Telehealth is defined by the Alfred Hospital as follows:
Telehealth offers video conferencing and other technologies to provide real time health related services and education or support for long distance users.
Telehealth provides the opportunity for both clinical and non-clinical services, education and support to be delivered, or accessed, without the need for expensive and time consuming travel.
High quality videoconferencing can be combined with supporting images to allow health professionals to interact face to face with remote peers or patients.
eHealth is not new. Institutions currently involved in delivering eHealth programs currently exist and the Alfred Hospital mentioned above is one. More important are future applications which will make use of the increased speed and ubiquity of the NBN and which will expand and improve on what is currently available.
Sweden’s eHealth Program
Below are the main point from an article in the Sydney Morning Herald on April 23 2012 with the title “Fibre-to-the-premises is helping develop e-health in remote parts of Sweden”.
- Sweden was one of the first countries to develop a comprehensive broadband policy focused on delivering community benefits.
- Like Australia, Sweden is deploying a fibre to the home network (FTTH)Like Australia , Sweden is enforcing “structural separation” – to ensure that providers and services have equal network access to improve services nationwide.
- The impact of Sweden’s broadband policies has been clearly seen at hospitals in Solleftea and Boras, in remote areas of the country. The two hospitals have reduced their radiology costs by 35per cent by using broadband to send images to Spain for diagnosis. The hospitals saved more than €800,000 a year, according to a European Union report.
- Patient waiting times also halved as neither hospital had been able to recruit a full-time radiologist and previously relied on visiting locums. Almost half of prescriptions in Sweden are transferred from the doctor to the pharmacy electronically via the national e-health network
- The system saves time for doctors, reduces errors and offers patients more flexibility when collecting medications. E-prescribing generated a net economic benefit of €95million in 2008 alone.
- Sweden is also developing a national electronic health records system to deliver further service improvements and cost savings.
Australian teleHealth Program
A $20.6 million telehealth program was announced on 22 January 2012, with the intent of using the NBN to provide new and innovative in-home telehealth services to older Australians, people living with cancer and those requiring palliative care.
Utilising the NBN to expand telehealth services into homes will help relieve pressures on Australia’s health system by providing more timely access to healthcare, reducing adverse health events and hospital re-admissions.
The NBN provides a platform for homes, doctors’ surgeries, pharmacies, clinics, aged-care facilities and allied health professionals to connect via affordable, reliable, high-speed and high-capacity broadband.
According to John Wilson from the Faculty of Medicine, Nursing and Health Sciences, Monash University:
“Clearly, the advantages of high-capacity broadband to both patients and the medical sector are vast — with applications limited only by our imagination.”
The Australian health sector faces major challenges, such as an ageing population, the rise in chronic disease, uneven access to specialist care, complex and costly diagnostic and therapeutic modalities, the healthcare consumer movement and health workforce shortages. New broadband technologies can contribute to improved healthcare delivery and personal wellbeing by enabling improvements in the quality and safety of care, access to services, and innovations in clinical care and health maintenance. Targeted home-based care and mobile care, linked or integrated health services, real-time and just-in-time monitoring of health and illness, personalisation of care using genomic information are some of the possibilities that are enabled by next generation broadband.
The Institute has a focus on health and biomedical informatics research actively promoted through the Health and Biomedical Research Unit.
Institute programs currently in progress
Ageing well with broadband
Australia has an ageing population. Broadband-enabled technologies can support people to retain their independence and maintain their health as they age. Additionally, high-speed broadband allows for connectivity from the home to other homes and a range of service providers increasing the wellbeing of occupants.
The project is developing a broadband-enabled exercise program that will promote health and wellbeing among older people, enabling them to stay in their homes longer and promote social inclusion.
The technology will be developed for the Microsoft Kinect platform and will be initially trialled with 20 older residents in Brunswick, Victoria�s first NBN release site.
An 18 month trial will assess the effectiveness of broadband-enabled interactive gaming technology to assist older people to maintain independence in their home through improved social connectedness, and physical and mental wellbeing.
This project is supported by the Victorian Government’s Broadband-Enabled Innovation Program.
