“What’s ethics got to do with it? “ Benefits and challenges of program evaluation. DVA’s Tele-monitoring Trial Kyleigh Heggie Director, Research, DVA Canberra Evaluation Forum 17 September 2015

DVA Tele-monitoring Trial The in-home telemonitoring trial provides eligible veteran participants, under the direction of a health care professional, with a combination of home-based monitoring devices using a high-speed broadband. The trial is testing if telemonitoring is a safe, effective and efficient complement to face-to-face GP consultations, and whether it can improve quality of life, help veterans live in their own home for longer, and reduce unplanned hospital admissions.

Why did DVA take this on? Opportunity to improve health outcomes for veterans with chronic illness. Decrease cost of unplanned hospitalisations. To see whether the technology could be incorporated in GP business model. Potential to extend the DVA flagship Coordinated Veteran Care (CVC) Program. Support veterans to stay in their homes longer. Opportunity to complement existing GP services Participation in health technology innovation. This photo illustrates one of the trial participants using the supplied equipment.

Benefits to the veteran community increased access to high quality health care services at home and support for Gold Card holders to continue living in their own homes for longer, delaying the need to move to residential aged care; reduce preventable hospitalisations, reducing length of stay in hospitals and avoidable readmissions; increased quality of life brought about by responsive management of chronic conditions; increased health workforce productivity (nurses taking on  the role of monitoring health and involving the veterans’ GPs), and reduced carer burden.

What role did ethics play? Research merit and integrity Justice Benefit Respect Trial participant Technology provider GP Provider

Privacy and data issues Informed consent Installation of technology and access to participants' residence Use of personal data Data management and security

Is the trial making a difference? Above left: GP practice checking on line results from a patients telemonitoring equipment. Above right: Community consultation on the telemonitoring trial.

From the Veteran prospective   From the Veteran prospective With the help of regular telemonitoring, John* declares that he now only takes 7 tablets a day (compared with 22 at one stage). His blood sugar levels have reduced from 17 to 7, his blood pressure has now normalised and his lung function has improved. “I thought I was on too many tablets but I didn’t have the tools or motivation to take control.” * For purposes of reporting all names have been changed

Impact on client John has become more involved in his own health. “I love the freedom this trial has given me. My readings take all of 5 minutes to do in the morning and now I only get checked and have tests when I need it. I have gone from seeing the doctor every few weeks to just a few times a year. I was also always having blood tests – now I can’t remember when I last had one!”  

Extension of the trial for a further 18 months Further evaluation What next? 2015-2017 Extension of the trial for a further 18 months Further evaluation

Thank you. Any questions? www.dva.gov.au/providers/provider-programmes/home-telemonitoring-veterans-trialsert website