Implementation of Telehealth in Australia - Case Study Example

Telehealth Name: Institution: Introduction The technological and medical concept of Telehealth is traceable to the original notion that there are possibilities of delivering medical care to people located a long-distance away from medical practitioners. Telehealth is far older than the current technology, which forms part of its foundation (Global Telehealth et al, 2010). For many years, different people have travelled long distances for consultative meetings with healers on behalf of those perceived as too ill to make such journeys. These people brought back the necessary advice on the treatment process that a patient had to undergo (Jelcic & Onslow, 2012). The military in many parts of the world developed messaging systems, which were to ensure constant communication between the battlefields and the medical base. Recently, postal offices and the telegram technologies were used in transmission of medical information as in the case of telephone and fax machines (Rodrigues, 2010). This paper does not seek to conduct an in-depth study of all the aspects in health, since the subject of health is extensive as it covers technological use in the delivery of health services and the working of those technologies. This paper seeks to provide a definition of Telehealth and discusses in brief the background information. The paper also seeks to provide a critical analysis of the implementation of Telehealth in Australia and the future development in this from of technology. Through these discussions, the paper aims at asserting that Telehealth plays a significant role in the improvement of the lives of citizen in Australia. Background Telehealth involves the use of electronic information and other forms of telecommunication technologies to provide support to long distance health care patient and other expert related information on health education, and administration of public health (ANZTC, 2000). The technologies used in this form of medical care include monitors, the use of the internet, stored and forwarded images, live streaming of videos, terrestrial and wireless communication (ANZTC, 2000). The technological and health care sectors in Australia are constantly working on the possible strategies that can be used in enhancing Telehealth to be able to meet the increasingly dynamic needs of the people in Australia (ANZTC, 2000). In Australia, Telehealth ensures the provision of financial incentives to eligible health professionals and those involved in the provisions of aged care services as a way of helping patients to have consultations with specialists concerning variety of health issues (Darkins & Cary, 2000). There is a notable difference between Telehealth and telemedicine. This difference lies on the fact that Telehealth has its basis on the provision of a broader scope of remote healthcare medicine compared to telemedicine, which is only specific to the provision of remote clinical services (Global Telehealth et al, 2010). Remote health care services provided by telemedicine encompass the provision of non- clinical services such as training services, conducting of meetings between health practitioners. It is also a way by which the medical field ensures constant education on how to improve the existing medical services (Jelcic & Onslow, 2012). Access to appropriate health care services formed the basis of the establishment of this technology. Organizations in Australia realized that the citizens living in remote and rural areas or those whose illnesses had restricted their mobility faced numerous challenges in their ability to access health care services (Global Telehealth et al, 2010). As a way of mitigation the misery that these individuals were facing, it was prudent to establish a system whereby health care services would be provided at the comfort of their homes (Global Telehealth et al, 2010). Most studies at the implementation stage evaluated the availability and the existing knowledge on how to operate different technological machines such as the digital stethoscope and close up cameras (Jelcic & Onslow, 2012). In other instances, they involved the existing knowledge on how to operate softwares such as Skype to be able to fulfil the objectives of the Telehealth (Global Telehealth et al, 2010). The evidence of the effectiveness of Telehealth was insufficient as there were unelaborate and weak study designs (Nay & Fetherstonhaugh, 2013). The conceptualization and operationalization of Telehealth covers a wide range of specialists’ services for both acute and chronic medical care. These include paediatrics, dermatology, oncology, burns, and psychiatry and wound care among others. When applied in these areas of expertise, Telehealth fulfils its objectives across a range of care from diagnosis to analgesic care (Darkins & Cary, 2000). The coordination and management of Telehealth across different states and territories in Australia varies. In some areas, Telehealth is coordinated from a central point by building a Telehealth network while in other areas, such as Tasmania, its management is under general practitioners and community centres (Maheu & Whitten, 2001). The Rural Health Alliance in Victoria and individual hospitals in South Australian and Western Australia also play a role in the management of Telehealth services (Jelcic & Onslow, 2012). One of the most successful of Telehealth services in the Australian context is video-based Telehealth service. The implementation of this form of technology has been adapted and sometimes tailored to different settings considering the geographical and technological challenges that exist (Maheu & Whitten, 2001). Through the implementation of Telehealth the Australian community has been able to access services across the care continuum may lead to an improvement of physical and emotional welfare of different patients (HIC, 2013). The technology has also ensured reduced waiting time for health care access and less travel involved in seeking the attention of medical practitioners (HIC, 2013). The technology ensured benefits to primary health care providers who used the knowledge gathered from video-conferencing with specialists to improve on their levels of understanding of different areas of specialty (HIC, 2013). This enhanced the provision of sufficient medical attention to patient and job satisfaction to these health experts (HIC, 2013). Telehealth has been