- Moreland City Council
- National Ageing Research Institute (NARI)
- Council on the Ageing (COTA)
- Merri Community Health Services
- NBN Co
Smart homes for the elderly: recent developments in Korea
Sung Jun Kim
PhD Candidate | Architecture, Building & Planning
South Korea is at the forefront of the rollout of broadband technologies and is a world leader in the rollout of optical fibre to support high- speed, high-bandwidth applications. Along with many countries, it is facing a demographic dilemma with a rapidly ageing population and a lack of aged care facilities.
Assistive technologies can support people as they age, and smart living environments, called silver towns have been built in South Korea to housing an aging population. Five towns were built between 1998 and 2007 making use of embedded information and communications technologies to support elderly Koreans in their own homes.
This research project is investigating the how smart technologies integrate with the spatial elements of the silver towns.
Silver towns also provide a wealth of information gained by exploring how elderly residents engage and adapt to embedded communications technology compared to those in other towns.
The insights of this research will shape and inform future policy directions about how best to integrate technology to support ageing well.
Making pathology reports smarter
Pathology reports are currently designed as a concise record of test results. Unfortunately, the technical emphasis of these reports makes them difficult to understand for many patients, representing a communication barrier between patient and physician. A more user-friendly report design that helps patients more easily understand their pathology results would enable greater engagement by patients in achieving positive health outcomes.
This project is developing a new type of pathology report that will enable a patient with a chronic disease to better understand, monitor and manage their condition through a customised health tool. The smarter pathology reports developed by the project team use message matching to connect the health message, the pathology results, with the patients preferred manner of delivery, to drive health-behaviour outcomes from the presented information.
The smarter pathology reports are activated via a small questionnaire to illicit patients’ presentation preference, with tailored messages sent from a centralised server to mobile phones. Patients also have the ability to log into the system and view their reports any time.
This project has received additional support from the Commonwealth Department of Health and Ageing.
This research project was completed in September 2011.
Overcoming geographical barriers for community health through 3D
There is acknowledged geographical and social inequality in the provision of high-expertise medical knowledge around the nation. These include: too few highly trained specialists, unequal distribution of expertise and patient location between metropolitan and rural and regional areas, ageing demographics and disparities in economic distribution.
Telemedicine offers an opportunity to reverse the negative impact of inequality in the provision of medical experts around the nation by providing health consultation via a broadband connection, no matter where the patient and clinician is located.
Typical telemedicine consultations rely on two dimensional video. However some applications will be enhanced by the provision of three dimensional (3D) video conferencing facilities. 3D high-definition technology enables the clinician to improve their observation of small muscle movements, such as dilation of the pupil, and depth perception, for example in wound management. The additional information provided by 3D high definition video conferencing enables more accurate monitoring of patients.
This project is developing tools that allow the provision of specialist medical services to patients who cannot access specialist medical practitioners. The platform is being integrated with existing wireless physiological telemetry providing real-time measurements of heart rate, body temperature and blood pressure. The use of high definition and 3D in combination, will improve the clinician’s ability to diagnose and assess the progress of a disorder, or response to treatment.
The expected outcome of the project is to develop a small-scale solution for tele-assessment and diagnosis of patients in geographically remote areas. Based in the IBES Broadband Application Laboratory, this facility will model 3D stereo video technology including high-quality audio within the context of controlled simulation of a variety of real- world communications networks. The project is validating the use of advanced 3D telediagnosis techniques in clinical situations through partnership with teaching hospitals.
The findings from this research inform the HD3D Next generation telemedicine project supported by the Victorian Government’s Broadband-Enabled Innovation Fund.
The IBES projects listed above are only a small subset of all IEBS projects.
Face to Face Healthcare a Reality for Regional Australia
On Wednesday 29th August 2012 at 11.45am the worlds first High Definition Point to Point -MultiParty -Telehealth Video Conference was demonstrated at the HISA Conference in Melbourne!
On stage at HISA Dr Kevin Arlett and Dr Karen Carlisle video conferenced Diabetes Care Coordinator from the Townsville Mackay Medicare Local office, Julie Randall as well as her diabetes patient Heather located elsewhere in Townsville for a consultation.
The five minute demonstration showcased the many benefits the NBN brings to supporting healthcare in regional Australia.
Mr Geoff Feakes, Chief Information Officer at Tunstall Australasia has been an integral part in the launch point-to-point multi-party telehealth conferencing.
“It is very gratifying to see our months of hard work translated into reality”, Mr Feakes said.
“Without the capacity of the NBN this wouldn’t be possible”.
