The Darling Downs Telehealth Team – our formula for success

Carolyn Bourke1, Shayne Stenhouse 2

 

1 Telehealth Service, Darling Downs Hospital & Health Service, Mt Lofty Nursing Home, Rifle Range Road, Toowoomba, 4350 carolyn.bourke@health.qld.gov.au

2 The Telehealth Service, Darling Downs Hospital & Health Service, Mt Lofty Nursing Home, Rifle Range Road, Toowoomba, 4350, shayne.stenhouse@health.qld.gov.au

 

Established in 2014, the Darling Downs Telehealth team consists of a Clinical Nurse Consultant and a Business Coordinator and together they have created a momentum for change with great teamwork.

Non admitted Telehealth service events have grown significantly in the past 3 years in the Darling Downs Hospital and Health Service, with a 15% increase in the past 12 months.

Their success can be attributed to great communication and a capacity to do things that can’t be done by challenging the norm and asking why not?

The benefit of the blended team has given rise to different ways of thinking – think like a clinician and thinks like a business manager to achieve our results.

 

Processes undertaken include:

  • Monitoring and streamlining data collection
  • Review clinical & administration processes
  • Monthly report to HHS Board members
  • Regular rounding with all specialities and all facilities
  • Establishment of sound relationships with the Administration and Clinical teams
  • Working on the business and not in business
  • Consultation with clinical and business leads
  • Creation of a telehealth action plan
  • Data review, measurement and analysis

 

New models of care under development:

  • Tele-chemotherapy
  • Tele-stroke
  • Tele-geriatric

 

Opportunities to bridge the gap:

  • Expand Tele-dental into school dental vans and private nursing homes
  • Collaboration with DDWMPHN – integrating public & private health care
  • Ongoing clinician engagement within General Practice
  • PTSS Project to decrease patient travel and achieve more care locally via Telehealth
  • Contribute to development of the Nurse Navigators role and telehealth capacity

Reporting and funding telehealth activity: A Queensland perspective

Stephanie Ferdinands1

1 Telehealth Support Unit, Queensland Health, Level 2, 15 Butterfield Street Herston 4006, stephanie.ferdinands@health.qld.gov.au

 

This presentation will outline: the current reporting requirements for telehealth activity in Queensland Health; the 2016-17 telehealth Key Performance Indicator; and the opportunities for funding telehealth activity provided for in the 2016-17 Queensland Activity Based Funding (ABF) model and associated 2016-17 Healthcare Purchasing Intention (HPI).

Accurate and timely reporting of telehealth activity has been essential in establishing the 2016-17 telehealth Key Performance Indicator, and in the development of telehealth specific funding localisations/ initiatives in the Queensland ABF model. Ultimately supporting the expansion of sustainable telehealth enabled services delivery models across the State.

Queensland Health has a range of established patient administration systems and two statistical data collections in place that facilitate the capture and reporting of telehealth activity data. The two statistical collections are: the Monthly Activity Collection (MAC) which enables the reporting of non-admitted patient telehealth service events and store-and-forward telehealth assessments; and the Queensland Hospital Admitted Patient Data Collection (QHAPDC) which enables the reporting of admitted patient telehealth events.

In 2016-17 the Queensland ABF Model continues to include a localisation to the National ABF model, providing opportunity for funding both the recipient-end and provider-end of in-scope telehealth non-admitted patient service events. Additionally, the 2016-17 HPI provides a payment for additional telehealth activity volumes (by provider or recipient) above the actual volumes for equivalent period in the previous year.  The 2016-17 HPI also provides a payment for in-scope admitted patient telehealth events, in-scope store and forward telehealth assessments and in-scope emergency department telehealth events.

Telehealth & Outreach Service Model Tool

Linda Cuskelly 1

1 Telehealth Coordinator, Metro North Hospital Health Service, Clinical Operations Strategic Implementation, MNHHS, Level 13, Block 7, RBWH, Butterfield Street, Herston Qld 4029

 

Telehealth & Outreach Service Model Tool

MNHHS was successful in obtaining seed funding to develop a model tool that can calculate cost and potential PTSS savings for providing a telehealth service.

