Delivering healthcare via telecommunications could open up home monitoring of aged care patients with chronic diseases, improving health outcomes and significantly saving costs.
The cost of delivering healthcare is increasing
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 $103.6 billion health expenditure during 2007-2008 – can help to reduce the load on our health 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.
Monitoring patient care using telehealth
Funded by the Australian Government Telehealth Pilots Program and CSIRO, we built on our e-health expertise and partnered with NGOs, local health districts, hospitals and industry partners TeleMedCare, iiNet and Samsung to deliver a national telehealth trial of home monitoring of chronic disease for aged care.
Trial partners across the country including ACT, Townsville, Bacchus Marsh & Melton, Launceston and Greater Western Sydney meant this was Australia's first large scale telehealth clinical trial.
In total 287 patients participated in the trial across the six sites. Test patients were provided with a telehealth device that included participant/clinician video conferencing capabilities, messaging features and the delivery of clinical and study specific questionnaires, as well as vital signs devices to monitor their ECG, heart rate, spirometry, blood pressure, oxygen saturation, body weight and body temperature, with glucometry an optional add-on.
The 12-month trial enabled chronic disease patients to self-manage their conditions at home through the provision of telehealth services. Health workers could assess changes in their patient's conditions remotely and provide appropriate care interventions earlier to help them stay out of hospital and improve their quality of life.
Home monitoring saves healthcare dollars and patient lives
Our research showed savings of 24 over the year to the healthcare system made through falls in the number and cost of GP visits, specialist visits and procedures carried out. Patients in the trial also reported improvements in anxiety, depression and quality of life, with many finding that home monitoring gave them a better understanding of their chronic conditions.
In addition the trial also showed a substantial 36 per cent decrease in hospital admission and most importantly a 42 per cent reduction in length of stay if admitted to hospital during the 12 month trial. This is a huge saving when you consider the cost of a hospital bed per day is estimated to be about $2,051 in Australia.
Patients also had a reduced mortality rate of more than 40 per cent.
Our research showed the return on investment of a telemonitoring initiative on a national scale would be in the order of five to one by reducing demand on hospital inpatient and outpatient services, reduced visits to GPs, reduced visits from community nurses and an overall reduced demand on increasingly scarce clinical resources.
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