Role of Telehealth in Organising Our Resources Around the Person’s Needs

1. Role of Telehealth in Organising Our Resources Around the Person’s Needs Kate Livock Project Manager Unscheduled Care NHS Grampian

2. Telehealth “The provision of health services at a distance using a range of digital and mobile technologies “ The National Telehealth and Telecare Delivery Plan for Scotland to 2015

3. Components of Telehealth Communications Technology Diagnostics Technology Bringing the Hospital to the Patient

4. Communications Technology • Telephone / Text. • Wi-Fi. • Blue tooth. • Satellite. • E-mail. • Video Conferencing. • Web and Digital television

5. Telehealth supporting NHS Grampian’s New Approach to Unscheduled Care • Extension of remote access for the multidisciplinary workforce • Working with partners to include telehealth in cross system working. • Provision of workforce training in the use of telehealth equipment. • Support for workforce in embracing the cultural change • Know Who To Turn To. • No Delays. • Zero Delays. • Living it Up - Moray • Clinical Decision support Service launched Sept 13 • North of Scotland Paediatric Pilot underway • Clinical Guidance Intranet (CGI) launched Sept 2013 • Working with Samsung to test a tablet device to • provide information @ the point of contact • Use of Telehealth in the provision of remote support for Mental Health patients in the islands • Piloting remote rehabilitation using VC for patients with COPD. • eBooking of appointments – MIU & others in development • Automated Vehicle Location System piloted in Aberdeen • Near Patient Troponin Testing Pilot commencing April 2014 11/11/13

6. Aims of Clinical Decision Support Service • To provide high quality clinical decision support to professionals across Unscheduled Care in Grampian. • To deliver excellence by organising our resources around a person’s needs. • To bring structure and efficiency to every Unscheduled Care patient journey.

7. Decision Support • Operational Mon – Fri 08.00 – 14.00. • Tel: 01224 558002. • Co-located in Operations hub with G Med & NHS 24. • Currently staffed by ED Consultants. • Over 1000 calls to date.

9. Two

10. Paramedic Case Study - Peterhead • 22 month old child (female) • 36 hr history of raised temperature (as high as 40c) and intermittent vomiting. • On examination -Temp 39.9c -Nasal congestion -No signs of resp distress -No evidence of rash • Given Calpol 120mg • Child fully clothed with heating on in house. • Requires further assessment. • Discuss with Decision Support

11. Traditional Pathway V Patient taken by SAS to RACH Emergency Dept. Pt assessed, treated and discharged. Parents required to arrange return transport to Peterhead in a taxi at a cost in excess of £50. Decision Support Pathway Paramedic contacts Decision Service by telephone. Full clinical assessment of pt relayed to DS clinician DS clinician discusses with patients GP. Pts GP agrees to further assess child at P’head MIU adjacent to Health Centre Crew transfer pt to P’head MIU ( 3minutes away) where they are expected. Pt discharged home. No transport costs incurred. Patient Pathway

12. Diagnostics Technology • Near Patient Testing – Troponin / Lactates • Telemetry • Digital Imaging • Ultrasound • Video Conferencing • Text or E-mailing of Digital Images to support diagnosis

13. Benefits of Telehealth for: Patients Patient Centred Care with improved patient experience, patient safety & outcomes. • By ensuring the right care is provided to the patient, first time through prompt assessment supported by telehealth. • By introducing an enhanced level of assessment at an earlier point in the patients Unscheduled episode of care using diagnostic telehealth. • Increased reassurance for patients and carers by easy access via telehealth to diagnostics and senior decision making advice. • Reduced requirement for patients to travel e.g. 1 hr journey for 10min Outpatient appointment • Ensures the transfer of patients is the most appropriate place at the most appropriate time.

14. Benefits of Telehealth for: Staff • Ability to provide reassurance to patients and carers. • Increased awareness of colleagues skills leading to confidence in the skill set of all members of a team. • Reduction in the duplication of activities and patients handoff’s between different parts of the service. • More efficient use of professionals time • Enhanced integration of professionals across Health & Social care providing greater support for Unscheduled Care services.

15. Benefits of Telehealth for: NHS Grampian and the Public Sector • Improved Governance and safety. • More effective and efficient use of limited resources e.g. people, transport (SAS), infrastructure etc. • Supports joined up high quality health and care. • Supports a number of the government standards.