Slide1: The Alberta SuperNet Broadband e-Health Sector Initiative Facilitating non-traditional alliances and impacting organizational boundaries Dr. Penny Jennett – P.I. Co-Investigators: Dr. M. Yeo, Dr. R. Scott; Dr. M. Hebert www.ucalgary.ca/telehealth E-Health 2004: Challenges Today for Success Tomorrow The 5th Annual Conference of CIHI and COACH Victoria, British Columbia May 8-11, 2004 Health Telematics Unit Global e-Health Research and Training Program


Overview: Overview Background Purpose Methods Results Challenges Conclusions and Next Steps


Slide3: 4700 linkages 422 communities Federally funded Multi-sectored 14 multi-disciplinary researchers from 4 universities Broadband – ISPs - 10 times dial-up - 560 kb What is the Alberta SuperNet?


BackgroundEight sub-projects: Background Eight sub-projects Public consultation Distance learning Disaster emergency Health Discrete choice Virtual clusters In home/community Libraries


Purpose: Purpose Share the views of: rural remote communities, households, care sites, health care providers, and the public and consumers (including patients) regarding: How they will use the SuperNet. How they believe the SuperNet should be evaluated. Outline challenges identified, including shared infrastructure Discuss implications and future steps.


Methods: Methods Planning and base line (done centrally) Household telephone interviews (n=161) Town hall meetings (n=8) Symposium (n=1) 2. E-health sub-project survey (done by health team) Key Informant (n=14) Questionnaires (n=50-60)


ResultsHousehold Telephone Interviews: Results Household Telephone Interviews


Baseline ResultsHousehold Telephone Interviews (n=161): Baseline Results Household Telephone Interviews (n=161) If your community currently has or plans to have telehealth in place, do you think that the Internet (SuperNet) should link with this service (telehealth)? Yes: 59 42.45% No: 10 7.19% Uncertain: 70 50.36% If Yes, how? Provide health information (EHR, diagnostics); teleconferencing; online advice with health professional; etc.


Baseline ResultsHousehold Telephone Interviews (Cont’d)(n=161): Baseline Results Household Telephone Interviews (Cont’d) (n=161) Value and Uses Reduce isolation Easier and improved access (to health professionals, diagnostic tests, electronic health records, prescriptions, and general health information i.e. seniors or people with disabilities.) Personal Health Record


Baseline ResultsHousehold Telephone Interviews: Baseline Results Household Telephone Interviews Value and Uses (Cont’d) Renewing pharmacy prescriptions Reduction in wait times and travel, time, better scheduling of appointments Increased knowledge, training, information about health/medicine using credible, reliable and timely websites.


ResultsTown Hall Meetings: Results Town Hall Meetings


Baseline ResultsTown Hall Meetings (n=8): Baseline Results Town Hall Meetings (n=8) Key Issues Context Situated - agriculture; oil&gas; ranchers; farmers; dairy; forestry; tourism Economic Development Nature of Applications (e-learning; e-work; e-health; disaster/emergency; e-business) Multi-sectoral and Multi-disciplinary


Baseline ResultsTown Hall Meetings (n=8): Baseline Results Town Hall Meetings (n=8) Key Issues Training and Support Costs (e.g. public sector; private sector; partnerships; businesses; and homeowners) Technical Infrastructure – connectivity (high bred model)


Baseline ResultsTown Hall Meetings (Cont’d)Key Health Issues: Baseline Results Town Hall Meetings (Cont’d) Key Health Issues Sites Home, care sites Clinical Suggested applications: mental health, child health, improved diagnostics, trauma. Access to specialists and consultations (e.g. videoconferencing – trauma and mental health). Secure information exchange/confidentiality Health Professionals Recruitment and retention Professional networking Professional development and training Business viability and costs


Baseline ResultsTown Hall Meetings (Cont’d)Value and Uses: Baseline Results Town Hall Meetings (Cont’d) Value and Uses New Services Access to health/medical information Health professional networking


