CSIRO to demonstrate evidence for telehealth under NBN project

The federal government has revealed the winning bidders for the $20.3 million grants program to evaluate NBN-enabled telehealth pilot projects, first announced in January last year, including the CSIRO planning the first large-scale use of patient-collected data uploaded to the PCEHR.

The Minister for Broadband, Communications and the Digital Economy, Stephen Conroy, said the nine projects will help demonstrate how important high-speed broadband is to the future of healthcare.

“We now live in a world where … healthcare doesn't only happen in a hospital, and aged care doesn't always mean having to go into a nursing home,” Senator Conroy said.

Grant consulting firm Bulletpoint has been keeping a list of the successful projects and has provided full details on its website.

The projects will cover around 2500 patients in 50 NBN communities, and comprise successful bids from the CSIRO, the Royal District Nursing Service and Flinders University.

Feros Care, Leading Age Services Australia, Silver Chain Group, Illawarra Retirement Trust and UniQuest will deliver aged care programs, while the Hunter New England Health District in NSW will look at cancer patients and Integrated Living will examine care for older Aboriginal and Torres Strait Islander people.

The CSIRO has received two grants totalling $5 million, with $3m awarded to a project examining home monitoring of chronic disease for aged care, and $2m to extend its Remote-I indigenous eye care program to evaluate telehealth over satellite broadband.

The eye care project, which is being run in conjunction with WA Health and the Australian Society of Ophthalmologists, recognises that indigenous Australians are at much greater risk of poor eye health, particularly in remote communities.

Using the Remote-I telemedicine platform, 900 patients will be involved across three sites in Queensland and Western Australia. Technical assessment will also be carried out to determine satellite broadband's efficacy in delivering telehealth.

“We have a strong background in tele-eyecare,” CSIRO Health Services research leader Sarah Dods said.

“This project will allow us to showcase how it can be rolled out to multiple rural and remote areas and help address the difficulties these communities face in accessing specialist eye care services.

“Our team is excited to be testing telehealth applications over the new satellite broadband service. By understanding the benefits, limits, and possible adaptations needed, we can design more effective telehealth services and help to overcome the barriers … in rural areas.”

Meanwhile, in the randomised-control trial evaluating home monitoring of patients with chronic disease, six sites have been chosen, comprising 450 patients who will be tracked over a year.

Participants will be drawn from patients with a history of chronic disease, or those hospitalised twice in the preceding 12 months.

The study will assess all major chronic diseases – congestive heart failure, chronic obstructive pulmonary disease, diabetes, hypertension and coronary heart disease – but patients with any chronic condition meeting the criteria are eligible candidates.

TeleMedCare will provide the telehealth platform and iiNet will contribute the fibre and fixed-wireless NBN connections.

Data collected at home by the patient – such as blood pressure and ECG readings, spirometry, pulse oximetry, weight and temperature – will be fed into the PCEHR.

Sites have been chosen to give a cross-section of hospital- and community-based care models, and the project will also evaluate usability for patients and clinicians, organisational change-management, business-flow processes, and workplace cultures.

“We’re trying to work out how to scale up telehealth nationally, and to do that we need to learn a lot about how these particular sites are adopting telehealth,” CSIRO ICT Centre chief scientist, Branko Celler, said. “We’re hoping to produce a resource package for anyone that wishes to deploy telehealth.

“But further, we want to provide the data that will go to government and Treasury and policy-makers and funding agencies to confirm to them or otherwise that telehealth has a very good cost–benefit, and has improved healthcare outcomes.”

The CSIRO will also interpret the data collected to analyse “risk stratification”, which classifies whether patients are sick but stable, showing signs of improvement or acuity, or pending hospitalisation.

“If we can do that effectively, we can then orchestrate the best response – from the GPs, from the community nurses, from the health services that are around the patient – to stop them going to hospital,” Professor Celler said.

“There is very good evidence that telehealth in the right setting can reduce hospitalisation by anything between 10 and 40 per cent, depending on what the baseline circumstances are.

“It reduces GP visits and improves patient self-management – there are some really positive aspects to telehealth.”

Professor Celler said that while this had been demonstrated internationally, there was not enough broad-based evidence from Australia.

“It’s the most comprehensive and the most carefully controlled study that I know of – and one of the biggest,” he said.

“Fundamentally, we want to demonstrate the impact telehealth has in improving the management of chronic disease – quite low cost and better outcomes – and deliver sufficient information to government and healthcare providers to scale this up nationally. That’s what’s happening worldwide, and we need the evidence for Australia.

“Our healthcare costs keep increasing. Telehealth methods in the home are increasingly shown to be cost-effective, to have a really big impact on reducing the burden of patients in hospitals.

Core measurements in the project will be completed by July next year, and the report handed down by the end of September, 2014.

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