National telehealth plan to improve rural health called for in Australia

Ahead of the forthcoming Australian Telehealth Conference 2015, one of the speakers has spoken to the media partner of the conference, Australian Aging Agenda Technology Review. In an article published on the Aging Agenda website, the speaker, Dr Shannon Nott, is quoted as saying “There needs to be a telehealth plan put in place in Australia. We need to start looking at telehealth and say this is something we should seriously invest in. We need to look at it and get it right from the start; that includes getting it right for indigenous communities [and] getting it right for rural and remote communities”.

Nott is said to have spent four months last year researching telehealth in rural and remote Alaska, Canada and Brazil including indigenous communities. The article quotes him as saying “In Alaska for every dollar that they spend on telehealth software and programs they save $10.50 in travel alone in terms of healthcare costs. Not to mention the hospital admissions avoided, the GP admissions avoided.”

[grow_thumb image=”” thumb_width=”150″ /]The Australian Telehealth Conference 2015 takes place on the 23rd and 24th of April in Sydney.

W Australia telehealth scheduling contract awarded to Telstra

Telstra Health has won a contract to provide its iScheduler product to the Western Australia Country Health [grow_thumb image=”” thumb_width=”250″ /]Service’s Statewide Telehealth Service, worth $3.2m over five years, according to an article in Pulse+IT. iScheduler will be used to support the scheduling and management of emergency telehealth services, patient telehealth consultations and education and training for doctors, specialists, nurses and other staff according to the article.

The Western Australia Country Health Service is the largest country health service in Australia and one of the biggest in the world, providing health services to approximately half a million people, over a vast 2.5 million square kilometres area. The range of health services provided cover primary health care, emergency and hospital services, population health, mental health, Indigenous health and aged care.

The Rural Doctors Association of Australia has, in October last year, previously criticised a new telehealth service launched by Telstra that was to connect patients to random GPs via phone and video, saying it could undermine the viability of rural general practice (see Australian Rural Doctor).
Telstra launched its ReadyCare service in October, announcing it would offer patients around the clock advice, diagnosis, referrals and prescriptions from doctors either over the phone or through video link.
The communications giant had claimed the service will deliver better healthcare to rural and remote Australians who live a long way from their doctor.
But the RDAA and the AMA disagreed.

State of telehealth in Australia – a GP’s view

As we have noted in the past, Australia has provided incentives for GPs to implement videoconference telehealth [grow_thumb image=”” thumb_width=”150″ /]consultations in remote rural areas. Simple though it may be from a conceptual point of view, providing the ability for people in isolated communities to have access to specialists can make an enormous difference to the healthcare they receive.

Dr Ewen McPhee, a GP from rural Queensland, writing in the Australian Family Physician’s December issue (“Telehealth: the general practice perspective”) briefly looks at the state of videoconference telehealth in Australia 3 years after the current incentives were implemented. “Three years later, the implementation of telehealth videoconferencing has been inconsistent and patchy, yet to be normalised as part of primary care practice” says McPhee.

Living in cities like London or New York it can sometimes be hard to imagine (more…)

Australia’s med device ‘Fast Track’ changes–webinar

[grow_thumb image=”” thumb_width=”150″ /]For over a decade, the Australian Therapeutic Goods Administration (TGA) has had a ‘fast track’ expedited review program in place for medical device importers–including mobile health–with existing CE Marks. Now this program, after a long campaign, will be extended to Australian manufacturers–and there are other changes. Arthur Brandwood, who spearheaded this effort, will be conducting a free webinar on Tuesday 18 November, noon Eastern Time (US). It will cover Australia’s aggressive deregulatory agenda, their tax incentive (43.5 percent for R&D expenditure), the simple process for regulation of clinical trials and TGA’s web based submission process for device approvals. (more…)

Health funding cuts in Australia

Health and science funding in Australia are facing huge cutbacks under the new Government [grow_thumb image=”” thumb_width=”150″ /]of Prime Minister Tony Abbott leading to expectations that the existing telehealth programmes will be reduced or abandoned as a direct result. A raft of cuts include closure of health and science agencies, funding cuts to major research institutes and the introduction of co-payment for each GP visit.

The Guardian reported that a cut of $1.8 billion of planned health payments to the States will take place over the next four years and The Lancet reports that the government’s share of the health service funding will be cut by $15 billion per year by 2024. The treasurer for New South Wales has stated that NSW itself would need to find an extra $1.2 bn over the next four years. ABC reported yesterday that the South Australian Government is planning to shut hundreds of hospital beds in next month’s budget in what will be the largest cut in its history.

