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Telehealth Ontario Surveillance: Telehealth Ontario Surveillance: Future ConsiderationsFuture Considerations

Alex PerryAlex PerryJune 13, 2008June 13, 2008

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AgendaAgenda

• Research objectivesResearch objectives

• Relevance of research questionsRelevance of research questions

• Investigative approachInvestigative approach

• Questions / commentsQuestions / comments

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Research ObjectivesResearch Objectives Can Telehealth Ontario calls provide advance Can Telehealth Ontario calls provide advance

information about hospital information about hospital emergency emergency department visits department visits and and hospital admissionshospital admissions for for respiratory illnessrespiratory illness??

1.1. Are Telehealth calls related to Are Telehealth calls related to hospital hospital admissionsadmissions for for respiratory illnessrespiratory illness at the health at the health unit level?unit level?

2.2. How can Telehealth be used to provide How can Telehealth be used to provide advance warning for increases in advance warning for increases in emergency emergency department visits department visits for for respiratory illnessrespiratory illness??

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Application of ResultsApplication of Results• Plan hospital service provisionPlan hospital service provision

• Initiate timely institutional and Initiate timely institutional and public health interventionspublic health interventions

• Facilitate clinical decision makingFacilitate clinical decision making

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ApproachApproach

1.1. Are Telehealth calls related to Are Telehealth calls related to hospital admissionshospital admissions for for respiratory illnessrespiratory illness at the health unit level? at the health unit level?

• Examine strength and temporality of association Examine strength and temporality of association between Telehealth calls and hospital admissions between Telehealth calls and hospital admissions

• Do age group or geographic sub-groups provide a Do age group or geographic sub-groups provide a better signal or more warning?better signal or more warning?

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ApproachApproach

2.2. How can Telehealth be used to provide advance How can Telehealth be used to provide advance warning for increases in warning for increases in emergency department visits emergency department visits for for respiratory illness respiratory illness at the health unit level?at the health unit level?

• Define “Define “important increaseimportant increase” in emergency department ” in emergency department visitsvisits

• Identify important increases in NACRS dataIdentify important increases in NACRS data• Apply signal processing techniques to Telehealth dataApply signal processing techniques to Telehealth data

(Modified CUSUM, Parallel Cascade Identification)(Modified CUSUM, Parallel Cascade Identification)• Assess performance: sensitivity, specificity, timelinessAssess performance: sensitivity, specificity, timeliness

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Telehealth Ontario Surveillance: Telehealth Ontario Surveillance: Future ConsiderationsFuture Considerations

Questions / Comments?Questions / Comments?