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Emily Seto



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    HS01 - Innovations in Community Care (COACH Session) (ID 51)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Not Rated
    • Presentations: 1
    • Coordinates: 6/07/2017, 08:30 AM - 10:00 AM, Room 202AB
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      HS01.01 - Digital Health in Home, Community, and Long-Term Care (ID 396)

      Emily Seto, IHPME, University of Toronto; Toronto/CA

      • Abstract

      As clinicians and managers consider healthcare delivery options that extend beyond the four walls of the hospital, clinic, or other healthcare setting, new models are emerging for primary, home, community, and long-term care. Canadian healthcare providers face a unique set of challenges that include a rise in chronic disease and an aging, widely dispersed population. How do we merge care pathways across traditional sectors and settings while incorporating new care models and technologies? This one-hour session features a 30-minute presentation and 30 minutes of moderated open discussion with a focus on innovative solutions and emerging technologies as tools in the quest to provide a continuum of quality care, from in-person to virtual.

      Panelists:
      Trish Barbato, SVP of Innovation & Strategic Partnership, Revera Inc. Barry Billings, Intelligence Care Archi-tech, Saint Elizabeth Health Care Emily Seto, Assistant Professor, Institute of Health Policy, Management and Evaluation, University of Toronto

      Moderator:
      Rodney Burns, CIO, Association of Ontario Health Centres

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    OS04 - Mind the Access to Care Gaps (ID 4)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical
    • Presentations: 1
    • Coordinates: 6/05/2017, 04:00 PM - 05:30 PM, Room 202CD
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      OS04.01 - Promising Telehealth Opportunities for the Yukon Telehealth System (ID 272)

      Emily Seto, IHPME, University of Toronto; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: An evaluation of the current Yukon Telehealth System was conducted to determine areas of strengths and possible improvements, as well as to determine the opportunities to expand the Telehealth System. This presentation will focus on the possible future evolution of the Telehealth System to provide Yukon citizens with effective and timely remote healthcare while reducing costs.

      Methodology/Approach: A mixed-methods approach was used, guided by the Clinical Adoption Framework. Quantitative data included usage data collected by the Telehealth Coordinator, billing data, and responses from questionnaires administered to community nurses and patients. Descriptive statistics were used to determine longitudinal trends and patterns of use. In-person focus groups and semi-structured interviews were conducted with 23 stakeholders (Telehealth Coordinator, community nurses, physicians, managers, etc.). In addition, semi-structured telephone interviews were conducted with four community nurses, nine physicians who provide services in Yukon (specialists who fly into Whitehorse), and other telehealth stakeholders. The two evaluators discussed the findings from each of the interviews/focus groups, and determined the emerging themes.

      Finding/Results: The use of the Yukon Telehealth System has been consistent around 1000 sessions per year since 2008, with 1099 sessions occurring in 2015 (69% for clinical care, 16% for educational, and 15% for administrative purposes). While there was a consensus on the value of the Telehealth System, including its role in providing timely access to care and cost savings from reduced travelling, there were also several areas of improvement that were discovered. Interviewees believed that the system was underutilized and that the equipment was out-dated. The telehealth units were often inaccessible due to their location (room already booked) and the process to establish a telehealth session was not as quick and easy as desired. In addition, the system was heavily dependent on one single person to coordinate services. Several areas of particular promise for telehealth expansion were discovered. Psychiatric consults conducted via telehealth could eliminate hours of travel for patients and provide sessions at a frequency optimized for individual needs. Some interviewees believed that an initial in-person consult would be preferable, but follow-up consults through telehealth would be appropriate. Dermatology could benefit not only from high-resolution store-and-forward images, but live consultations with the patient which would enable viewing of relevant areas of the body by dermatologists that may not be obviously related to the issue. Telehealth could also be used for orthopaedic cases, where wait times to see an orthopaedic surgeon can be exceedingly long in Yukon. Triaging via telehealth to efficiently determine patients who require orthopaedic surgery and those who do not, as well as providing follow-up telehealth consults post-surgery were found to be of particular benefit.

      Conclusion/Implication/Recommendations: Many healthcare challenges exist due to the remoteness of the Yukon communities and the relatively small population. However, this also affords many opportunities to leverage telehealth services to provide Yukon citizens with efficient and effective healthcare. Telehealth for psychiatry, dermatology, and orthopaedics appear to be areas of particular promise in Yukon.

      140 Character Summary: This presentation will discuss the evaluation and areas of opportunity for the Yukon Telehealth System.

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    OS15 - Virtual Care Trailblazers (ID 21)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/06/2017, 01:00 PM - 02:00 PM, Room 202AB
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      OS15.03 - Implementation and Evaluation of a Sustained Heart Failure Telemonitoring Program (ID 312)

      Emily Seto, IHPME, University of Toronto; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: A sustained smartphone-based Heart Failure Telemonitoring Program was implemented within a large hospital Heart Function Clinic. The Program is unique compared to other telemonitoring programs due to its real time feedback to patients, low cost, minimal technical support requirements, and ability to be used without additional healthcare personnel beyond the patient’s current care team. This presentation will discuss the lessons learned from the implementation process and the preliminary results from the evaluation.

      Methodology/Approach: An implementation strategy and evaluation plan were developed prior to implementation of the Telemonitoring Program. Patients were recruited from a Heart Function Clinic starting August 2016, with anticipated enrolment of 200 patients within the first year. Patients receive a Bluetooth-enabled weight scale, blood pressure monitor, and smartphone installed with the Medly application. Each morning, patients are instructed to take their weight, blood pressure, and answer symptom questions on the smartphone. An algorithm uses the patient data to generate automated patient self-care messages and alerts to the healthcare provider at the earliest sign of worsening health. Evaluation data will be collected while the Program is operational for quality improvement. During the first year, the Program will undergo a particularly rigorous evaluation to determine its benefits and areas for improvement. The evaluation will include health outcomes (eg, hospitalization rates, mortality), process outcomes (eg, number of alerts), adherence, quality of life and self-care (validated questionnaires), and interview data from patients and healthcare providers.

      Finding/Results: The implementation strategy included an analysis of baseline clinical workflow, as well as the effects of the Program on workflow post-implementation. Several processes were established in preparation for implementation, including for alert management, technical support, clinician and patient training, patient enrolment, and equipment management. Currently, a cardiologist receives alerts via emails and manages them in collaboration with two nurse practitioners. However, in the future the two nurse practitioners will provide the majority of management. A technical analyst (0.25FTE) who is part of the hospital’s Telehealth group is managing all other support duties. Nine patients have been enrolled to date (September 2016). A slow initial rollout enabled technical and workflow issues discovered after implementation to be resolved with minimal disruption to patients and clinicians. Adherence to taking daily measurements is currently high (95% of all possible days). For this presentation, the available baseline, one month, and six month evaluation data will be summarized.

      Conclusion/Implication/Recommendations: Very few implementations of sustained telemonitoring programs exist in Canada. Therefore, sharing the implementation experiences is crucial to ensure best practices, avoid repeating mistakes, and for quality improvement. In addition, evidence of the impact of such programs is important to promote the establishment of similar programs across Canada and beyond.

      140 Character Summary: This presentation will discuss the implementation and evaluation of a sustained smartphone-based Heart Failure Telemonitoring Program.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.