Where will this leave the Australian telehealth and telecare services which have been showing rapid take-up in the recent past, helped along by several far-sighted Government initiatives such as Medicare Locals and telehealth pilots? And what impact will there be on the recent One in Four Lives industry initiative?


AliveCor community screening test finds atrial fibrillation in 1.5% (AUS)

A year-long pilot program in Australia to screen for for atrial fibrillation (AF) found new, previously undiagnosed AF in 1.5% of those tested. The SEARCH-AF study used the AliveCor Heart Monitor ECG  to test 1,000 customers 65 years and older through community screening in suburban Sydney pharmacies. Pharmacists used the AliveCor device, attached to an iPhone, to transmit 30-60 second ECG recordings to study cardiologists. If AF was suspected, the follow-up was a GP review and a 12-lead ECG performed. AF is the most common heart rhythm abnormality and puts an individual at five times the risk for stroke (National Stroke Association). Early diagnosis and treatment cost savings are straightforward: over $20,000 (~£12,400) for prevention of one stroke. (This Editor’s opinion–it’s an understatement.) Per the study summary:

The incremental cost-effectiveness ratio of extending iECG screening into the community, based on 55% warfarin prescription adherence, would be $AUD5,988 (€3,142; $USD4,066) per Quality Adjusted Life Year gained and $AUD30,481 (€15,993; $USD20,695) for preventing one stroke. (“Feasibility and cost effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies”, Thrombosis and Haemostasis, Ben Freedman, MD et al., 1 April online (subscription access required for full study)

15 new AF diagnoses per 1,000 may not sound high, but using the above estimate, this type of community screening using AliveCor or a similar device translates to a cost saving of over $310,425, assuming that all undiagnosed AF resulted in a stroke. Even if less, it is a nice return on investment, health and future outcomes. (This Editor invites more accurate cost analysis.) AliveCor release (San Francisco Business Times). Additional coverage CNet AustraliaThe George Institute for Global Health Australia project page which extends the study to GP clinics

Excellent new report on using digital tech in health

An excellent new report is out now on the use of digital technologies in health systems covering all the [grow_thumb image=”” thumb_width=”150″ /]key areas of application. A digitally-enabled health system studies the Australian health system and how it is to be improved by the use of various digital technologies.

Published by the Commonwealth Scientific and Industrial Research Organisation (CSIRO), Australia’s national science agency, this is a well researched and written report with the underlying analysis applicable to most countries, not just Australia. With contributions from eight experts, and presented in clear language, this is well worth a read. A free download of the report and links to infographics are available on the CSIRO report page.

Australia, in common with many other countries, faces pressures on its health system: “Treasury estimates suggest that at current rates of growth, and without significant change, health expenditure will exceed the entire state and local government tax base by 2043, and require almost half of all government taxation revenue” says Sarah Dods in the introduction to the report. CSIRO suggests several developments to meet this challenge – no surprises here, but nevertheless useful to remind ourselves of these: reduce reliance on hospitals, better manage hospital resources, make in-home patient monitoring (telehealth) the norm and introduce rigorous data security and privacy.

On hospital admissions there is a discussion on managing CSIRO logoEmergency Departments and re-routing ambulances to hospitals with shorter queues, a practice that is already taking place in some parts of the country. There is a section on the use of RFID tags to manage both equipment and continuity of care in hospitals. Another section looks at telehealth and self-monitoring. Other sections look at video conferencing (“tele-presence”) and remote diagnosis.

Sony to launch new telehealth camera at Australian Healthcare Week

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Sony Australia and New Zealand today announced it will officially launch its new Patient Monitor telehealth camera system at Australian Healthcare Week. Sony’s IP Patient Monitor,  NCSRS46P, has been developed in Australia to meet the specific needs of regional healthcare, according to Sony.

The solution enables two-way audio and one-way video communication over IP, typically a broadband internet connection. It has been created in an environment where privacy, ease of installation, simplicity of use and reliability are key concerns. The camera has a powerful 36x optical zoom that allows the healthcare professional or specialist to easily and efficiently view the area of interest and effectively assist with diagnosis.

Although the official launch is next week, there are over 200 IP Patient Monitors in use across Australia, say Sony, including in New South Wales where they are used as part of the Greater Western Clinical Outreach Project.

