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Telehealth could deliver massive savings: CSIRO

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Using telehealth technology to help the chronically ill to monitor and manage their condition at home could almost halve mortality rates and save the health budget up to $3 billion a year, according to CSIRO researchers.

Announcing the results of a 12-month trial, the CSIRO team reported that chronically ill patients provided with a telehealth service in their home not only had reduced mortality, but had less need for medical care and experienced shorter stays in hospital.

The outcomes add to evidence of the potential for telehealth technology to significantly improve the lives of patients while at the same time reducing the cost of their care.

The trial involved 287 patients with an average age of 71 years, who had at least one chronic illness such as congestive heart failure, chronic obstructive pulmonary disease, diabetes, hypertension and coronary heart disease and had been hospitalised twice in the preceding year.

They were each provided with an internet-connected telemedicine device that could monitor vital signs including ECG, heart rate, lung function, blood pressure, oxygen saturation, weight and temperature as well as video conferencing and messaging capabilities.

Patients were asked take their measurements once a day.

Participants reported benefits including the early detection of potentially deadly heart problems, a sharp fall in the number of visits to the doctor, and greater understanding of their illness and how to manage it.

Lead researcher Dr Rajiv Jayasena said these improvements resulted in a 24 per cent saving on Medicare costs for participants, as well as a 36 per cent reduction in hospital visits, a 42 per cent drop in the length of hospital stays and a 40 per cent decline in the mortality rate.

Telehealth Nurse Coordinator at Djerriwarrh Health Services, Lay Yean Woo said the system allowed her to monitor her patients and detect any abnormalities from her office, saving time that can be spent seeing more patients.

“This technology as helped me as a nurse and this has made my time more efficient in the way I deliver my service,” Ms Woo said. “Also, with the time that has been freed up, I can look at more new clients being referred to me. At the end of the day I know they are better looked after.”

While older Australians have some health habits – only 7 per cent smoke and 41 per cent report undertaking regular physical activity – 70 per cent are overweight or obese, almost a third consider their health is poor or only fair, and 20 per cent have problems that severely or profoundly limit their mobility.

As life expectancy has increased, more patients are developing chronic and complex health problems. Caring for them is placing an increasing demand on the health system, and the pressure is likely to intensify as their numbers swell. Currently, around 15 per cent of the population is 65 years or older, but the Australian Institute of Health and Welfare estimates that proportion will reach 22 per cent by the middle of the century and 24 per cent by 2096.

Dr Jayasena said that, with older patients with multiple chronic diseases accounting for 70 per cent of health spending, these benefits had the potential to deliver significant savings to the health budget.

The CSIRO has calculated that if the telehealth service was rolled out to the half a million Australians it considers would be good candidates, the nation could save up to $3 billion a year on health costs.

“Our research showed that the return on investment of a telemonitoring initiative on a national scale would be in the order of five to one by reducing demand on hospital inpatient and outpatient services, reduced visits to GPs, reduced visits from community nurses and an overall reduced demand on increasingly scarce clinical resources,” Dr Jayasena said.

The CSIRO, through its Smart Safer Homes initiative, is also fitting homes with sensors that track patient movement and raise the alarm when something out of the ordinary, such as being still on the ground for a period of time, happens.

Adrian Rollins