The future of health care delivery: Telehomecare

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As the role of technology in our daily lives grows, more and more Canadians are turning to digital tools to manage their health and well-being.  By empowering Canadians to take control of their health, these new tools are proving beneficial not only to patients but to health care providers and the health care system.

One innovative program is Telehomecare.  Working with TELUS Health and funded by the Ontario Ministry of Health and Long-Term Care and Canada Health Infoway, the Ontario Telemedicine Network (OTN) has developed an integrated Telehomecare service that provides daily health monitoring and weekly health coaching for patients with Chronic Obstructive Pulmonary Disease (COPD) and Chronic Heart Failure (CHF).  OTN is a leader in telemedicine solutions that enable health care organizations and health care professionals to provide virtual care.

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OTN’s CEO, Dr. Ed Brown, believes programs like Telehomecare will lead to an improved and more sustainable health care system. “Leveraging technology helps health care professionals provide better care and better value at the same time, particularly for patients with chronic disease who benefit the most from home monitoring,” he says.  Thousands of Canadians already use TELUS Home Health Monitoring (HHM) in Ontario, Quebec and British Columbia.

Telehomecare focuses on empowering Ontarians to learn how to manage chronic conditions like CHF and COPD to prevent exacerbations.  As a result, the OTN-TELUS HHM partnership, together with the Local Health Integration Networks (LHINs), Telehomecare delivery organizations, hospitals and Community Care Access Centres, are reducing system costs, emergency room visits and hospital admissions.

Telehomecare patient Beatrice, 77, explains how the system has affected her daily life: “Telehomecare has definitely improved my quality of life. I feel like my nurse is there with me every day,” she says. “I have personally learned a lot in the process like understanding the impact that managing my diet, exercising and thinking positively can have on my health.”

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OTN Telehomecare was recommended to Beatrice by her physician, Dr. Sanjeev Goel, a family physician at Wise Elephant Family Health Team. The program makes it easier for Dr. Goel to meet the complex care needs of his patients – many with chronic diseases, like Beatrice, who frequently end up in hospital if they are not monitored closely. He says Telehomecare helps him care for patients in ways he normally couldn’t.

For example, Dr. Goel received an instant message from Beatrice’s Telehomecare nurse alerting him that Beatrice had a rising fever and cough. Dr. Goel was immediately able to get a prescription to Beatrice over the phone.  Without daily monitoring, Dr. Goel may have become aware of Beatrice’s worsening condition too late to avoid hospital admission.

In the first phase of OTN Telehomecare implementation, patients with CHF and COPD were enrolled in the North East LHIN by the North East CCAC, in the Central West LHIN by William Osler Health System (Osler) and in the Toronto Central LHIN by Toronto Central CCAC.

“The outcomes have been remarkable,” says Laurie Poole, a Registered Nurse and VP, Telemedicine Solutions at OTN.  Early results from the Central West LHIN based on Osler’s utilization data indicate a 71 per cent reduction in hospital admissions and a 43 per cent reduction in ER visits.   More, Poole says the level of patient satisfaction with Telehomecare is tremendous.  As Beatrice put it, “I really can’t believe the care I’m getting.  I never expected it.”

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For Matt Anderson, Osler’s President and CEO, Beatrice’s reaction is exactly what the Telehomecare partnership is all about – commitment to better care for the community. The team at William Osler’s knows firsthand the value of Telehomecare.  Anderson says there has been remarkable co-operation between Osler, OTN and TELUS as well as the Central West LHIN and the CCAC.

“With any new program, there were challenges to overcome in implementation, but when you have a program with such clear clinical benefits, it makes it easier for people to rally around it. The barriers are low and the return high,” says Anderson. Telehomecare can grow in a number of ways too and Anderson envisions the program evolving to address other illnesses and eventually being used in a truly preventative way.

Dr. Ed Brown agrees.  “We are thrilled to see use of this technology platform accelerating and the benefits beginning to be realized in the community. It’s a win for patients and the health care system.”