NZ close to a tipping point for telehealth
Growth in the uptake of telehealth by district health boards (DHBs) over the last three to four years means New Zealand is close to a tipping point, according to research published late last year by the NZ Telehealth Forum.
Commissioned by the National Health IT Board (NHITB), the stocktake of DHB telehealth activity shows that all DHBs are using telehealth to some degree, although most are introducing it to improve service models rather than to reshape the way patients receive care.
A lack of defined remuneration frameworks added to some resistance to using the technologies by individual clinicians is still a barrier to increasing use, although the stocktake shows that concerns of the integration of video conferencing in particular is being slowly overcome.
For the purposes of the stocktake, the NZ Telehealth Forum defines telehealth as including telemedicine using vide conferencing and store-and-forward technologies, telemonitoring, mobile health using smartphones and interactive portals.
Questionnaires were sent to all DHBs asking about the use of video conferencing, any other technologies being used or planned, what the DHBs thought were barriers to uptake and what support that the forum and the NHITB could offer to increase uptake.
The results show that almost all of the DHBs are making use of telehealth technology to some degree with Northland, West Coast and Canterbury most active in using telehealth technologies for clinical services involving care of patients.
Video conferencing is the dominant technology in use, along with mHealth applications, email consultations and devices for remote telemonitoring.
It also showed that 10 of the 20 DHBs have a telehealth strategy in place or being developed and 10 also have appointed telehealth clinical leaders.
Nineteen DHBs are using video conferencing for meetings and clinical education but 16 are also using it for for direct clinician-patient interactions.
According to the report, “DHBs are using VC for follow-up visits, some first specialist assessments, acute assessments, ward rounds and nurse-led clinics. Most involve services between secondary/tertiary sites and smaller regional sites. A few services are provided directly to patients in their home.”
Fifteen DHBs are planning on new telehealth services to be added in the next year, including extending current services to new sites and adding new services.
The main video conferencing network providers are Vivid Solutions, Gen-i and Dimension Data, which are all active members of the forum's VC working group and are working on interconnectivity between networks.
Three DHBs are providing remote telemonitoring support for patients and five others are planning to provide or considering this type of support, while Waitemata DHB is deploying mHealth and smartphone technologies in programs for diabetes support, maternity and community alcohol and drugs service.
“DHBs are also using text messaging tools for communications between health professionals and for appointment reminders,” the report found. “Two DHBs have provided VC links for GPs to participate in teleconsultations with specialist services and two are planning to provide links.”
Waitemata, Hawkes Bay and Auckland DHBs will be implementing email patient consultations as part of shared care planning initiatives.
The DHBs reported that the main barriers to uptake include interconnectivity of video conferencing across provider networks, infrastructure investment and adequate technical support, as well as a lack of appropriate reimbursement models.
The NZ Telehealth Forum is now conducting phase 2 of the stocktake, which will survey primary health organisations and non-government organisations.
The NZ Telehealth Forum has also gone live with the New Zealand TeleHealth Resource Centre website, developed in association with Mobile Health Solutions.
Posted in New Zealand eHealth