Medical Council Revises Statement on Telehealth
www.nzdoctor.co.nz - Aug 2016
A new statement on telehealth practices is intended to make sure current guidelines don’t get in the way of innovative IT solutions, Medical Council chair Andrew Connolly says.
“When I talk to GP colleagues and others they are really quite excited by some of the opportunities IT provide," he says, referring to rural health initiatives in particular.
The document clarifies definitions of the terms “in-person”, “telehealth” and “video consultation”.
It also reminds practitioners that any treatment offered online should be to the same standard as an in-person consultation and so include updating the patient’s clinical records and notifying his or her primary care provider.
Particularly important is consideration of whether a physical examination would add “critical information”. If this is the case, the patient may have to be referred to another practitioner before treatment is provided or further diagnostic services requested.
Doctors are also reminded of rules around prescribing: “Issuing prescriptions by electronic means only does not meet current New Zealand legislative standards,” as all prescriptions must be personally signed.
Mr Connolly says this is the first review in only three years and, with technology changing rapidly, another could well be required in the next three to four years.
Click here to read the full statement.
The Selwyn Foundation
Telehealth Pilot for Health Independence
selwyncare.org.nz - Oct 2015
The Selwyn Foundation is currently using a telehealth pilot to monitor the health of elderly patients remotely using touch screen technology.
The system was designed to aid people over 65 who have been diagnosed with a chronic disease such as high blood pressure or an airway disease. The purpose is to aid people in managing their own health and provides remote monitoring and support.
Patients are able to monitor and record their vital signs with the 'My Health Clinic at Home' service daily. Results are securely transmitted to a telehealth nurse and reviewed. Video conference facilities are the available to discuss any necessary changes to health management. This is a supplementary service that is used in conjunction with the patients current care provision. Results are shared with the patient's clinician to assist in management of their condition.
The pilot program will involve 20 participants, using a touch screen tablet and health measuring devices. These measure weight, oxygen saturation, blood glucose, blood pressure and body temperature. This is a free trial and is designed to be simple and easy to use for those with limited or no computer experience. All training, equipment and internet access is provided by the Selwyn Foundation.
The intended purpose of this pilot is to empower people through education and self-management of health issues. It is designed to reinforce GP's recommendations and facilitate early intervention of health care problems which will hopefully aid in maintaining wellness and reduce the burden of an aging population on the healthcare system.
In addition to the medical monitoring, smart house technology is available with safety monitoring devices available. This includes an alarm pendant, smoke detector as well as movement and fall detectors.
The pilot will run for 6 months, ending in December 2015. It was developed with the aid of Feros Care Telehealth Services who have been involved in providing telehealth solutions for the elderly in Australia for the last 6 years.
The pilot has been approved by the Health and Disability Ethics Committee and is being independently evaluated by the University of Auckland's UniServices. It is hoped that the technology will be made available in 2016.
Click here to read the full report.
NEMO goes to Kaitaia
Northland District Health Board is currently taking part in a two year trial of a high tech telemedicine system allowing remote access to specialist emergency care.
The Neonatal Examination and Management Online (NEMO) system is an Australian system that was developed to aid in remote examination and neonatal patient management.
Although developed initially for neonatal patients, Northland is the first to use the system for adults and children. The main benefit is the ability for medical staff at Kaitaia Hospital to have a direct, real time video link to Whangarei Hospital Intensive Care Unit (ICU).
The NEMO system is run from a computer work station in Whangarei which remotely connects to a portable video unit in Kaitaia. The camera and call settings can be altered by the clinician at the Whangarei end. The unit allows them to communicate with the whole team involved in patient care as well being able to see what is going on. An added high specification camera on an extended viewing arm allows for additional patient viewing from a better observational angle.
Currently the focus for using the system is acute emergency care, allowing rapid specialist assessment and aiding in decision making in regards to the need for transport to Whangarei and the most suitable form of transport for the patient.
NEMO is also being used to deliver educational sessions and for ICU nursing support. There have been several nursing refresher sessions for using specialised breathing circuits since the trial began. The effectiveness of this form of education is being assessed to ensure it is useful.
The trial is in collaboration with the University of Queensland's Centre for Online Health and is important as it will allow each health care provider to evaluate the system and share the results both nationally and internationally.
"The opportunity that this brings is for Northland DHB to understand whether this type of technology can enhance clinical practice and, at the end of the day, save lives," says the Clinical Head of ICU in Northland and project clinical lead, Doctor Katherine Perry. "If proven, Northland DHB would look to introduce this type of system to all Northland's outlying Hospitals."
Medico-legal Issues in Telehealth
While written for Victoria, this paper does still discuss a number of very important Medico-legal issues that are generally applicable when implementing telehealth within New Zealand.
The paper finds that while there are a number of important medico-legal risks that must be addressed, provided the risks are identified, acknowledged and dealt with appropriately, this should not be a barrier to a successful Victorian telehealth system.
This document is provided as a resource only. Nothing in this document should be taken to be legal advice and health service providers and clinicians should seek independent legal advice about any medico-legal matters relating to telehealth.
Click here to read the full report.