ResultsKey Informant Interviews: Results Key Informant Interviews


ResultsKey Informant Interviews (Cont’d)General Uses: Imagery Teleradiology Teleultrasound Teledermatology Current Services Clinical Educational Admin Global Opportunities Results Key Informant Interviews (Cont’d) General Uses Image Rich Store and Forward


ResultsKey Informant InterviewsGeneral Value to Rural Communities: Results Key Informant Interviews General Value to Rural Communities Unique infrastructure “backbone” in Alberta that gives rural and remote communities opportunities for socio-economic development and more job opportunities: Health Sector Jobs Health Sector Support Businesses Telework Home-based businesses & work Professional Education People moving back to smaller communities from urban areas.


ResultsKey Informant Interviews (Cont’d)Value to the Health System: Value-add of a broadband infrastructure to usual health service delivery and current telehealth services. Community readiness (i.e. providers, organizations, patients/public). Operationalizing strengths and limitations of the SuperNet. E-Health recommendations for policy and decision makers. Results Key Informant Interviews (Cont’d) Value to the Health System


ResultsKey Informant Interviews (Cont’d)Value to Health Regions: Allows rural health care teams to keep more complex patients with video conferencing support. Facilitates administration of Health Regions. Better sharing of health care resources. Expansion of staff development and mentorship opportunities. Development of new e-health clinical applications that improve access and/or quality and reduce costs. Results Key Informant Interviews (Cont’d) Value to Health Regions


Slide22: Allows organizations to think and strategize differently regarding level of service and support. Supports health care organizations working better intersectorally. Provides mentorship and clinical support to expand knowledge and skills of rural providers. Screens patients in their own communities to determine if they require specialized services. Increases the number of telehealth clinical applications available in rural communities. Improves access, quality and costs of patient care. Results Key Informant Interviews (Cont’d) Value to Health Care Organizations


ResultsKey Informant Interviews (Cont’d)Value to Health Care Providers: Decreased travel time and costs. More efficient use of time. Improved access to telehealth services, consulting resources / support, research resources. Capacity building for rural and urban providers Improved image and sound quality for diagnostic assessments. Results Key Informant Interviews (Cont’d) Value to Health Care Providers


ResultsKey Informant Interviews (Cont’d)Value to Consumers/Patients: Improved quality of care in rural communities. Improved access to services and information. Access to health care services in home communities. Increased health care options within and outside of the Region Decreased travel time and costs. Decreased stress, particularly for elderly. Unknown what kind of SuperNet high speed Internet services or applications will be available to the very small communities. Results Key Informant Interviews (Cont’d) Value to Consumers/Patients


Evaluation: Evaluation Patient/Public/Consumer – patient outcomes; quality of life; isolation; wait times; time saved Providers – time saved; efficiencies; capacity building. System (layers) – cost benefits; # of clinics; # of pts seen; wait times; time saved; capacity building Technology Infrastructure – connections; quality; reliability; functionality; internet service providers


Evaluation (Cont’d): Evaluation (Cont’d) Hard indicators and soft indicators Short term, intermediate and long term Arms length or internal Comparison How frequently? Quantitative or Qualitative Little mention of context – workflow, workplace, change management


Evaluation (Cont’d): Evaluation (Cont’d)


Challenges: Challenges Informed Awareness Costs Sustainability Business Case Technical Infrastructure Reliability Gateway; bridge; interface Security/Privacy People Staffing Education Support Readiness Shared Infrastructure


Conclusions and Next Steps: Conclusions and Next Steps Multi-sector and discipline approach Various stakeholder groups within health and medicine Community economic lens Triangulation within and across sub-projects


Summary: Summary Background Purpose Methods Results Challenges Conclusions and Next Steps


Slide31: Thank You! Dr. Penny Jennett jennett@ucalgary.ca Health Telematics Unit Global e-Health Research and Training Program www.ucalgary.ca/telehealth