Question

Compare telehealth in Ontario to Successful Telehealth Programs?

-look at a couple of comparable telehealth programs that are begin shown to be successful

-what did changes they implement to make it work for users

Answer 1

Telehealth in Ontario

Telemedicine is often used to provide mental health services to patients , particularly those residing in underserved rural and remote communities with limited access to in-person services. Optical Transport Network(OTN) utilization in all regions of Ontario with the greatest absolute increase for patients residing in urban southern Ontario. Per capita rates have increased over time, with higher rates in Northern Ontario, especially for Devoloping Societies (CSDs) research in rural northern centres. We understand that there is a lack of objective measure for measuring telemedicine behavior, which is problematic for comparison.

Concerns over the technology 's reliability have been cited as reasons why patients and doctors refuse to use telemedicine. Data from the Ontario Health Insurance Program (OHIP) show that due to technological problems, just 0.2 per cent of visits are reduced. With various telemedicine services, the levels of technological problems vary, and can change over time. Telemedicine providers, for example , reported technical difficulties in as many as one in five visits during the startup of a new telemedicine program in a review of 1,000 patient visits. In a case-series of 53 patients over 9 months, another study in a pediatric cardiac unit reported no technical difficulties. Technical issues can be overcome by investing in suitable equipment and facilities, and training for those using the equipment. In medical environments, the level of missed and canceled appointments are also an concern. 10.7 per cent of all planned visits were postponed or cancelled for OTN-flagged OHIP billings.

Throughout rural Northern Ontario the proportion of telemedicine use in mental health and addictions is smaller than in other areas of the province. It is not due to lower per capita use of mental health and addictions in the north, but due to a higher rate of use of OTN for other specialist fields of treatment, such as oncology, surgery (consultation and follow-up), and internal medicine. Telemedicine helps to compensate for the lack of medical specialists with practices in northern and rural areas, thereby realizing monetary and environmental benefits associated with reduced patient or provider travel and the potential health benefits of increased access to medical care.

The primary drawback is that the OTN data is obtained for billing purposes and not for analysis purposes. One important drawback is that the statistics from OHIP underestimate patient visits in First Nation communities. Furthermore, OHIP data only counts patient – physician interactions and excludes physician – physician consultations or sessions on care management. This also prohibits non-medical clinical use. For example, OHIP data exclude visits with other healthcare professionals such as nurses, occupational therapists, or physical therapists and exclude family visits in remote parts of the province that connect patients to loved ones. With the exception of telemedical services provided to patients in First Nations communities that are billed to the federal government, however, doctors must use OTN for clinical services to qualify for provincial remuneration, and most doctors bill OTN clinical sessions as fee-for - service.

Successful Telehealth Programs

Most hospitals use telehealth services to expand their scope and increase the quality of care delivered.

In fact, several large telehealth pilot programs have already been effective in reducing the costs of healthcare and readmission rates.

Researchers looked at three health-care organizations that adopted a remote monitoring system for patients for the report:

Home Veterans Health Administration, HealthCare Services, and Centura Health.

T

he aim was to reduce rehospitalization rates for Medicare patients for each of those organizations. Providers kept an eye on the health condition of patients, and acted when appropriate. Patients in some situations have access to a 24-hour call center to help with any health-related inquiries.

The Outcomes:

§ · The program of the Veterans Health Administration resulted in a 40 percent reduction in patient overnight stays compared to prior to the start of the program. Hospital utilization for eight major conditions , including diabetes, hypertension and congestive heart failure, has also been significantly decreasing. However, 85 percent of patients reported being happy using the telemedicine system.

§ · After Partners HealthCare started using telemedicine, more than 1,200 patients participated in the initiative and the readmission levels for participating patients were decreased by 51 per cent. Additionally, heart failure-related readmissions decreased by 44 percent. The company says it has been saved in excess of $ 10 million.

§ The original aim of Centura Health's initiative was to reduce readmission levels by 2 per cent for these conditions. That goal was far exceeded-readmission rates were reduced by 62 percent. In comparison, the overall number of participants' Emergency Department visits dropped from 283 to 21.

Keys to success in telehealth

Some of the factors that were common to those successful telehealth programs included:

Patients were kept responsible for improving their health and they sought real-time input from clinicians about how their lifestyle decisions influenced their conditions.

· The organizations enrolled participants in the programs before leaving the hospital, making it clear that telemedicine was part of the ongoing care of the individual.

· Doctors spoke about the program to patients, which helped them become more involved in their own care.

Keys for telehealth success

Some of the factors those successful telehealth programs had in common included:

§ Patients were held accountable for maintaining their health, and the organizations provided them with real-time feedback on how their lifestyle choices affected their conditions.

§ The organizations enrolled participants in the programs before they left the hospital — that made it clear that telemedicine was a part of the person’s on-going care.

§ Doctors talked to patients about the program, which helped make them more engaged in their own care.

10 Critical Steps for a Successful Telemedicine Program

Step # 1: Vision setting i.e. access to care model, cost savings model, market access model

Stage # 2: Developing a Financial Strategy Long Term

Phase # 3: Create a comfortable and secure work environment

Phase # 4: Telemedicine mainstreaming into the daily treatment process

Step 5: Planning and ensuring effective training;

Step # 6: Make sure you've got a full-time coordinator and a good leader and cheerleader.

Step 7: A Project Plan = Reasonable Expectations = Manageable Milestones

Stage # 8: Implementation horizontal vs. vertical

Step # 9: Good commercialisation is critical

Step # 10: Publishing your results and accepting criticism and recognition from outside