Nasa Walton1, D. Anderson1 B. Peloquin2, M. Angove2, R. Newell1.
1 West Moreton Hospital and Health Service
2 Philips Healthcare – Hospital to Home Division
Introduction – West Moreton’s Mobile Enhanced Care (MeCare) is a working clinical service that integrates community and hospital based chronic disease management for complex chronic disease sufferers in their home via a point of care solution. This model of care was developed as five per-cent of our current patient population consumes 50 per-cent of the hospital clinical budget. 200 of our highest acuity chronic disease patient in the 2014-15 finical years consumed $12m of which $9M was directly attributed to chronic disease management related costs.
MeCare is a hybrid clinical care model that has eHealth technology at its core, enabling a multidisciplinary service to proactively manage and support the care of a patient during their healthcare journey by coordinating care delivery with patients in their home. The technology solution delivers psycho-social and physiological monitoring and home videoconferencing capability co-developed in partnership with Philips. The service emphasis is on patients with Chronic Respiratory Disease, Diabetes, Chronic Heart Disease and Chronic Kidney Disease.
Methods – The point of care solution in the patient’s home enables patients to upload vital signs; blood pressure, heart rate, oxygen saturation, blood glucose, temperature, INR and weight, via Bluetooth, to a dedicated tablet. The tablet application, Philips Healthcare’s eCareCompanion (eCP), facilitates patient interactions, via patient surveys and video conferencing. The metrics are transmitted to the Philips hosted eCareCoordinator (eCC) application. eCC supports population health management by providing the multidisciplinary team (RN, Pharmacist, psychologist, health coaches and Physicians) with a dashboard based daily review of each of their patients, allowing them to prioritise patients and adjust care plans or intervene as needed. MeCare team members are able to view daily summaries and biopsychosocial trends of the patients enrolled in the service, schedule appointments, education, surveys and participate in video conferencing calls directly with the patient and GP. Other non-QH clinicians, (GP’s, NGO’s and other care givers), are also able to securely access the system via a web client, contributing to the care plan, case conference with the service and maintain an integrated longitudinal record.
Results – The Philips eCC and eCP Intensive Ambulatory Care as a Service (PaaS) solution are cloud based applications hosted on Salesforce.com and Amazon platforms. The data is securely stored in non Australian jurisdictional datacentres. The program has worked with various Qld Government agencies and Qld Government data security, privacy requirements and has approval to deploy the solution in the various cloud providers around the world.
The technology offers significant support to enhance patient empowerment through simple and robust integration between the monitoring devices/ patient tablet, the MeCare unit and community based care. Our presentation will discuss the challenges and our success in delivering the technical point of care solutions in patient homes and the telehealth hub.