CSIRO, together and six private and public health service delivery organisations, is conducting Australia’s first large scale randomised control trial of telehealth services. (Image: TeleMedCare)
Home Monitoring of Chronic Disease for Aged Care
The NBN Home Monitoring of Chronic Disease for Aged Care project is a A$5.47M trial to demonstrate the deployment, operation and evaluation of an NBN-enabled telehealth system for home monitoring of patients with chronic disease.
The research aims to demonstrate how home monitoring of chronically ill and elderly patients can reduce hospitalisations and improve health outcomes, quality of care and reduce costs to the community and the health system.
The study, funded by the Australian Government under the National Broadband Network (NBN) Enabled Telehealth Pilots Program, will deploy in-home telehealth services for 150 patients over six fibre and fixed-wireless NBN connected sites around Australia.
CSIRO will also evaluate the success of the service over a period of 12 months and develop new methods for automated risk analysis of patients to better target telehealth interventions.
The project partners include six health organisations and two commercial companies, iiNET and TeleMedCare.
"We are very excited to be at the helm of this project bringing together the best minds across CSIRO from health services, computer science, mathematics, statistics and social science, to work with our partners on Australia’s first large scale telehealth study."
Dr Sarah Dods, Research Leader, CSIRO Health Services
About the project
Managing the rising cost of delivering healthcare is a major challenge for Australia.
Targeting health services to assist the chronically ill and ageing population, which accounted for over 70 per cent of Australia’s A$103.6 billion health expenditure during 2007-2008, can help to reduce the load on our heath system and hospitals.
'Frequent flyers' are high cost patients to the health system, who typically have a combination of complex medical conditions such as lung disease, cardiovascular disease or diabetes and visit the hospital two or more times per year.
By helping these patients self-manage their conditions at home through the provision of telehealth services, health workers can assess changes in their conditions remotely and provide appropriate care interventions earlier to help them stay out of hospital and improve their quality of life.
Health services delivered through home telemonitoring have been shown to deliver cost-effective, timely and improved access to quality care. They can also help reduce social dislocation and enhance the quality of life.
The project is a A$5.47m trial with A$3m funding from the Department of Health and Ageing to conduct Australia’s first large scale telehealth clinical trial that will help deliver the information and evidence needed to deploy telehealth services nationally.
The 12 month trial has been specifically designed by CSIRO to collect robust scientific data that will help determine whether the use of telehealth services can be used to significantly reduce hospital admissions for these older ‘high-cost’ patients by up to 40-50 per cent.
The study is Australia’s first multi state, multi site randomised clinical trial of telehealth services. It will involve six sites connected to the National Broadband Network; most will be connected by optical fibre with one site using fixed-wireless broadband. The sites include:
- Townsville (Local Health District)
- Greater Western Sydney (Nepean/Blue Mountains) (Local Health District)
- Greater Western Sydney Nepean/Blue Mountains) (Anglican Retirement Villages) (NGO)
- ACT Health (Canberra Hospital)
- Ballarat, Victoria (Local Health District)
- Northern Area Health District, Launceston, Tasmania (Rural Local Health District)
"This research will give us the opportunity to collect evidence to inform the case for a wide-scale roll-out of telehealth services for Australia. It will also contribute to addressing the urgent need to contain the escalating cost of health services and improve the quality of care for our chronically ill and ageing populations."
Dr Sarah Dods, Research Leader, CSIRO Health Services
Each site will recruit 25 chronically ill patients to the study who will be provided with telehealth services connected to the NBN and another 50 chronically ill patients who will act as controls.
CSIRO will work with partners including NGOs, local health districts and hospitals to deliver the home-based telehealth service.
Commercial partners in the project include telecommunications company, iiNet and telehealth platform provider TeleMedCare who will each co-invest funding into the project.
iiNet will provide the connection to the NBN in each of the patient’s homes. TeleMedCare will provide the deployment, training, support and specialised in-home monitoring units that will enable participants to monitor their condition from home.
Using the in-home telehealth system, patients will monitor a full range of vital signs measurements including Electrocardiogram (ECG), blood pressure, weight, lung function, body temperature, blood oxygen and blood glucose levels.
The unit allows patients to complete health questionnaires, a health diary and learn about their conditions through educational resources.
It can also deliver video and messaging capabilities, enabling direct communication between the healthcare team and patient.
Evaluating the telehealth service
In addition to measuring healthcare outcomes for the trial patients based on hospitalisation rates, CSIRO researchers will also look at all the elements that influence the success of a telehealth services over a fast broadband connection.
The team will look at analysing business processes, organisational change management, workplace culture, communication requirements and the way individual sites implement the telehealth service models.
CSIRO may also develop a sophisticated risk stratification decision support system that could eventually be used Australia-wide to determine a person’s health status on a daily basis. This is an essential part of scaling up telehealth services.
This tool could be used to reduce the workload on clinical care workers so they can easily determine whether a patient is ill but stable, ill and getting a little worse or ill and rapidly deteriorating and at risk of becoming hospitalised. They can then coordinate the best possible response.
Some of the 150 test patients and 300 control patients participating in the trial will also have their progress tracked in part through the national Personally Controlled Electronic Health Record (PCEHR) system and will ultimately have their longitudinal health record from the trial uploaded to the PCEHR.
Patients who participate in the trial will only have their identity known to local health care workers.
All patient data will be de-identified using privacy protection tools before analysis by CSIRO researchers.
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