IMPROVING PARTNERSHIPS WITH COMMUNITY HEALTHCARE PROVIDERS & TELEHEALTH IN ED

Diana Badcock

EMET and Telehealth

-Build it and they will come

-Emergency Medicine Education & Training EMET

-Technology is the tool

-Telehealth

EMET Enhance standard of regional emergency care

Build a credentialed regional workforce

Reinforcement of relationships within local health network

Improve remote clinical advice and support

Professional development of existing staff at BH

Weekly • Echuca

Fortnightly • Swan Hill

Monthly • Castlemaine

Other

• Charlton • Inglewood • Kyneton • Heathcote • Rochester • Kerang

2

5

1 1

5

2

Swan Hill (12)Echuca (22)Castlemaine (6)GP (2)EMC Candidates (36)Other (GP Workshop & SES Training Day)

last 6/12 - average 76 days providing training and education in

the region for the region

EMC/D

2012 2013 2014 2015 2016

new 4 8 4 6 2 24

pass 3 7 4 1 3 18

EMC/EMD accreditation RACGP accreditation

STP ED registrars - rural & remote

STP GP registrars STP Anaesthetic & ICU

Rotations

Use of technology

www.edcentral.com.au

ISimulate FACEM chat groups/teaching chat groups Teleconferencing and Telehealth

Victorian ED Data set 2015-16

Assessment, Evaluation or Treatment

provided through Telehealth by Doctor or

Nurse on unplanned emergency patients in

region in acute healthcare facility

Quality healthcare- 7 rights

Right care

Right patient

Right provider

Right place

Right time

Right outcome

Right cost

Duty Consultant

hotline 8104 managing sickest patients

overseeing rest (48,000 /year)

teaching on run (junior docs and students)

counsel roster

relationships right safe and secure

(and happy)

Problem

Disconnect between aligning vision with resources

Results

58 Consults

Triage

3 cat 1

15 cat 2

25 cat 3

15 cat 4&5

- 48 captured by tool

- 12 avoid transfer

+ 6 optimised transfer

“The telehealth system increases the senior

medical leadership and experience in our

local ED significantly by bringing the

Bendigo Duty Consultants into the room

with us.”

“Telehealth has prevented the need for

transfer of some patients, whilst for

others has expedited the transfer with

arrangements being made by the Duty

Consultant.”

“This program has been very useful for

us…. especially with a patient with no

advance care directive …input from them

to discuss options was very beneficial …

following up with the family to discuss

the options for them to decide on.”

“Thank you for taking time to speak with

me this morning….. for people who are

not able to access the ED or even a GP

easily….like my son…..telehealth is the

answer. Instead of calling police,

ambulance and his carer to sedate and

bring him to you….this is easy.”

Emergency Physicians

“You gather so much more information by

seeing the patient and the surrounds”

“We should do telehealth before we take any

transfers. We can support and give advice and

keep some of these patients treated locally.

Those that come can benefit from having

access to our skillset earlier. “

Learnings Improves relationships

Improves quality care and transfer

Optimisation of regional points of care

Improves local hospital profile

Improves patient and staff satisfaction

-New skill set

-Time & Reliable network

-Unintended consequences

Cornerstone for clinical & educational EM outreach services provided in country by the country -available to all healthcare providers -encompass deficiencies in community for chronic as well as acute and emergency healthcare provision -wherever they are located -wherever they are sent -funded -activity counted

Questions?