Building an Architectural Component Model for a Telehealth Service

Taylor, Alan; Morris, Greg; Tieman, Jennifer; Currow, David C.; Kidd, Michael; Carati, Colin

doi:10.4236/etsn.2015.43004

Cited by 8 publications

(5 citation statements)

References 1 publication

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“…These add to the complexity of planning for service delivery [36, 37]. Providing a telehealth enhanced palliative care service required dedicated technical resource to be made available to support clinical service delivery.…”

Section: Discussionmentioning

confidence: 99%

Using telehealth to support end of life care in the community: a feasibility study

et al. 2016

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BackgroundTelehealth is being used increasingly in providing care to patients in the community setting. Telehealth enhanced service delivery could offer new ways of managing load and care prioritisation for palliative care patients living in the community. The study assesses the feasibility of a telehealth-based model of service provision for community based palliative care patients, carers and clinicians.MethodsThis study was a prospective cohort study of a telehealth-based intervention for community based patients of a specialist palliative care service living in Southern Adelaide, South Australia. Participants were 43 community living patients enrolled in the Southern Adelaide Palliative Service. To be eligible patients needed to be over 18 years and have an Australian modified Karnofksy Performance Score > 40. Exclusion criteria included a demonstrated inability to manage the hardware or technology (unless living with a carer who could manage the technology) or non-English speaking without a suitable carer/proxy. Participants received video-based conferences between service staff and the patient/carer; virtual case conferences with the patient/carer, service staff and patient’s general practitioner (GP); self-report assessment tools for patient and carer; and remote activity monitoring (ACTRN12613000733774).ResultsThe average age of patients was 71.6 years (range: 49 to 91 years). All 43 patients managed to enter data using the telehealth system. Self-reported data entered by patients and carers did identify changes in performance status leading to changes in care. Over 4000 alerts were generated. Staff reported that videocalls were similar (22.3%) or better/much better (65.2%) than phone calls and similar (63.1%) or better/much better (27.1%) than face-to-face. Issues with the volume of alerts generated, technical support required and the impact of service change were identified.ConclusionsThe trial showed that patients and carers could manage the technology and provide data that would otherwise not have been available to the palliative care service.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12613000733774 registered on 02/07/2013.

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Section: Discussionmentioning

confidence: 99%

Using telehealth to support end of life care in the community: a feasibility study

et al. 2016

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“…The transition to telehealth involves changes to a complex interactional system, not just the institution of new technology [ 37 , 38 , 56 ]. Ongoing evolution of telehealth utilisation may require re-engineering of clinical processes, novel components that sit outside currently established health service delivery models [ 137 ], and examination of optimal roles for telehealth modalities in ‘balanced portfolios’ of healthcare delivery modes [ 58 ]. The development of integrated electronic solutions for clinical support services such as e-prescribing, and ordering of pathology and imaging investigations, are important adjuncts to enable delivery of truly ‘virtual’ care.…”

Section: Responses From the Healthcare Sectormentioning

confidence: 99%

“A decade’s worth of work in a matter of days”: The journey to telehealth for the whole population in Australia

Dykgraaf

Desborough

Toca

et al. 2021

International Journal of Medical Informatics

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Introduction Internationally the COVID-19 pandemic has triggered a dramatic and unprecedented shift in telehealth uptake as a means of protecting healthcare consumers and providers through remote consultation modes. Early in the pandemic, Australia implemented a comprehensive and responsive set of policy measures to support telehealth. Initially targeted at protecting vulnerable individuals, including health professionals, this rapidly expanded to a “whole population” approach as the pandemic evolved. This policy response supported health system capacity and community confidence by protecting patients and healthcare providers; creating opportunities for controlled triage, remote assessment and treatment of mild COVID-19 cases; redeploying quarantined or isolated health care workers (HCWs); and maintaining routine and non-COVID healthcare. Purpose This paper provides a review of the literature regarding telephone and video consulting, outlines the pre-COVID background to telehealth implementation in Australia, and describes the national telehealth policy measures instituted in response to COVID-19. Aligned with the existing payment system for out of hospital care, and funded by the national health insurance scheme, a suite of approximately 300 temporary telehealth Medicare-subsidised services were introduced. Response to these initiatives was swift and strong, with 30.01 million services, at a cost of AUD $1.54 billion, claimed in the first six months. Findings This initiative has been a major policy success, ensuring the safety of healthcare consumers and healthcare workers during a time of great uncertainty, and addressing known financial risks and barriers for health service providers. The risks posed by COVID-19 have radically altered the value proposition of telehealth for patients and clinicians, overcoming many previously encountered barriers to implementation, including willingness of clinicians to adopt telehealth, consumer awareness and demand, and the necessity of learning new ways of conducting safe consultations. However, ensuring the quality of telehealth services is a key ongoing concern. Conclusions Despite a preference by policymakers for video consultation, the majority of telehealth consults in Australia were conducted by telephone. The pronounced dominance of telephone item numbers in early utilisation data suggests there are still barriers to video-consultations, and a number of challenges remain before the well-described benefits of telehealth can be fully realised from this policy and investment. Ongoing exposure to a range of clinical, legislative, insurance, educational, regulatory, and interoperability concerns and solutions, driven by necessity, may drive changes in expectations about what is desirable and feasible – among both patients and clinicians.

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“…A simplified framework of eHAM is shown in Figure 1. The aim of the framework presented in Figure 1, according to Taylor et al (2015), is to support nations and organisations in achieving the enhancements and advantages shown in the pyramid (at the top of the model)-more specifically, improved care quality and access, increased productivity, efficiency, and cost-effectiveness, wellinformed health policy, and increased evidence-based practice. The model's components are created to be typical, optional, and adaptable to meet local demands when used in any specific eHealth service.…”

Section: Governance and National Ownershipmentioning

confidence: 99%

e-Health Application, Implementation and Challenges: A Literature Review

Kovačić

Mutavđžija

Buntak

2022

Business Systems Research Journal

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Background: World Health Organization, through a partnership with European Union, encourages the implementation e-health systems. E-health is a relatively old concept that is upgraded with new technologies and is directed toward monitoring different health conditions with the help of technology. Objectives: This paper’s main objective is to demonstrate e-health application possibilities in today’s healthcare organisations and its impact on the quality of provided health care services using ISO/TR 14639 Health informatics Capacity-based eHealth architecture roadmap. Methods/Approach: In this paper, we used the e-health architecture model for literature review based on individual areas of the model - ICT infrastructure, e-health infastructure, health process domain components, governance and national ownership. Results: Research confirms that new technologies have a favourable and significant impact on population health; however, more developed countries show a better understanding of the concept and are moving towards implementing laws and regulations for e-health practices. Conclusions: Through this research, we concluded that new technology significantly impacts health, but this impact is limited due to different development of countries. That is why it is very important to develop health literacy, which is the ability to comprehend, access, retrieve, and use health information or health services.

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Building an Architectural Component Model for a Telehealth Service

Cited by 8 publications

References 1 publication

Using telehealth to support end of life care in the community: a feasibility study

Using telehealth to support end of life care in the community: a feasibility study

“A decade’s worth of work in a matter of days”: The journey to telehealth for the whole population in Australia

e-Health Application, Implementation and Challenges: A Literature Review

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