faced with numerous challenges related to the start-up cost, quality of video and poor internet connectivity. Other than these challenges, it is important to note that video consultations have been used together with telemonitoring as a composite type of Telehealth that is considered as cost effective (Nay & Fetherstonhaugh, 2013). There has been an increase in terms of acceptability, especially in the area of professional education despite the existence of concerns about the quality and cost of machinery (Rodrigues, 2010). Telehealth has provided timely healthcare in situations where face-to-face consultations are not available due to challenges arising from separation by distance or other barriers. This technology was not meant to replace but to reinforce face-to-face consultation (Darkins & Cary, 2000). Review of Telehealth care – supporting people to live independently and safely at home: an Australian program Feros Care is an organization that has been providing residential and community services in Australia for more than two decades. The vision of this organization is to be acknowledged as a leader in finding innovative ways of improving community lifestyle and aged care solutions (Feros Care, 2011). The mission of this organization is to provide assistance to the ageing in the society to live better lives through the application of better ways that can be used in creating new opportunities the meet the dynamic needs and challenges. Other than community related programs, Feros care also facilitates the operations of Residential Aged care facilities in northern Australia (Feros Care, 2011). One of the reasons for the development of Telehealth care in Australia is that many people are living longer and the country is experiencing a drop in its birth rate. Australia is the country with second highest life expectancy, which expected to grow from an average of 81years to 85 years by 2015. Most of the ageing individuals in Australia have the desire to live independently in their homes (Feros Care, 2011). Ageing life is characterized by combinations of anxiety, disability and diseases, which are known to place considerable burden on the ability of these individuals to live an independent life. There is also a constant need of family members of the aging to seek ways of improving on the informal care that they provide to ensure they accord the elderly with comfort and safety in their own homes (Feros Care, 2011). Huge budget deficits in the provision of health care and the need for workforce reduction has increasingly put pressure on the government to initiate innovative techniques of providing health care services to the ageing to ensure that their needs are met as expected and their health conditions are improved at the comfort of their homes (Feros Care, 2011). Response by Feros Care Demographic challenges faced by ageing population necessitated Feros care to embark on new methodologies of thinking in terms of improving on the health care of the aging in the community (Feros Care, 2011). The use of technology became a key focus not only in its efficiency in operations but also in its provision of broader opportunities in direct delivery of services. In the perspective of this organization, the use of technology in the provision of health care services could provide sufficient time for patients and their caregivers; it could also be essential in providing safe health care services (Feros Care, 2011). This could ensure the wellbeing of the patients due to numerous health care support avenues that the practitioners could use to monitor the progress of their client (Feros Care, 2011). Feros Care began the process of exploring Telehealthcare technologies that would be of assistance in the provision of quality services to the ageing members of the community. The objective was to use Telehealth technologies in the provision of continuous and timely interventions and support to patients who were living in the community with chronic health diseases. Telehealth facilities were also to ensure constant monitoring of the safety of these clients in relation to accidents and other health emergencies. Telehealth facilities in this case were to provide telecare service (Feros Care, 2011). Design of a pilot program Using variety of products within telecare and Telehealth technologies, that were deployed to numerous clients who were under the care of Feros care, the program was initiated to run for nine months and the foist data analysis completed in late 2010 (Feros Care, 2011). Telehealth technology that was implemented by Feros Care employed the use of communication-based technologies whose main roles were to monitor chronic and degenerative conditions (Feros Care, 2011). Through the Telehealth monitors together with other health peripherals installed in the patients’ houses, the monitor could produce certain signals that were an indication that client had to measure (Feros Care, 2011) . The client could be assisted in measuring specific signs and be helped in answering symptomatic questions related to the findings on their health conditions. The monitor could also guide the patient in using its clear text display and audio announcements to understand a series of measurements and questions related to the health of the client (Feros Care, 2011). The information generated from the measurements and the answers provided by the client was sent automatically to the registered nurse whose role was to monitor the readings through a safe website and coordinates with the health representative of the client. It is important to note that during the implementation process, each monitor was customized depending on the needs of the client and the health conditions of the client (Feros Care, 2011). How Telehealth works This system functions through a daily health interview. This is a major part of this system as it provides specialist with information vital for the wellbeing of the client. During this process, the client is prompted to conduct healthy interview by answering questions relevant to their health conditions (Feros Care, 2011). This step also involves measuring vital signs using various Telehealth devises and monitors. The second step involved in the use of Telehealth is the transmission of recorded measurement and answers to the monitoring station where they are to be analysed by a registered nurse (Feros Care, 2011). The third stage is the follow up segment. This applies in