New Technologies and Platforms
Jennifer Tieman, Flinders University
Inaugural National Palliative Care Research Colloquium
July 2013
Technology Context
• More people using technology
– Absolute numbers ↑, proportion of population ↑,
participation by specific groups ↑, mobile technology ↑
– But still digital divides
• More platforms, technologies, software
– Dynamic environment
– Consider gaming: Physical device(s)
used, operating systems, application
software, networking, and connectivity
– But issues in integration, compatibility
• More expectation of telehealth
– Timely access, remote monitoring,
telecommunications, patient
empowerment, knowledge development,
new service models, reducing error, managing demand
Australian Context
• National eHealth Strategy 2009
– Commonwealth-State MOU 2012-2014
• NHETA
– Clinical documents including PCEHR,
– eFoundations including standards, interoperability,
security and access
– National infrastructure including health identifiers
and clinical terminology
– Implementation activities (eg eHealth rollout sites)
• National Digital Economy Strategy
– Health and Ageing Goal
• NBN
• MBS Online - Telehealth
PC and Telehealth
• Cradle Coast Electronic
Health Information Exchange
• Advance Care Directives
and PCEHR
• NBN Telehealth Pilots Program
(Aged, Cancer, Palliative Care)
• CareSearch, COMPAC modules, PCOC,
Hammondcare Dementia,
• NHMRC
– Internet &Telemedicine 2010-2012
Implications
• Significant driver in health system with
hopes about demand, supply and
delivery benefits
• Telehealth foundations
are being built
Telehealth in the Home:
Palliative Care, Aged Care and
Clinical Rehabilitation in SA
Funded by the Australian Government under the National Broadband
Network (NBN) Enabled Telehealth Pilots Program’
Project Partners:
Flinders University
South Australian Local Health Network
Southern GP groups, ACH
Three clinical streams
• Palliative care:
Integration of online tools, remote monitoring,
information and resources and regular online
communication to support home-based patients and
their carers.
• Aged:
Video conferencing to support clinical care in RACF.
• Rehabilitation in the elderly:
Introduction of e-rehab including online tools,
information provision and communication to support
home-based rehabilitation services for the elderly,
including people recovering from stroke or fractures.
Palliative Care Study
• Palliative Care (Telehealth Research Group)
– Kate Swetenham (SAPS), Tim To (SAPS),
Jennifer Tieman (CareSearch), David Currow
(DPSS), Deidre Morgan (DPSS)
• Structured online face to face: patient-nurse;
carer-network facilitator
• Patient online self-assessments: SAS, AKPS,
AQoL, FitBit
• Carer online self-assessment: SAPS tool
• Virtual case conference
Outcomes of interest
• Telehealth feasibility
• Patient, carer, professional engagement
• Service delivery changes
• Clinical metrics
• Cost elements
Where are we up to?
• Ethics submitted
• Protocol
– Clinical algorithms, Patient consent processes,
Data collection processes, Analysis requirements,
• IT resources and apps developed (and refined)
• Technology architecture mapped
• Negotiations, agreements with providers and
with partners
• QA test with patient volunteers
• Documentation processes underway
Technology: Research Agenda
• PC as a test bed
– Across the health system
– Community intersect
– Cross over into high priority health areas
• Policy implications of telehealth research
• Align with clinical needs
– Health at the heart of telehealth
• Role of big data
Research Issues
• Undertaking research not just projects
– Funding is often project based
• Complex interventions
– Appropriate study designs?
– Articulating and measuring outcomes?
• Telehealth requires specification of
current practice
• Access to the technology
• Research teams
– Multidisciplinary (outside of health professionals)
– Working knowledge of the technical base needed
– Understanding each other
• How to build a starting point?
CareSearch would like to thank the many people
who contribute their time and expertise to the project including
members of the National Advisory Group and the Knowledge
Network Management Group.
CareSearch is funded by the Australian Government
Department of Health and Ageing.
www.caresearch.com.au