Ontario Telemedicine Network

1. 3/25/2012
The Taming of the Queue 2012
Telemedicine’s Contribution
Contents
Telemedicine’s impact:
– The Ontario Telemedicine Network (OTN) results
– Other studies
How telemedicine can reduce wait times while
improving access and efficiency
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2. 3/25/2012
OTN
An independent not-for-profit organization primarily
funded by the Government of Ontario
• Members include all hospitals and hundreds of other
health delivery and education organizations in Ontario
Partners with:
– Federal and Provincial e-Health
Organizations
– Keewaytinook Okamakanak
(Northern Chiefs) Tribal Council
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OTN: Available Everywhere
One of the world’s
largest & most active
TM networks.
Programs & services
delivered
collaboratively at
more than 1,400
sites using 2,600
telemedicine
systems
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3. 3/25/2012
OTN Vision
Telemedicine will be a
mainstream channel for
health care delivery and
education.
OTN Goals
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4. 3/25/2012
OTN “Virtual” Channels
1. Healthcare Office 2. Emergency Care
3. Learning 4. Home and
Community
2011 Clinical Utilization
Clinical Events* 170,875
Annual growth rate 39%
Consultants 1,622
Physician Consultants 1,180
* Includes videoconferencing and store-forward telemedicine consultations;
Excludes telehomecare
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5. 3/25/2012
OTN Annual Results 2011
By using telemedicine rather than travelling for an in-person
consultation, 170 million km of patient travel was avoided in Ontario
92 million km of travel was avoided in Northern Ontario which would
have cost the Northern Health Travel Grant Program $38 million
Hospitals avoided 625 admissions/transfers through emergency
mental health crisis access
Telestroke enabled 187 tPA deliveries that might otherwise have not
been possible
Using teleophthalmology, Retinal specialists reported to being able
to assess 10 patients in 40 minutes vs 2 hours when seen in person
90% of referring physicians said telemedicine improved their ability
to manage patients in their own community and 76% reported
improved access for their patients.
OTN Wait Time Impacts
Dermatology consult wait times reduced from 5 weeks to 10 days
Endocrinology consult wait times reduced from 4-6 weeks to less
than 4 weeks
Diabetic retinopathy screening wait times reduced from 6 months to
4 weeks
Emergency child & adolescent psychiatry consultation wait times
decreased from 6 – 9 months to within 72 hours
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6. 3/25/2012
OTN Study: Telehomecare in Chronic
Disease Management
Self-reported data from 813 enrolled patients with
CHF and COPD
64 – 66 % decrease in hospital admissions
72 – 74% reduction in emergency department visits
16 – 33% decrease in number of primary care physician visits
95 – 97% reduction in walk-in clinic visits
High levels of patient and provider satisfaction
Other Published Examples
Canada Health Infoway studied digital imaging and found that
radiologists were 27% more efficient using the technology
Alaska telehealth studied their store-forward ENT service over 16
years and found a reduction in average wait to see an ENT surgeon
from 4.2 months prior to telemedicine introduction to 2.1 months
after three years of introduction.
The VA studied 17,025 chronic disease patients receiving
telehomecare and documented a 25% reduction in number of bed
days
Kaiser implemented PCP to specialist e-consults in San Francisco
and found a 13, 18, 26, 42% reduction in the need for a face-to-face
visit for Rheumatology, Cardiology, GI and Endocrine respectively
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7. 3/25/2012
OTN Vision - By 2015
Over 1,000,000 patients served, with improved access to
better integrated, quality care
Over 40,000 telehomecare patients annually with
increased self-management skills and reduced utilization
of more expensive health system resources
Over 25,000 healthcare providers using telemedicine to
collaborate around patient care, best practices and
health education
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Cardiology Clinic
Next
Available
Clinic
Jan 31
Feb 10
Feb 18
Mar 1
Nov 21
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8. 3/25/2012
Telemedicine will make the health care
system and providers more efficient
Reduce unnecessary travel and transfers
Enhance provider efficiency through store-forward
Leverage lower-cost providers to do more
Address geographic maldistribution of providers and
associated wait time variation
Reduce ED visits and hospitalization rates by improving
self-management of chronic disease
Improve collaboration among providers
Empower new and better models of care delivery
How can we accelerate adoption?
Policy:
1. Overcome systemic payment and payment model barriers to e-
consults and provider collaboration
2. Share efficiency benefits among providers and funder
Lower the cost and increase the simplicity of
telemedicine:
3. Invest in telemedicine service development
4. Develop solutions that fit provider workflow
Assist in matchmaking
5. Provide real-time information on available resources and wait
times
6. Simplify provider requests and information exchange
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9. 3/25/2012
Appendix
APPENDIX
“Store Forward” or “eConsult”
Telemedicine Definition
Send pictures and patient data to a specialist for
advice or a consultation
Examples: dermatology, ophthalmology, ENT
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10. 3/25/2012
http://learning.otn.ca/
Dr Ed Brown, CEO
ebrown@otn.ca
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