The Royal District Nursing Service (RDNS), a not-for-profit mobile nursing organisation, is planning to trial a new telehealth service on the pregnancybirthbaby.org.au website where people can make video calls directly through their Web browsers.
Speaking at the Connected Australia event in Sydney this week, Philip Robinson, general manager, internal investments at RDNS, said the new service will be piloted later this year through to 2014.
“What we are doing now currently with them [Healthdirect Australia and the National Health Call Centre Network] is setting up a GP advice line, something similar [to the helpline],” he said.
“It’s not public yet, but you will be able to go to the website – which provides support to mothers and families in that first 12 months of life or during pregnancy – and you will have the option to make a video call using technology called WebRTC.”
WebRTC allows for video conferencing through a Web browser plug-in. Robinson said it can be used on Chrome, Firefox, Internet Explorer, but cannot currently be used with Apple's Safari browser.
Robinson also spoke about the organisation's piloted medication management video conferencing service to link patients in their homes to healthcare professionals in its 24/7 contact centre. The project funded by the Victorian government’s Broadband Enabled Innovation Program. So far the pilots have gone successfully, with overall positive feedback from users, he said.
“We had a client who was having a video consultation with a nurse. The nurse said ‘you are not looking particularly well today, how are you feeling?’ The client said he felt a bit if chest pain, so the nurse asked him if it radiated up his left arm and he said it did. The nurse took that as a sign of a coming heart attack and called triple zero. The ambulance arrived and saw the nurse was still on the screen keeping an eye on the client until they arrived,” he said.
“These intangible benefits are hard to measure and put a cost on, but it means it can basically save lives.”
RDNS staff travel about 10 million kilometres per year, and make 400,000 visits per year that involve medications, Robinson said. Total face to face visits have reduced by a factor of two, he said. “So takes about half the time to do a home visit by video than it does car.”
Not all services related to medication can be replaced by telehealth, Robinson said. “You can’t get injections by telehealth, for example, but basic medication services like blister packs of medications that the client can hold up to the screen and identify which medications they are going to take has been very well accepted.”
He said a most clients have a video consultation about five to six days per week, and one day of face-to-face interaction with a nurse who checks up on their health and medication regime.
One ongoing issue with RDNS' pilot projects is the access to reliable, high-speed broadband. He pointed out a problem with the National Broadband Network rollout being focused on Greenfield sites.
“It’s important to rollout [the NBN] to where the consumers are. Rolling it out to a Greenfield site doesn’t help our aged care services. What we are really struggling with is getting that NBN to areas where the aged population is – the middle suburbs, not the outer suburbs.”
Until the NBN is fully rolled out, Robinson said he is relying on Telstra’s business grade ADSL services, with 4G being crucial to the delivery of service. “We did try it on 3G, and 3G does not cope for video.”
Another issue is the struggle to get ongoing funding and government support so that RDNS can move its pilot projects into a ‘business as usual’ service offering.
“The [contact centre] is fully fitted out to use it. There are also rooms fitted out for telehealth that are sound proof where you don’t have the noise around you as you would on the telephone. But it’s really our business model that’s holding us back – how you get funding for devices for the home and broadband to the home, and that’s government funding. That’s the usual problem with telehealth – the pilot gets funded, but we hardly get funding for business as usual.”
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