neoRehab service delivery trial within TCP Toowoomba

Samantha Donohoe1, Brioh Guffin2

 

1 Transition Care Program, Baillie Henderson Hospital, Browne House, Level 1 PO BOX  Toowoomba, QLD, 4610, samantha.donohoe@health.qld.gov.au

2 Transition Care Program, Baillie Henderson Hospital, Browne House, Level 1 PO BOX  Toowoomba, QLD, 4610, brioh.guffin@health.qld.gov.au

 

Background:

Within the Toowoomba Transition Care Program (TCP), the use of neoRehab clinically validated videoconference software is enabling real time service delivery via iPads. Within this model, the multidisciplinary community-based rehabilitation team of allied health professionals, nursing, case management staff, and allied health assistants, are alternating weekly home visits with videoconference consults, for appropriate clients. A staff member sits with the client and operates the neoRehab software on the TCP iPad in the client’s home, whilst the clinician is able to provide his/her review consult from the team office, with purpose-designed clinical measurement tools on-screen to assist in monitoring progress.

A three month pilot study was undertaken to review and update the existing Toowoomba TCP neoRehab service delivery resources (user guide and clinical guidelines) and review the implementation and service delivery of neoRehab within Toowoomba TCP. This innovative change to service delivery for clients in Toowoomba and surrounds has, in its initial stages, demonstrated time, resource and cost effectiveness.

 

Method:

Data focussed on capturing occasions of service (OOS) and additional parameters to identify the overall clinical service advantages of the integration of neoRehab into our existing service delivery model has been collected and analysed from a period including March, May and June, 2016. In addition, we have obtained staff feedback during informal interviews within the TCP team.

 

Data collection results (summary):

  • 23 of 26 sessions in three months substituted face-to-face consultations (~88.46%)
  • In 12 weeks, TCP saved approximately $1,574.35 using neoRehab as an alternate to face-to-face consultations
  • In 12 weeks, Toowoomba TCP completed 26 neoRehab sessions which saved an overall amount of $1,893.41
  • Overall, TCP saved $735.05 in staff costs
  • Overall, TCP saved $1,158.36 in car travel costs
  • In 12 weeks, the overall saving per OOS was approx. $69.43, with an average of 58.58km saved per OOS
  • 16 out of 26 neoRehab sessions had no episodes of disconnection or disruptions

 

Aspects that made the TCP team less inclined to use neoRehab included; technical difficulties, reception black spots particularly in the rural areas. Further, neoRehab isn’t as hands on as regular service delivery, and the poor sound quality at times when full reception isn’t available has been a barrier to use with our older clients at times.

All staff members were able to identify how neoRehab is useful in their area of practice and identified that it saves both staff and client time, and reduces the travel time, thus making the service more efficient and more responsive. Additionally staff indicated that neoRehab was beneficial for building teamwork by being a useful learning tool for both clients and staff. The team has identified that they would like to know more about the application of features of neoRehab.

 

Future Direction/consideration:

Please note: due to the preliminary nature of our data, we are aware that the following is representative of data collected as part of a series of first steps in a longer-term plan to integrate neoRehab into our team’s service delivery model. In future, we hope to conduct formal research to obtain reliable evidence in support of the feasibility of neoRehab within a community-based rehabilitation setting. We anticipate this data will be applicable to health services beyond our own, across our district, and further afield.

 

Conclusion

NeoRehab is showing promising potential as a feasible, cost effective advancement with further integration into our existing model of service delivery. Further scope for formal research over a six months period exists to quantify the feasibility, cost and clinical effectiveness of this service model within our team.

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