TELEGERIATRICS

1
TELEGERIATRICS TELEREHABILITATIONin
Alberta

• February 24, 2003
• Anne Morrison
• Senior Operating Officer - GRH
• Isabel Henderson
• Director, Clinical Support - GRH

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Introduction

• Telehealth experience to date across the province
  has included clinical activity, learning activity
  and business activity
• There is wide-spread interest in expanding
  clinical delivery across Alberta
• Rehabilitation and Geriatrics identified as key
  areas for clinical Telehealth development
• Capital Health given leadership role for
  Telerehabilitation and Telegeriatrics

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Introduction

• Alberta we//net objectives for Telehealth
• Improve rural/remote access to services
• Support information, education, technology for
  rural doctors and providers
• Improve efficiency of specialized health services
• Note in 2002 many RHAs had limited use due to
  still-recent technology installations

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Project Methodology

• Participation Rehabilitation - over 25
  professionals from 11 RHAs Geriatrics - over 20
  professionals from 11 RHAs
• Input obtained from key stakeholders -
  physicians/administrators/staff from RHAs and
  Alberta Mental Health System
• Literature reviews, benchmarking analyses used

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Project Methodology

• Literature Review used to identify projects, best
  practices relevant to Rehabilitation and
  Geriatrics

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Project Methodology

• 13 centres examined for benchmarking analyses
  key functional applications
• Rehabilitation and Geriatrics consultations
• Assessment/prescreening
• Discharge planning/post-discharge follow-up
• Education, information for patients and
  caregivers
• Training of health care professionals
• 11 RHA Surveys (Telehealth Activity Inventory)
• Steering Committee meetings held by
  teleconference and videoconference

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Project Methodology

• Submitted inventory of Telehealth activities
• Identified key programs
• Service types (Teleclinical/Telelearning/Telebusin
  ess)
• Utilization statistics
• Implementation status
• Described current activities
• Clinical Consultation, Discharge Planning,
  Education, etc.
• Outlined planned activities
• Teleclinical Activities
• Expansion of Telelearning
• Supervision/Mentoring of Students, Staff

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Provincial Priorities

• Priorities Identified by RHAs
• Teleclinical Rehab Ger
• Clinical consultation ? ?
• Discharge planning for complex cases ?
  ?
• Speech Language Pathology ?
• Seating ?

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Provincial Priorities

• Priorities Identified by RHAs
• Telelearning Rehab Ger
• Patient/family education ? ?
• Staff continuing education ? ?
• Supervision/mentoring of students/staff
  ?
• Telebusiness
• Service Delivery Protocols for Geriatrics
  ?

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Priorities for Teleclinical

• Priorities Identified by RHAs Rehab Ger
• Clinical Consultation ? ?
• Access to professionals for
• specialized consultation
• Telehealth assessments can be full,
• pre-screening or post-discharge
• Discharge Planning for ? ? Complex
  Cases
• Involvement of local, remote
• partners in discharge planning
• helps expedite patient discharge

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Priorities for Teleclinical

• Priorities Identified by RHAs Rehab Ger
• Speech Language Pathology ?
• Rural/remote areas require access
• to professionals for specialized
• consultation
• Seating ?
• Specialists not available in rural/
• remote areas
• Travel a burden/barrier

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Priorities for Telelearning

• Priorities Identified by RHAs Rehab Ger
• Patient/Family Education ? ?
• Helps deliver diagnoses, treatment
• options, interventions, strategies, etc.
• to remote areas
• Staff Continuing Education ? ?
• Improving practitioners knowledge
• base
• Reduced cost, access, collaborative
• learning
• Supervision/Mentoring of ?
• Students/Staff
• Videoconferencing being explored

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Priorities for Telebusiness

• Priorities Identified by RHAs Rehab Ger
• Need to standardize service ?
• delivery protocols across
• RHAs
• Participation in provincial/ ? ?
• national committee meetings
• Conducting job interviews ? ?
• Telehealth a potential cost-saver ? ?
• due to expenses of travel

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Observed Differences

• More formal long-standing Rehabilitation
  arrangements are in existence across Alberta
• Geriatrics has a smaller specialized provider
  base
• Training of staff a critical issue for Geriatrics

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Recommendations

• Important to support clinicians in using
  Teleclinical applications through
• Protocols
• Best Practice
• Utilization Review
• Research
• Technology

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Conclusion/Tactics/Next Steps

• Telehealth has potential for enhanced service
  delivery and education across province
• Need to start with core group of non-problematic
  services and expand from there
• Essential infrastructure, training needed to
  support clinicians
• Piggy-back on work of existing forums (e.g.,
  Alberta Geriatric Advisory Committee)