situations where the analysis proves that the readings or responses received are higher or lower than the normal or the acceptable range. In such situation, a follow up call to the client must be initiated and in acute cases, the registered nurse has the responsibility of communication directly to the client’s caregiver to provide necessary instructions concerning the actions that should be taken to ensure that the client regains his or her original or normal condition (Feros Care, 2011). In situations where the client needs urgent medical attentions, he or she is required to visit a registered medical practitioner to ensure that necessary attention is given to the promotion of life and health. This is the stage of proactive management of health. The involvement of the medical practitioner is only necessary when the caregiver cannot provide the necessary due to professional incompetence (Feros Care, 2011). Approach to Telehealth program At its pilot stage, Feros Care undertook the program to assess the efficiency of Telehealthcare technologies in terms of the provision of quality healthcare services and its financial feasibility in Australia (Feros Care, 2011). The application used at the pilot stage of the program was not new but had a high significance to Australia because it was the first attempt of implementing Telehealthcare with the objective of mainstreaming and standardizing the technology. This was to perceive it as the service option for the aged in Australia and the best option to be used in community care. The use of this form of technology was also important to Australia because it implemented and extensive range of safety and health monitoring equipment (Feros Care, 2011). In addition, Telehealth deployed communication capable health monitoring systems, which were to bypass the need for patients to use manual techniques while entering vital data concerning their signs and symptoms. This technology also explored the viability of a mainstream operation for the perspective of small and medium aged care provide r that could be supported by the health budget set aside by the Australian government (Feros Care, 2011). Implementation of the program The delivery of Telehealth technology within the homes required the selection of the client demographic; determination of those needs among clients that were best place to benefit from Telehealth technologies the selection of appropriate equipment and devices that could met the needs of the clients (Feros Care, 2011). It is important to note that during the implementation of Telehealth program, new services were provided alongside already established systems to ensure that there were limited or no cost incurred by the clients (Feros Care, 2011). The selection of Telehealth clients had its basis on individual medical conditions and factors that could benefit from the technology. At the pilot stage, about 18 clients of ages between 65 and 90 years were selected (Feros Care, 2011). Some of the variables considered during this selection process included the gender of the client, their family status, and the conditions they were suffering from. These conditions included chronic illnesses such as diabetes, unstable blood pressure and level of anxiety (Feros Care, 2011). Majority of those selected in the pilot program were aged between 80- 89 years especially those with unstable blood pressure as their conditions were considered as best fit for the services of Telehealth considering the fluctuating nature of their blood pressure (Feros Care, 2011). Telehealth monitoring devices that were used included Telehealth hub, weighing scale, blood pressure monitor, pulse oximeter, and glucose meter. All these devises were designed such that they could transfer and readings or measurements to the Telehealth hub without requiring the client to enter them using the manual method. The interviews developed were dependent on the conditions of each client (Feros Care, 2011). Post implementation of the Telehealth program Those subjected to the use of Telehealth technology reported positive results on their wellbeing. Of the 18 individuals sampled, 69% reported that they were less concerned about the severity of their health condition since the technology provided necessary safety measures for the protection of their health (Feros Care, 2011). About 49% felt the need to pay less visits to health practitioners considering that they could easily communicate using Telehealth technologies. About 44% felt that their living conditions had improved since the introduction of Telehealth (Feros Care, 2011). Benefits and challenges of Telehealth program The program provided devises that are not only easy to use reliable to produce sufficient results about the health progress of an individual. During the implementation of the pilot program, for instance, 100% of those sampled felt that the monitors were easy to use (Feros Care, 2011). Telehealth program introduced a feeling of security among the clients as the technology was considered as perfect for the provision of adequate healthcare services that would ensure that the aged could be independent and living an improved quality of life (Feros Care, 2011). Other than geographical challenges that made the implementation of Telehealth technologies complex to implement in areas considered as remote, there were technological challenges that characterized the implementation process. One technological challenge was devise failure (Feros Care, 2011). The failure of monitors for instance was considered as an inconvenience to the understanding and delivery of reliable results. Technological devises also require training to enable the patients to understand the best techniques. In situations where clients received insufficient training on how best to use the technological devises, there were instances of errors resulting from wrong readings or wrong techniques of applying the apparatus in the process of improving on health care services (Feros Care, 2011). Future developments in Telehealthcare The Australian health sector just like any other health sector in the world is experiencing sustainability challenges and pressures. This has led to the need for reform agendas that include the adoption of a new model for medical care that involves the use of available technology (Altman et al, 2014). This involves the development of eHealth strategic plans and implementation policies. Australia for a long time has been