What is telehealth?
Telehealth is the use of information and communication technologies to deliver health care when patients and care providers are not in the same physical location. For example, illnesses can be diagnosed and treatment provided via secure video conference. To be effective, telehealth relies on fast broadband internet services. Healthcare related education, research and evaluation can also take place using telehealth facilities.
- For patients: Faster access to care and shorter wait times. Remote patients can remain close to home, making consultations more convenient and reducing travel.
- DHBs: Fairer health system because of better access to care. More educational options for DHB staff via specialist video training.
- Specialists/consultants: Less time spent travelling for consultations. Greater control over scheduling. Closer working relationship between specialists and primary care.
- Aged care workers/nurses: Reduced need to transfer older patients. Increases nurses' knowledge through more exposure to specialist consultations.
- General practitioners: GPs who serve rural health facilities need to travel less frequently. Store and forward allows for accessible referrals and second opinions.
- Allied health workers: Rehabilitation and physiotherapy can take place via videoconference, meaning less time and budget spent on travel.
Types of telehealth
The three key areas of telehealth in New Zealand are:
- Telemedicine – video conferencing and store and forward
- Telemonitoring – remotely collecting and sending patient data
- mobile health (mHealth) – using mobile communication devices like smart phones and tablet computers to send health information or support lifestyle programmes
If you are introducing telehealth, there are a number of technical and administrative aspects you will need to understand. This can be a little daunting – remember we are here to help!
Key elements of telehealth
Data Type: The type of data you use might be standalone video or audio, combined video and audio, text (eg, blood pressure, weight and symptoms), continuous monitoring streams, alarm signals or specialised recordings (eg, ECG and EEG).
Data Transfer: Data transfer can take place in real-time (synchronous) where the patient is usually present or on a ‘store and forward’ basis (asynchronous) where the patient is not usually present.
Who is Involved: Clinicians and patients, and patients’ family and whānau are the main parties usually involved in a telehealth consultation. It is possible for a number of people to take part in videoconferences. For example, a consultant might be with a medical student at one site, while a patient, members of their whānau and a rural nurse specialist are at another site.
The Type of Consultation: A number of different types of consultations can take place using telehealth. These include:
- initial specialist assessment
- follow-up appointments
- discharge planning meetings
- multidisciplinary team meetings
- acute assessments
- ward round
- triage assessments
- therapy/treatment appointments
Scheduling the consultation: Planned consultations are usually scheduled ahead of time, with locations and equipment booked by both parties. Facilities likely to need to have urgent consultations, such as emergency departments, can quickly make the appropriate equipment available.