The Australian Healthcare Week will be from 25-27 March at the Australian Technology Park in Eveleigh, New South Wales.

One in Four Lives: the Australian 3ML

Australia was delivering personal healthcare at a distance (by radio and plane) long before ‘telehealth’ and, indeed ‘telecare’ were coined. One therefore wonders in what way a consortium of Australian companies were inspired by England’s 3millionlives (3ML) in developing their own version: One in Four Lives. Perhaps they thought they could do better.

10 months after the One in Four Lives launch in May 2013, they have produced a white paper (PDF download) which is, in effect, a manifesto calling for government support. It has some well-respected authors who accurately opine that the real challenge is not technological but is in “…creating sustainable, profitable business models that can meet the needs of governments, services operators, clinical practice and patients.”

The telehealth-world politics of this consortium might make an interesting study. We can only scratch the surface and wonder… According to the UK’s Telecare Services Association, its chief executive Trevor Single attended the original kick-off meeting in Australia. Who is not ‘in’ is quite interesting. Tunstall, the instigator of 3ML in England and which has a strong presence in Australia, is notable by its absence. Also missing are significant providers such as Silver Cross and OzCare, and the leading Australian universities and institutions in telehealth research. The dominant partner appears to be BT which, as our UK readers will  be aware, led by its Clinical Director, Global Market Development at BT Global Services, Angela Single, has ambitions to dominate the telehealth world.

Related media items:
The Australian, May 2013: BT leads big push to roll out national telehealth services
 ARN, March 2014: Telehealth could save “unsustainable” federal health budget, according to a white paper

New industry group promoting telehealth in Australia

A new group of industry stakeholders is asking the Australian Federal Government to adopt telehealth as a means to cut the growing national health budget. A whitepaper from the group was presented in Canberra on Wednesday to MP Steve Irons, chair of the House of Representatives Standing Committee on Health by George Margelis (who has previously contributed here at TTA) representing MPT Innnovation Group.

Members of the One in Four Lives group include the Australian Information Industry Association (AIIC), BT Australasia, Anywhere Healthcare, Philips, MPT Innovation Group and the University of Western Sydney (according to Pulse IT) and is chaired by Lisa Altman, Health Practice Director at BT Australasia (part of BT Global Services). The name One in Four Lives reflects that 25% of Australians have chronic health conditions.

Australia has widespread use of telehealth as the many news items we have reported bear out. However majority of these are video link type schemes and the new group is advocating greater use of more sophisticated telehealth schemes using home-based connected sensors and dedicated monitoring clinicians.

If, like me, you thought One in Four Lives sounded familiar, that is probably because the words “Three Million Lives” may have flashed through your mind. Three Million Lives, or 3ML, is a programme that was launched by the UK Goverment in 2011 to get that many people using telehealth. Just to complete the comparison, BT also happens to be the lead company in 3ML.

See also Australian Aging Agenda

Telehealth awareness week in SW Victoria (Australia)

Barwon South West is one of five regions in the most densely populated state in Australia, Victoria. [grow_thumb image=”” thumb_width=”150″ /]Starting on Monday 17th March Barwon South West is holding a week of telehealth awareness activities to coincide with the Australian Telehealth Conference 2014 (ATC2014).

Organised by Barwon Health, the Telehealth Awareness Week 2014 (THAW2014)  will consist of thirteen face-to-face and online events spread across the week, but excluding the two days of the ATC2014 conference.

Rebecca Eastgate, Regional Telehealth Program Manager for Barwon Health tells me that their week of activities including the webinars, “are probably too specific to our region and our local audience to be useful to those beyond Australian shores”. However if you are reading this in Australia, then you may want to look up the THAW2014 events list on Eventbrite and register for any of the meetings or Webinars that are of interest.

Inquiry into telehealth services in Queensland

“A statewide healthcare system with new capacity, co-operation, transparent reporting systems, [grow_thumb image=”” thumb_width=”150″ /]financial accountability and with patients the focus of attention—this is a vision all Queenslanders want to see.” So opened the message from Campbell Newman, Premier of Queensland, Australia, in Blueprint for better healthcare in Queensland in February last year. Turning to telehealth Mr Newman said “In remote communities, this government will work to provide 24-hour access to safe and sustainable care through a revised network of Telehealth facilities for the very first time. This is a 21st century solution to a problem long-regarded as impossible. Our plan will provide reliable health services in places where they were never previously available.”

