Telehealth from acute care to aged care
Inner East Melbourne Medicare Local’s (IEMML) telehealth team is trialling an expansion of its aged care telehealth program to set up consultations with specialists from the Department of Geriatric Medicine at Eastern Health.
While video consultations with private specialists are becoming increasingly common in aged care, providing telehealth to aged care residents from public hospitals is a more difficult task, particularly when it comes to funding the services.
Last week, IEMML's telehealth team helped facilitate four consultations during a three-hour period from Eastern Health geriatricians with residents of Uniting Aged Care Strathdon. Two of the consults were with Transition Care Program (TCP) patients temporarily receiving care at Strathdon.
The TCP is a jointly funded initiative between the Department of Health and Ageing and the states and territories to provide temporary care in a residential aged care facility for older people leaving hospital. It aims to help older people to return home after the temporary stay rather than prematurely entering residential care.
In the private sector, specialists can claim an MBS rebate for providing telehealth consults to patients in residential care, as can the aged care facility. Working out how to provide consultations with public hospital specialists was one of the key points of the trial.
For this trial, Eastern Health volunteered its time, but in order to test this service and develop a sustainable model, the two consultations with long-term residents at Strathdon were bulk-billed privately.
For the consultations with the two TCP patients, the specialists were happy to allocate time to TCP patients as part of their day-to-day duties at Eastern Health.
The trial involved the assistance of Eastern Health's director of geriatric medicine, Professor Peteris Darzins (pictured), geriatricians Dr Chuong Goh and Dr Phillip Agg, and Dr Ray Perraton, a GP from Forest Hill Medical Centre.
Eastern Health used its own telehealth facilities, while IEMML loaned equipment to Strathdon.
Lisa Paulin, IEMML's telehealth support officer, said telehealth can mean the difference between getting specialist care for many older residents and getting no specialist care at all.
“However, one of the key challenges we continue to face in getting medical specialists and general practitioners to practice telehealth with aged care residents is showing that it can be an efficient way for them to see patients,” Ms Paulin said.
“One of our goals in setting up this trial was to provide an opportunity for the geriatric team at Eastern Health to try both private and public applications of telehealth. That’s why we arranged consultations with long-term Strathdon residents and with temporary residents involved in the Transitional Care Program.”
The IEMML telehealth program has been connecting private specialists with aged care residents in its catchment area since mid-2012, but the focus on specialists working in public, acute care settings is new.
Sue Wood, manager of integrated services at Strathdon, said it was the facility's first telehealth experience and “it could not have gone any better”.
“We’re finding that TCP patients are coming to Strathdon with increasing levels of care needs and the opportunity to get specialist assistance with that makes a big difference for our staff,” Ms Wood said.
“It was amazing how easy it was to arrange and great to have such immediate access to a geriatrician. The GP involved was really impressed and is keen to continue.”
The trial with Eastern Health focused not only on showing the value for patient care, but also on demonstrating potential workflow options for specialists using telehealth from a public acute care setting.
“The trial with Eastern Health made a clear case for telehealth in a public setting by showing that in many cases it can replace on-site visits that take up specialist time in getting to and from different locations,” Ms Paulin said.
“Feedback from both the geriatricians and the GPs involved also highlighted how much more efficient patient care can be with the improved communication between those involved in providing patient care.”
Further telehealth consultations with residents of Strathdon UAC and Victoria Grange Aged Care are planned in the coming week, and the team hopes to support further consultations by the geriatric medicine team at Eastern Health.
Adam McLeod is director of strategy and eHealth at Inner East Melbourne Medicare Local.
Posted in Aged Care