The challenge: 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.

Our response: Monitoring patient care using telehealth

We’re undertaking Australia’s first large scale telehealth clinical trial. Telehealth is the delivery of health-related services and information via telecommunication technologies.

Funded by the Australian Government Broadband Enabled Telehealth Pilots Program, the 12-month trial will help deliver the information and evidence needed to deploy telehealth services nationally. We have also designed the trial to determine whether telehealth can be used to reduce hospital admissions for high cost patients by up to 50 per cent. It will be undertaken with 150 patients over six fibre and fixed-wireless high speed broadband connected sites around Australia.

We’re working with NGOs, local health districts, hospitals and industry partners iiNet and TeleMedCare to deliver the project.

Managing chronic disease at home using telehealth.


Show transcript
[Music plays and text appears: Managing Chronic Disease at home with Telehealth] [Image changes to Professor Branko Celler, Research Leader, CSIRO]

Prof Branko Celler: The population is ageing. Those aged over 65 will double and those aged over 85 will quadruple in the next 20-years.

[Image changes to show an ambulance reversing into a bay]

Chronic disease at present consumes over 70 per cent of the total healthcare budget and is growing so rapidly that it could consume all of the States budgets within 20-years.

[Image changes to show patients being treated inside a hospital]

Telehealth is one of the best ways of trying to reduce hospitalisation, therefore, hospital costs.

[Image changes to show an elderly man blowing into a mouthpiece with his results being displayed on the Telehealth monitor]

The Telehealth system is basically a monitoring system with quite a large screen to help guide the patient through the different procedures.

[Image changes back to show monitor now on a Blood Pressure screen and the elderly man is entering information into it]

Typically, the process takes 20-minutes. Patients take their blood pressure, they record their blood oxygen, their blood glucose, their electrocardiogram, their body temperature, their body weight and they answer a number of clinical questionnaires.

[Image changes to show an elderly lady with a thermometer in her mouth and then back to the monitor which now reads Measuring]

This data is then gathered and sent off, almost immediately, to a remote website to become visible to the care team.

[Image changes to show a member of the care team, Lay, reviewing the results of the patients’ tests on a computer screen]

The data is collected in real-time and can be viewed almost immediately, particularly for patients connected to a broadband system.

[Image changes to show Lay Yean Woo, Diabetes Nurse, Djerriwarrh Health Services]

Lay Yean Woo: I monitor my clients once a day and looking at reviewing all the data entries that have been transmitted to me. It is quite straightforward and it is a very easy process. I can see the information in real-time, I can monitor them, following up with a phone call if there’s any issues with their health.

[Image changes to show Lay on the phone with a patient giving results: “Your blood sugar levels is looking a lot higher this morning”]

Also with the time that has been freed up for me I can look at more new clients being referred to me.

[Image has changed back to Professor Celler]

Prof Branko Celler: The trial targets chronically ill patients that have complex chronic conditions that tend to take them to hospital multiple times a year.

[Image changes to show Lay assisting an elderly man entering data into the Telehealth system]

They begin to self-manage and this is really important, because this has been demonstrated to be very effective in helping to keep patients out of hospital. So the patients are a key player in the total management of their chronic condition.

[Image has changed to show Bill and Janice. Text reads: Janice’s Husband and Carer]

Bill: I jumped on it straightaway, when Lay came to me and said would we like to do it? And there was no hesitation. Before she was going to the doctors two or three times a week and now she only goes once every three weeks.

[Image changes to show Bill performing a finger prick test on Janice and entering the results into the Telehealth system]

And with the help of this monitor I don’t get so scared anymore.

[Image has changed back to Janice and Bill and then shows Bill walking two dogs]

Before I was wondering if it’s safe to leave the house, because many times I’ve come home and she’s been laying on the floor, or she’s injured herself.

[Image has changed back to Janice and Bill]

And it takes a lot of pressure off your GP. This way you don’t need to go down there if it’s only something minor.

[Image has changed back to Professor Celler]

Prof Branko Celler: If Telehealth is to be scaled up nationally we need to have a way of being able to identify changes in patient health status on a daily basis. CSIRO’s developing some very interesting new tools to facilitate this, and to allow nurses to understand the patients’ condition on a day by day basis.

[Image has changed back to Janice and Bill]

Bill: I can’t thank her enough for what she’s done for Janice and what the machine has done.

[Music plays the CSIRO logo appears on screen with text: Big ideas start here]

The results: Improving health and reducing hospital admissions
By helping chronic disease 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.