A year on, the Health and Community Services Committee of the Queensland Parliament has opened an inquiry into telehealth services in the public sector health services in Queensland. The inquiry will consider the implementation of telehealth by the Department of Health and Hospital and Health Services, including the Rural Telehealth Service that was announced in the Blueprint for better healthcare in Queensland.

The committee will examine trials, pilots and other sites, consider the value for money of the delivery of telehealth services, examine the factors that support successful implementation of telehealth services, identify any barriers to successful implementation and consider strategies to address such barriers. The committee intends to visit some rural and regional telehealth sites and hold public hearings in Brisbane and other locations.

The committee will receive an initial public briefing from the Department of Health on Wednesday 5 March at 11.00am in Brisbane. The briefing program is available here. This public briefing will be broadcast live via the link, and a transcript of the briefing will be published here when available.

New paper in the Practical aspects of Telehealth series

Establishing Telehealth in an institution, published this month in the Internal Medicine Journal, is the title of the fifth and latest in the Practical aspects of telehealth series of papers. According to the abstract the paper describes the development of a large teleoncology network over a vast geographical area in North Queensland, Australia.

The authors propose that the workforce, funding and infrastructure at rural sites, as well as the traditional mindset of healthcare professionals are key barriers to successful implementation of telehealth programmes. In the case of the Queensland teleoncology network, the rural hospital at Mt Isa, 900 km away from the central site, has been continually enhanced over a 5- to 6-year period. The success of the scheme is credited to these helping to overcome usual barriers.

Previous papers in this series are Practical aspects of telehealth: doctor patient relationship and communication, Practical aspects of telehealth: financial considerations (Journal in Internal Medicine), Practical aspects of telehealth: Are my patients suited to telehealth? and Practical aspects of telehealth: set-up and preparation for video consultations


Telehealth in South Australia – Medicare Locals

In 2011 the Australian Government established new organisations called Medicare Locals to plan and fund [grow_thumb image=”” thumb_width=”150″ /]extra health services in communities across Australia. Country South South Australia Medicare Local (CSSAML), one such Medicare Local, has been very active in promoting telehealth/telemedicine in its region covering just over 7% of South Australia.

Health areas to which telehealth has been directed by CSSAML include psychiatry, psychology, gastroenterology and cardiology. Videophones in GP practices and non-hospital settings provide telepsychology, telepsychiatry and other specialist services to support GP’s in rural communities via the State Government’s Digital Telehealth Network; (more…)

Three conferences coming up soon

There are three telehealth conferences coming up in March and April which are noteworthy.

The Australian Telehealth Conference 2014 is on the 19th and 20th March in Melbourne. It is brought together by a set of key organisations in the field: the Health Informatics Society of Australia (HISA), the Allied Health Professions Australia, the Australasian Telehealth Society, the Australian College of Rural and Remote Medicine, the Australian Medicare Local Alliance, the Health Information Management Association of Australia and the Royal Australian College of General Practitioners. Keynote presentations cover mHealth, Integreated Care, Rural Medicine, Law and others. More info is on the ATC 2014 website.

Next up, from 30 March to 1 April the Mid-Atlantic Telehealth Resource Summit 2014, in Fredericksburg, VA (USA) will examine ways in which telehealth adds value to patients, practitioners, hospitals etc. Participants will explore the concept of value-add through an interactive program. More on this is on the MATRC 2014 website.

Finally we have the California Telehealth Network 2014 Summit on April 28 and 29 in Newport, CA. Subtitled Growing California’s Connections, this is the second annual event and will build upon information, ideas and practice with even more presentations, educational sessions and networking opportunities. More on CTN 2014 Summit website.

Telehealth is independent of broadband rollout – Australian DoH

We reported in September last year (Telehealth and Broadband in Australia) that the cost of the National Broadband Network in Australia was being debated with telehealth being proposed as a potential[grow_thumb image=”” thumb_width=”150″ /] justification. The Australian broadband rollout was very ambitious with fibre to the premises (FTTP), one of the costliest solutions, as the target. The Government has now lowered its sights and does not expect to connect all premises with FTTP.

Recently a series of questions were raised in the Australian Parliament on both the status of telehealth in Australia and the broadband programme and what impact, if any, the latter has on the first.  The written reply from the Australian Department of Health is not unexpected and enlightening. (more…)