Telemedicine Networks of Ontario

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Telemedicine Networks of Ontario

• Showcase Ontario
• September 15th, 2004

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A Telemedicine Consultation
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Education Meetings

• Training
• Case conferences
• Televisitation
• Multidisciplinary Team Rounds
• Group therapy

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What is Telemedicine?

• Live two-way videoconferencing
• Uses medical peripheral devices
• Can examine, prescribe and treat remote patients
• Delivers professional education across distance
• Links health care professionals to their
  colleagues in larger centres
• Saves time, money and stress

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Medical Peripheral Equipment
Patient Exam Camera
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Medical Peripheral Equipment

• Otolaryngoscope
• Endoscope ...

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Provincial Collaboration

• PTOC (Provincial Telehealth Operations Committee)
  meets bi-weekly
• Membership from all three provincial telehealth
  networks NORTH Network, CareConnect VideoCare
• Working towards provincial interoperability
• Clinical, Technical Evaluation Working Groups

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• www.northnetwork.com

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Funders, Members, Partners
Multiple Funding Sources

• Provincial Government (4)
• Ministry of Health and Long-Term Care
• Federal (2)
• FedNor
• Hospitals
• Smart Systems for Health
• Tribal Councils Communities

• Patient care programs
• Corporate
• Professional Associations
• Long-Term Care
• Research Programs

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Total Patient Consultations
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Total Educational Events
October 1, 2002 June 30, 2004 1564 Educational
Events Up to 3000 participants monthly
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Programs Special Projects

• Teleopthalmology
• Teleradiology
• Telecorrections
• Emergency Applications
• Telestroke
• Teleburn

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NORTH Network Satisfaction

• Patient Satisfaction 96
• Referring Physician Satisfaction 98
• Specialist Satisfaction 94

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Currently Under Development

• Nurse Practitioner Telehealth (19 sites)
• Sioux Lookout Zone (19 sites)
• New Member Sites (12 sites)
• Education capacity increase (11 sites)
• Long-Term Care Homes ( 4 sites)
• Community Mental Health ( 4 sites)
• CCAC ( 1 site)
• Hospital Ambulatory Clinics (25 clinics)
• Webcasting
• Canada Health Infoway

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NORTHs Strategic Priorities
1. Mainstreaming Telemedicine
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NORTHs Strategic Priorities

• 2. Tele-homecare Primary Care
• 3. E-ICU
• 4. Emergency Care

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5. EHR Integration
NORTHs Strategic Priorities

• Secure access to patient records, including
  digital images
• Development of Store and Forward infrastructure
• Integrate telemedicine EHR into provincial EHR

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Enabling Patient-Centred Care Closer To Home
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Southwestern Ontario
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VideoCare is Working
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Connecting Patients and Providers
2,326 patient encounters (Jan and Aug 2004)
104 Telemedicine units 43 hospital
sites Nearly all clinical activity involves
regional programs
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Regional Clinical Programs

• Renal Dialysis
• Geriatrics
• Oncology
• Mental Health/Crisis Mgt
• Acquired Brain Injury
• Palliative Care
• Wound Management

• Pediatrics
• Stroke
• Genetic Counseling
• Ophthalmology
• Orthopedics
• Burns
• Pain Management

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Medical Education

• Video Care connects medical students in Windsor
  to London-based faculty (LHSC, SJHC,L and UWO)
• CME/CPD sessions shared with regional partners
• Grand Rounds increasing in number of events and
  clinical specialties

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Strategic Directions

• Strategic plan developed by Regional Steering Cmt
• Priorities
• Cost-effective access
• Seamless coordination
• Collaboration innovation
• Accountability

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Vision 2008 Stabilize, Measure Grow

• Over next few years, priorities include
• Stabilize services, secure necessary resources
  and build relationships
• Develop and adopt quality methodologies and
  evaluation framework/indicators
• Larger expectation is to grow clinical activity,
  expand use of diagnostic devices and expand to
  more sites

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Mission Enabling patient-centred care closer to
home