In collaboration between Healthcare Improvement Unit and MNHHS, Linton Curley, Manager Reporting & Business Analytics, MNHHS has recently developed a Telehealth & Outreach Service Model Tool. This activity and costing model is able to calculate Weighted Activity Units (WAU). Activity Based Funding (ABF), Own Source Revenue (OSR), Labour and Non-Labour costs associated with a proposed telehealth clinic.

This model will be managed by the Telehealth Support Unit, Healthcare Improvement Unit and will be available to all QHealth Telehealth Coordinators within the state to use when considering new Telehealth proposals.

The model aims to provide an overview of the revenue, cost, activity and PTSS implications of creating a new Telehealth service or changing an existing clinic arrangement to Telehealth.  This model tool will be used to provide stakeholders with a relatively thorough insight into the impacts beyond the obvious benefits to the patient being treated locally.

The model has an embedded guidance document that provides detail regarding selection choice, impacts, assumptions and scope of the tool.

The model has protected underlying macros and reference sheets that store ABF non-admitted Tier 2 price weights, MBS item numbers, MBS billing eligibility map & distance calculator, administration and clinician wage rates, teleconferencing equipment and levy and travel costs associated with outreach services.

The model also has the capability to calculate average potential savings for Patient Transport Subsidy Scheme using annual volume of patients expected to attend the proposed telehealth service.

The telehealth coordinators complete a questionnaire for;

  • What clinical service area and specialty is considering delivering telehealth
  • Who will be delivering this service from both the provider site and recipient sites
  • Is the proposed service a new or existing service
  • When will the service commence
  • Is the intention to provide private or public telehealth services or both
  • Is the recipient site outside of the RA1 eligible area if providing private MBS services
  • How many new and review cases will be seen in the telehealth clinic
  • What is the duration of a new and a review appointment
  • Will the clinic be solely telehealth or a mixture of telehealth and face to face
  • Does the service proposal include Outreach visits to the recipient site

 

When the questionnaire is completed a summary of the telehealth proposal will populate. This includes graphs that show the projected revenue and expenditure for both the providing and recipient sites.

Think teamwork for telehealth success

Shayne Stenhouse1, Carolyn Bourke2

1 The Telehealth Service, Darling Downs Hospital & Health Service, Mt Lofty Nursing Home, Rifle Range Road, Toowoomba, 4350, shayne.stenhouse@health.qld.gov.au

2 The Telehealth Service, Darling Downs Hospital & Health Service, Mt Lofty Nursing Home, Rifle Range Road, Toowoomba, 4350, carolyn.bourke@health.qld.gov.au

 

The current Telehealth team for Darling Downs Hospital & Health Service (DDHHS) has been together for the past 19 months.  We have reflected on why we have been successful. How do we measure our success? So our discussion will be reflecting on us as a team in a change management environment.

Each Team Member Has Emotional Intelligence -Effective teams possess not only technical skills, but also emotional intelligence. In fact, studies have shown that emotional intelligence is more important than the IQ of each team member. It turns out that if individuals are socially aware, the whole group puts in better quality work.

A Good Mix of Introverts and Extroverts-The balance introversion and extroversion can affect how teams work. As a society, many often think of extroverts as doers, go-getters, superior team-players. Though the tide towards valuing individual strengths regardless of extroversion or introversion may be changing, extroverts are still often perceived as being more competent team members as they seem to get along with others more easily.

They Share and Understand Their Common GoalsThere is a need to have common goals and shared ambitions in order to be as efficient as possible.

They Make Time for Humor – Humor might not be such an obvious factor in the effectiveness of a team, but actually humor inspires trust and intimacy —which can lead to better team interactions

They Communicate Proactively – Communication is obviously important, but what really matters is proactive communication. Proactive communication can be materialized in four ways:

  • Team members provide information before being asked.
  • They provide support and assistance before being asked.
  • They take team initiative by providing guidance and making suggestions to other team members.
  • They provide updates, creating situational awareness for other team members.

Strong Leadership at the Helm- Even when all the team members fit in with the above, teams still need great leadership. The role of the leader isn’t only to set an example and to motivate team members, but also to provide effective feedback and to nurture the soft skills mentioned above.

As Change Agents we must have the following:

  1. Clear Vision
  2. Patient yet persistent
  3. Asks tough questions
  4. Knowledgeable and leads by example
  5. Strong relationships built on trust

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