Tunstall Australia’s telehealth team developed the multi-party video conferencing capability for the NBN telehealth projects.
The new video conferencing module integrates Tunstall’s icp triagemanager and the myclinic@home device with the telehealth system to allow the multi-party video conferencing between patients at home and their care team.
Telehealth is a revolutionary heath system that allows patients with a chronic health condition to monitor their health and vital signs with the involvement of their care providers, from the comfort of their own home.
The point-to-point multi-party video conferencing demonstration at HISA is a monumental achievement that will assist with demonstrating the benefits of integrating telehealth into the healthcare system for regional and remote Australia.
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Telehealth awaits promise of NBN
Peter Ryan reported this story on Monday, April 4, 2011 08:29:00
TONY EASTLEY: The national broadband network with all its promised high speeds is still a long way off but already thousands of patients in rural and remote Australia are using broadband, albeit slow, for their day-to-day healthcare needs.
AM’s business editor Peter Ryan reports that doctors and clinicians are eagerly awaiting the NBN, but telehealth experts are already trialling a new technology that will save not just money but lives.
(Sound of a machine beeping)
PETER RYAN: This is healthcare in the not-too-distant future but the tools will familiar to many tech-savvy households – high definition television, video conferencing and the latest iPad. All that’s missing is superfast broadband.
TESS VAWSER: The white cell count has come through as 20,000. Now that is quite high…
PETER RYAN: The hi-tech simulation is being carried out by telehealth experts at the Australian Centre for Health Innovation at Melbourne’s Alfred Hospital. But the scenario in a regional hospital involving a seriously ill nine-month baby boy will be all too real for many parents.
Local nurse Tess Vawser is using broadband technology to get an urgent online consultation from a specialist in Melbourne who otherwise would be hours away by car.
TESS VAWSER: Two hours ago, he had this convulsion and he was witnessed by his dad. Dad’s brought him in. He is actually was a bit more alert, he is a bit miserable and he is a little bit listless at the moment…
PETER RYAN: Based on the symptoms seen and heard down the line, the specialist decides to take no chances.
SPECIALIST: It could be a serious infection. It could be even meningococcal. What you’ll need to do is transfer him down to the children’s hospital fairly urgently.
TESS VAWSER: Okay.
PETER RYAN: David Ryan of the Grampians Rural Health Alliance in regional Victoria says even with the current slower speeds, doctors in the bush can already see the benefits in saved travel time.
DAVID RYAN: The technology has got to a point in telehealth where you can have a high-definition video conference, you can have it stay up. It won’t drop out and you basically end up in a situation where the clinicians are starting to accept it as a technology, as a tool of trade.
They are starting to see it as the only way of doing business. They’ll now consider the option to use video conferencing and telehealth devices instead of jump in the car at the first thought.
PETER RYAN: At the moment, many patients travel to rural health centres to connect remotely with doctors but in the future under the NBN, patients won’t have to leave their homes.
Gayle Boschert of Grampians Health says that prospect has many patients excited.
GAYLE BOSCHERT: The patients talk about going to see the doctor on the telly and they talk about that down the street so it is not an unusual thing now. It is something that has been totally accepted by the community and it has been ongoing now for nearly three years.
PETER RYAN: Steve Pascoe of the Cochlear Implant Centre says the dollar savings from broadband consultations are significant.
STEVE PASCOE: We are saving about $500,000 a year – we reckon we don’t have to employ as many people to do this because instead of having four clinicians out in our regional, we only maybe have two out there and the rest will be serviced by remote.
PETER RYAN: At the moment doctors can’t charge for broadband consultations but that will change in July when remote telemedicine becomes an official item claimable under Medicare.
TONY EASTLEY: Business editor Peter Ryan reporting from Melbourne
Healing hands with a robotic touch
Below is an extract from a article on the NBN web site posted on Wednesday 17 October 2012 by Dan Warne.
A new robot in Nepean Hospital, NSW, can perform some operations better than human surgeons, according to one specialist.
That’s not to say the robot does its own thing on autopilot — it is still controlled by a surgeon, but has multiple ‘hands’ — not just two — and is capable of operating at unusual angles and with very fine movements that would be challenging for a human surgeon.
It can also be connected to broadband and used for surgery in areas where there aren’t enough surgeons to operate on patients needing procedures.