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RBWH Preadmission Services Provided by TelehealthLinda Cuskelly, Telehealth Coordinator, Clinical Operations Strategy Implementation, MNHHS
Dr Kellie Wren, Director Peri Procedural Support Unit, Royal Brisbane & Women’s Hospital, MNHHS
Clinical Operations Strategy Implementation (COSI)
How it all started….
2
Clinical Operations Strategy Implementation (COSI) MNHHS
• In April 2016 patient asked
‘Can I be seen via telehealth?’
• Linda met with Dr Kellie Wren
• Kellie said ‘Yes’ to see patient
and also happy to see other
patients via telehealth if
clinically appropriate
• 5 sites identified for high
numbers of patients travelling to
Brisbane for Preadmission Services
How we got other sites on board and
coordinated the service…
3
Clinical Operations Strategy Implementation (COSI) MNHHS
• QHealth facilities contacted
o Telehealth Coordinators in each HHS
o Director of Nursing (DON) in smaller rural sites
o Nurse Unit Manager (NUM)
• Set days for service negotiated at each site
• Contact and post code list created for all facilities involved
• Booking form developed and sent to all facilities for
feedback
o Date & time of appointment
o Tests & obs required
o Appointment duration – how long appointment will take
4
Clinical Operations Strategy Implementation (COSI) MNHHS
Meeting the challenges head on….• Lack of communication at some sites around using a Virtual
Meeting Room (VMR) number
o Further training with sites using VMR numbers
• Complaints from rural sites regarding;
- How long appointments were taking
- Lack of room availability at some sites
- Rural sites unable to provide nurses for long periods
o Videoconference into patients homes when appropriate
o Videoconference into patients GP practices
o Streamlined Preadmission Telehealth Appointments
from 4 hours down to 1 hour
Recent feedback since streamlining the
Telehealth appointments…
Extract from email received August 2017
Christine McInally, Telehealth Coordinator
Central Qld Hospital Health Service
“CQ is very happy with the new layout and timing of the
PREAC telehealth clinic. The patients are very happy with
such fast appointments. Great job. This gives Rockhampton
the ability to see more telehealth patients from yours and
other specialties each week
5
Clinical Operations Strategy Implementation (COSI) MNHHS
• Access to test results and observations when
using Telehealth Portal into patients homes
• Clinicians understand these limitations and have
defined specific strategies for obtaining information
that support their portal assessment
o Self managing patients get tests and obs done
through GP before surgery date
o Patients requiring additional support come to
RBWH for any additional tests day before
surgery6
Overcoming the challenges when
videoconferencing into patients homes…
Clinical Operations Strategy Implementation (COSI) MNHHS
How we connect with our patients in their
homes…
7
Clinical Operations Strategy Implementation (COSI) MNHHS
Telehealth Portal
can be accessed through
a web browser on a PC,
MAC or Laptop
Telehealth Portal can be
downloaded via the
‘Pexip App’ onto any
Android or iOS phone or
device
8
What we need for the Telehealth Portal to work?
• Reliable internet.
• Virtual Meeting Room (VMR) number so our
clinicians can dial into a patients home, RACF or GP
• The VMR number is provided via email to either
patient, RACF or GP before telehealth appointment
(Videoconference) takes place
Clinical Operations Strategy Implementation (COSI) MNHHS
How a Virtual Meeting Room (VMR) works
9
To connect with our patients or
external partners everyone dials
the 6 digit VMR number at the
same time
Pexip app users
press join
Telehealth Portal
users press connect
QHealth Cisco
Jabber users press
start
Clinical Operations Strategy Implementation (COSI) MNHHS
10
Point to
point call
Doctor dials same
VMR number at
designated time to
connect
Patient / Carer / Nurse
dials same VMR
number at designated
time to connect
Clinical Operations Strategy Implementation (COSI) MNHHS
11
Multipoint call
Additional people
(family) can dial into
call if required by
dialling same VMR
number at same time
Clinician dials same
VMR number at
designated time to
connect
Nurse dials same
VMR number at
designated time to
connect
Clinical Operations Strategy Implementation (COSI) MNHHS
Where are we now…
12
Clinical Operations Strategy Implementation (COSI) MNHHS
As of 31/10/2017 there have been a total of 1,201
Telehealth consultations all over Queensland
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Linda Cuskelly
Telehealth Coordinator
Clinical Operations Strategy Implementation
Metro North HHS
Dr Kellie Wren
Director Peri Procedural Support Unit
Royal Brisbane & Women’s Hospital,
Metro North HHS
Clinical Operations Strategy Implementation (COSI) MNHHS
