Hospital to the Patient
Communications Technology • Telephone / Text. • Wi-Fi. • Blue tooth. • Satellite. • E-mail. • Video Conferencing. • Web and Digital television
Telehealth supporting NHS Grampian’s New Approach to Unscheduled Care • Extension of remote access for the • Know Who To Turn To. multidisciplinary workforce • No Delays. • Working with partners to include telehealth in cross • Zero Delays. system working. • Provision of workforce • Living it Up - Moray training in the use of telehealth equipment. • Support for workforce in embracing the cultural change • Use of Telehealth in the provision of remote support for Mental Health patients in the islands • Piloting remote rehabilitation using VC for patients with COPD. 11/11/13 • e. Booking of appointments – MIU & others in development • Automated Vehicle Location System piloted in Aberdeen • Near Patient Troponin Testing Pilot commencing April 2014 • Clinical Decision support Service launched Sept 13 • North of Scotland Paediatric Pilot underway • Clinical Guidance Intranet (CGI) launched Sept 2013 • Working with Samsung to test a tablet device to provide information @ the point of contact
Aims of Clinical Decision Support Service • To provide high quality clinical decision support to professionals across Unscheduled Care in Grampian. • To deliver excellence by organising our resources around a person’s needs. • To bring structure and efficiency to every Unscheduled Care patient journey.
Decision Support • Operational Mon – Fri 08. 00 – 14. 00. • Tel: 01224 558002. • Co-located in Operations hub with G Med & NHS 24. • Currently staffed by ED Consultants. • Over 1000 calls to date.
Paramedic Case Study Peterhead • 22 month old child (female) • 36 hr history of raised temperature (as high as 40 c) and intermittent vomiting. • On examination -Temp 39. 9 c -Nasal congestion -No signs of resp distress -No evidence of rash • Given Calpol 120 mg • Child fully clothed with heating on in house. • Requires further assessment. • Discuss with Decision Support
Patient Pathway Traditional Pathway V • Patient taken by SAS to RACH Emergency Dept. • Pt assessed, treated and discharged. • Parents required to arrange return transport to Peterhead in a taxi at a cost in excess of £ 50. Decision Support Pathway • Paramedic contacts Decision Service by telephone. • Full clinical assessment of pt relayed to DS clinician • DS clinician discusses with patients GP. • Pts GP agrees to further assess child at P’head MIU adjacent to Health Centre • Crew transfer pt to P’head MIU ( 3 minutes away) where they are expected. • Pt discharged home. • No transport costs incurred.
Diagnostics Technology • Near Patient Testing – Troponin / Lactates • Telemetry • Digital Imaging • Ultrasound • Video Conferencing • Text or E-mailing of Digital Images to support diagnosis
Benefits of Telehealth for: Patients Patient Centred Care with improved patient experience, patient safety & outcomes. – By ensuring the right care is provided to the patient, first time through prompt assessment supported by telehealth. – By introducing an enhanced level of assessment at an earlier point in the patients Unscheduled episode of care using diagnostic telehealth. – Increased reassurance for patients and carers by easy access via telehealth to diagnostics and senior decision making advice. – Reduced requirement for patients to travel e. g. 1 hr journey for 10 min Outpatient appointment – Ensures the transfer of patients is the most appropriate place at the most appropriate time.
Benefits of Telehealth for: Staff • Ability to provide reassurance to patients and carers. • Increased awareness of colleagues skills leading to confidence in the skill set of all members of a team. • Reduction in the duplication of activities and patients handoff’s between different parts of the service. • More efficient use of professionals time • Enhanced integration of professionals across Health & Social care providing greater support for Unscheduled Care services.
Benefits of Telehealth for: NHS Grampian and the Public Sector • Improved Governance and safety. • More effective and efficient use of limited resources e. g. people, transport (SAS), infrastructure etc. • Supports joined up high quality health and care. • Supports a number of the government standards.