• Positively impact delivery of health care
  services across Southwest Ontario
• Seamless coordination of high quality,
  cost-effective access
• Strong collaborative and partnership approach
  with its partner organizations and Telemedicine
  Networks of Ontario

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Next steps

• As VideoCare stabilizes current clinical and
  educational programs and implements quality and
  evaluation indicators, opportunities exists to
• Expand use of VideoCare by current clinical
  programs,
• Seize opportunities to build new clinical
  programs, and
• Enable quality healthcare decision making in
  rural and remote segments in SW region through
  educational events (CME, etc)

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Success Factors

• Dedicated, regionally-based VideoCare Staff
• In-kind contribution by Partner Organizations
• Smart Systems for Health, Agency (and LARGnet)
• MOHLTC Operational Capital funding
• Telehealth Networks of Ontario

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• Leaders in Telemedicine Services in Eastern
  South Eastern Ontario
• A new way of caring closer to home
• www.careconnect.org

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CareConnect Improving Access

• Network built on strong clinical TM programs
• Cardiology, Paediatrics, Mental Health,
  Dermatology
• Real patients in real time
• Partnership Agreements
• 41 sites 26 health care organizations
• Performance Metrics/Activity levels

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CareConnect Partners

• Site Readiness Assessment
• Clinical Training Certification
• Clinical Protocol Development
• Ongoing Education for Partners
• Physician Workshops Training
• Equipment Standards
• Technical/Bridging support

HOTLINE [phone] support_at_careconnect.org
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Clinical Results - 2004

• Explosive Growth!
• 142 increase in clinical activity
• 250 total increase in activity
• 89 total growth/new sites
• gt1500 clinical consultations
• Adult Paediatric services

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Education Results to date

• gt900 education sessions
• gt1500 participants
• Medical Rounds
• Nursing Rounds
• OHA Education Sessions
• Medical Student/Residency education sessions
• Continuing Education (CME)

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Total CareConnect Activity
Data for 2004 is projected based on activity
levels in first 6 months.
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CareConnect Program Growth
Data for 2004 is projected based on activity
levels in first 6 months does not take into
account new sites/programs.
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CareConnect Visionaries

• University of Ottawa Heart Institute
• Leader in consulting services
• Waiting times reduced from 3 months to 1 month
• CHEO
• Leader in education clinical sessions
• St. Francis Memorial Hospital
• Leader in improving access to care
• Dermatology consults reduced from 4 months to 4
  weeks with SCO Health Service

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French Language Services

• Hôpital Montfort
• The Ottawa Hospital
• Royal Ottawa Health Care Group
• - CareConnect, Northern Ontario and Provincially
• Northern Ontario Francophone Psychiatric
  Program (NOFPP)

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CareConnect New this Fall

• Expansion of Telepsychiatry
• Adult and Paediatric Services
• Crisis Intervention (24 x 7)
• First Episode Psychosis
• Centre of Excellence (CHEO)
• Expansion of Cardiology
• Semi-acute care
• 24 x 7
• Nursing Rounds
• Support Groups
• Patient Education (smoking cessation)

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CareConnect New this Fall

• Expansion of Paediatric Services
• Clinical and Education
• Expansion of French Language Services
• Telestroke
• Acute care (tPA)
• Stroke rehabilitation/follow-up
• Education
• Increase in education capacity
• Medical Student Residency Training/Education
  Program

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Telemedicine Networks of Ontario

• Looking Ahead

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Evaluation Framework

• Accountability
• Essential part of funder and partner balance
  sheet
• Provincial evaluation framework
• Balanced Scorecard Approach
• Core set of Telemedicine Indicators

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Challenges and Opportunities

• Future
• Opportunities
• Common Infrastructure
• Standard Protocols
• Greater efficiency
• Province-wide applications

• Challenges
• Policy
• OHIP fee schedule
• Licensure
• Credentialling
• Technology
• Interoperability
• System management

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Ontario Needs Telemedicine
Telemedicine is a key enabler and a
critical element in the sustainability of our
health care system.