Australia’s first e-health monitoring service from the Loddon Mallee Health Alliance (LMHA) in northern and central Victoria has many exciting elements, but also some worrying aspects.
The monitoring service is for people with chronic conditions, such as heart disease, diabetes and asthma. A monitoring unit developed by the University of NSW and now marketed by MedCare Systems enables patients to be monitored at home. The touch screen unit can be used to measure blood pressure, lung function, temperature, carry out ECGs, as well as gather data such as blood glucose levels.
The information is sent back to a server hosted at the UNSW and from there it is distributed as web applications to nurses, GPs and other medical staff. The service helps to reduce the number of hospital visits these people need to make and improves their quality of life. At the same time it places less strain on the hospital system, thus saving money.
However, due to lack of broadband facilities in remote and rural Victoria, video monitoring is not possible although RPM technology is capable of delivering such functionality. Most of these patients don’t have a large discretionary income and most can’t afford a broadband connection. Furthermore, a video consult is not defined as a consult under the regulations of the Australian healthcare system, so doctors cannot claim this under the current regime.
LMHA is implementing 100 of these units in regional Victoria. The first units are now in operation in Mildura. In Kyabram (near Shepparton) 10 units would be used by the bush nurses for chronically ill people, many of them on remote farms in the area. Another group of units would be installed in Ouyen in the very north-west of the state and another group at Maryborough in central Victoria.
The project objectives were to:
- trial the implementation of a tele-health solution to manage chronically ill clients in their own homes;
- develop an understanding of the clinical efficacy of the RPM technology;
- gain insight into the technical capabilities of the RPM technology in Australian rural health environments; and
- measure clinical and economic benefits for ongoing sustainability for the project.
Acceptance and use of the units has been excellent and is influenced by the patients’ personal motivation to manage their own health and wellbeing. Clients felt much more reassured and connected to the health agencies and were aware that nurses were reviewing their data daily and would respond if necessary. Clients were taking ownership of their measurements and making positive changes to manage their health better. The pilot also found that there was a decreased number of routine nursing visits, significant savings in travel and RPM allowed agencies to increase their reach to clients that would otherwise not have been catered for.
The pilot concluded in December 2008.
Next G videoconferencing
Another innovative application being used by the Loddon Mallee Health Alliance (LMHA) in Bendigo and developed by Momentum Technologies uses the Telstra Next G mobile service. Nurses, patients and GPs are linked into this videoconferencing network.
LMHA is also working on a trial to use videoconferencing in air ambulances, for example, when critically ill patients need to be transported from regional hospitals to Melbourne. A videoconference can take place between the air ambulance and the hospital, and initial assessments can be made about who and what would be needed on arrival.
The service can also be used to assist ambulance staff in case of patient emergencies. A range of telemetry services can be added as well, transmitting essential diagnostics to the hospital.
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