Support for the clinician in providing a regional telehealth service

Telehealth coordinators in hospital based telehealth services: Who are they and what do they do?

Many studies have identified the importance of ‘telehealth coordinators’ for successful telehealth implementation and operation. However, little is known about the telehealth coordinators’ functions, the skills and competencies required and the reasons for their influence. This study aimed to examine the key functions of telehealth coordinators in the Queensland public health system, their perceptions about their role, and the level of competencies to support this role. All telehealth coordinators within Queensland Health Telehealth Services were invited to complete a questionnaire. We collected: (i) demographic information; (ii) details of their telehealth work; and (iii) information about knowledge and skills relevant to their telehealth coordinator role. Eighteen of 20 (90%) participants completed and submitted the survey. Telehealth coordinators were responsible for a range of tasks relating to telehealth consultations, technical assistance, administration, research, promotion and marketing. Nearly all telehealth coordinators ( n = 17, 94%) were confident in carrying out the tasks of their job. The majority of telehealth coordinators ( n = 13, 72%) thought education and training relating to telehealth would help improve their job. The top three topics that telehealth coordinators were keen to learn about were: (i) examples of clinical use of telehealth; (ii) types of technologies used; and (iii) telehealth clinical and business models. Our participants were all hospital-based; as the use of telehealth is growing outside of the traditional hospital settings, the role of telehealth coordinators is likely to change.

Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital

BACKGROUND

The Princess Alexandra Hospital Telehealth Centre (PAH-TC) is a project jointly funded by the Australian national government and Queensland Health. It seeks to provide a whole-of-hospital telehealth service using videoconferencing and store-and-forward capabilities for a range of specialities. The aim of this study was to investigate whether the introduction of a new telehealth coordination service provided by a tertiary hospital centre increased telehealth activities of a tertiary hospital. Evaluation included service delivery records and stakeholder satisfaction.

METHODS

Telehealth service delivery model before and after the establishment of the centre is described as well as the project implementation. The study retrieved data related to the number and scope of previous, and current, telehealth service episodes, to ascertain any change in activity levels following the introduction of the new telehealth coordination service. In addition, using a cross-sectional research design, the satisfaction of patients, clinicians and administrators was surveyed. The survey focused on technical utility and perceived clinical validity.

RESULTS

Introduction of a new centralised telehealth coordination service was associated with an increase in the scope of telehealth from five medical disciplines, in the year before the establishment, to 34 disciplines two years after the establishment. The telehealth consultations also increases from 412 (the year before), to 735 (one year after) and 1642 (two years after) the establishment of the centre. Respondents to the surveys included patients (27), clinicians who provided the consultations (10) and clinical or administrative staff who hosted the telehealth consultations in the remote site (8). There were high levels of agreement in relation to the telehealth option saving time and money, and an important health service delivery model. There was evidence from the remote site that modifying roles to incorporate this new service was challenging.

CONCLUSION

The introduction of a centralised coordination for telehealth service of a tertiary hospital was associated with the increase in the scope and level of telehealth activity of the hospital. The project and model of health care delivery described in this paper can be adopted by tertiary hospitals to grow their telehealth activities, and potentially reduce costs associated with the delivery of services at a distance.

Teleconsultation from a secondary hospital for paediatric emergencies occurring at rural hospitals in Queensland

We reviewed telehealth consultations for acute paediatric patients presenting at rural sites in the Mackay district in 2012. Patient data and outcomes were collected prospectively, and a survey of the referring clinicians was undertaken. Thirty four patient consultations were conducted via telehealth with 14 referring clinicians. Most of the referrals were for respiratory illnesses, including bronchiolitis. We received feedback surveys for 16 consultations (57% response rate). In 47% of the cases, the paediatric team felt that transfer was avoided by using teleconsultation. In 80% of consultations, the referring clinicians felt that video consultation was more effective than telephone alone. In 30% of cases, the referring clinicians felt that the patient would have been transferred to higher facility in the absence of the telehealth facility. Clinicians thought that almost all consultations had educational value and reduced their anxiety in dealing with acute paediatric problems. There were no adverse outcomes or delayed transfers of patients staying at their rural sites. We recommend that telehealth consultation occur for all enquiries about acute paediatric patients at rural sites, especially if transfer of the patient is being considered.