involved in pilot programs concerning the use of Telehealth and this has led to the development of less sustainable and seasonal initiative that do not provide long terms solutions to existing challenges (Altman et al, 2014). It is important to note that over the years the Australian government through its eHealth plans has successfully been omitting Telehealth despite the existence of overwhelming evidence that it would ensure a rapid impact in priority areas such as remote and rural regions of Australia (AIHW, 2012). An implementation of such a program would not only ensure the an improvement in the indigenous quality of healthcare, it would also meet the growing demand and ever increasing changes among citizens in accessing conventional delivery networks of health care in primary and critical areas (AIHW, 2012). To enable sufficient improvement of Telehealthcare, it would be important for the two levels of government in Australia to own the initiative and fully implement researched and piloted areas. Such services when adequately marshalled will play an enabling role in providing necessary changes in service area while at the same delivering all the required apparatus to respond to the growing needs of both primary and acute sectors. These sectors will provide adequate services to the increasingly aging population in Australia (Altman et al, 2014). It is important to net that the government of Australia has been embracing a digital economy which has in most situations provided guidance in situations of policy setting and the decision making process that is often necessary in the improvement of and development of all technological initiatives including Telehealth (AIHW, 2012). This is despite the fact that much mention has been made in different media houses concerning the individual Telehealth initiatives that have increasingly charactized the development of healthcare sector. This has necessitated the need for the establishment of a vision for Telehealth as a broader based aspect of healthcare reforms (Smith et al, 2012). A properly disseminated national strategy towards the development of efficient Telehealth will not only ensure the provision of sufficient healthcare services, it will also ensure that the small-scale individual Telehealth care initiatives are broadened in a way that enhances their intended goal and vision (Smith et al, 2012). It is evident that in Australia there is a growing consensus from the studies of Telehealth activities that a national strategy aimed at improving should be geared toward the achievement of a specific target, realization of a given purpose and ensure that the strategy is efficient (AIHW, 2012). This strategy will ensure the development of new and more business models and other clinical interventions. This will ensure dome form of unity between the government of Australia and private businesses will develop a mutual relationship on how to operate for the benefit of the public, especially those considered in need of Telehealth technologies (AIHW, 2012). The commitment of the Australian government to the establishment of policies for the implementation of Telehealth is considered as critical in the current development of a new and cost effective model of medical care (Smith et al, 2012). One in Four Lives is an Australian Telehealth initiative that will be essential in making decisions that are more informed concerning the sources of finance which will help in improving return on investment and overall outcome on health services in Australia (Altman et al, 2014). Despite the urgency required for the formulation and implementation of the national strategy, it may take much time to ensure that it brings about appropriate response from all the relevant stakeholders. However, in the interim, it will be important for the government to advance opportunities that are more palpable and parallel with the intended strategy (Smith et al, 2012). Through such techniques, the government will be able to adopt its eventual options that are relevant the success of One in Four Lives. If sustainable healthcare in Australia is to be supported by the implementation of Telehealth, then it will be part of a long-term commitment to redesign healthcare service to ensure that it supports self-care and provides better coordination and treatment to those suffering from chronic illnesses at the comfort of their homes (Altman et al, 2014). The strategy must also ensure sufficient training to caregivers and clients to enhance quality of service (Smith et al, 2012). Conclusion Telehealth is a technological field that deals with the provision of healthcare services in areas where face-to-face communication between the client and a medical practitioner is restricted by long distances and geographical design of rural are remote areas in Australia. Service delivery is made possible through the implementation of health policies that facilitate the use of technology to advance healthcare service. Australia is a country experiencing an increase in its ageing population, which in turn necessitates high instances of chronic illness (Smith et al, 2012). Feros Care is an organization in Australia that ran a 9-month pilot program on how to establish ways by which Telehealth can be used in supporting people to live independently and safely at home. Through its programs, Feros Care wanted to minimize movement between clients and medical experts. In addition, the program was also aimed at providing a platform where clients would take personal responsibility on issues related to personal wellbeing. In terms of the future, there is need for the Australian government to become an active participant in the formulation and implementation telehealth strategy as a way of ensuring that healthcare services to ageing population in rural Australia are improved. It is evidenced the Telehealth has been neglected by the Australian government despite the existing evidence on its potential to revolutionize the health sector (Altman et al, 2014). Furthermore, a development and implementation of such a strategy would create a partnership between the Australian government and private organization and this will be important in the opening of the business world (AIHW, 2012). References Altman, L, Holt, S, Morgan, G, Roche , S. (2014). One in Four Lives: The Future of Telehealth in Australia. University of Western Sydney. Australia, pp. 3-4. 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