1. Staying Strong with Technology 1.0March 2014 Indra Arunachalam – Strategic Projects Manager

2. Bringing Technology into Care Objectives: Use scarce resources to service increasing demand Find alternative ways of delivering services to rural and remote communities Building capacity in consumers to be techno-savvy Increase productivity and efficiency March 2014 Slide 1 1.0

3. Two Pilot Project iPad for regional Carers – reducing social isolation Staying Strong – Telehealth Monitoring for older Aboriginal and Torres Strait Islanders March 2014 Slide 2 1.0

4. iPad for Carers Project Pilot project funding from QLD Department of Communities 20 carers participating – iPad + 4G Wi-Fi each Regional Central QLD – 100 to 300 kms from Rockhampton Over 3 months in 2013 March 2014 Slide 3 1.0

5. Why Carers? Carers experience the lowest collective wellbeing - social isolation is a contributing factor Carers experience financial challenges - more than half are on a pension or allowance With the ageing population, more Australians will take on caring roles More people want to stay at in their own home March 2014 Slide 4 1.0

6. How was it implemented? Carer Support Officer trained on use of iPad CSO provided one-on-one training to Carers One group of 4 Carers opted for group training Followed by informal model driven by inquiry and learning – with CSO and within Carer network Carer needs drove iPad usage – email/Skype CSO, Carer’s facebook forum, useful external links March 2014 Slide 5 1.0

7. Evaluation Question Did the iPad device assist Carers in regional areas to reduce social isolation? March 2014 Slide 6 1.0 ‘we can connect to our son in Afghanistan’ ‘it goes everywhere with me’ ‘shortens miles between people’ ‘let’s Skype with a cuppa tea’ ‘can use it for research’ 92% had positive impressions 62% made them feel more connected 93% used it for social network + entertainment

8. Suggestions for Future Carers be assessed for indicators of social isolation – pre and post project Ensure internet coverage is not a barrier Consider iPad use for both Carer and Care Recipient Secure forum to address security concerns Access to integratedliving sites – newsletter, policies, training Adequate ongoing support to maximise benefits e.g. helpdesk Staged capacity building in Carers March 2014 Slide 7 1.0

9. Staying Strong Project Objective: Improve the health and wellbeing of Aboriginal and Torres Strait Islanders by: supporting older Aboriginal and Torres Strait Islanders access telehealth monitoring at their home or a hub developing and implementing cultural activities that connect older Aboriginal and Torres Strait Islander Australians with younger people to raise cultural awareness and respect Indigenous history and heritage March 2014 Slide 8 1.0

10. Benefits of Telehealth Reduce emergency hospitalisations More accurate and timely diagnosis Increase awareness of own health conditions Increase independence and self-management Reduce need for GP home visits Peace of mind for older person and family March 2014 Slide 9 1.0

11. Telehealth Service Model Individualised monitoring plan with relevant vital health sign parameters, acceptable margins and frequency Monitor temperature, blood pressure, weight, pulse, oxygen levels, blood glucose levels and/or peak flow rate Measure at home or at telehealth services hub and transmitted to central location for triage management RN triages and responds to out-of-margin readings Provide vital health sign readings to participants/GPs to support diagnoses March 2014 Slide 10 1.0

12. Project Participants Eligibility criteria: Identify as Aboriginal and Torres Strait Islander Aged over 50 years Live in project trial site Current trial locations: Armidale, NSW Coffs Harbour, NSW Goodna, QLD Toowoomba, QLD March 20141.0 Slide 11

13. Project Evaluation Did it improve provision of health services? Did it empower people to better manage own health? What were the supporting and inhibiting factors in the uptake of telehealth among Aboriginal and Torres Strait Islanders? Did it reduce number of hospitalisation/length of time in hospital? Did the cultural activities improve the older person’s social connectedness? Did it enhance cultural awareness and respect for indigenous history and heritage? Did the project improve people’s quality of life (wellbeing index)? March 20141.0 Slide 12

14. Evaluation Methodology Baseline and Follow-up surveys – Personal Wellbeing Index – Attitude to Technology – Social Connectedness Yarning Circles with participants In-depth interviews with – 8 project participants – 4 key stakeholders – Staying Strong registered nurses and project team March 2014 Slide 13 1.0

15. Participant Profile Currently 89 people receiving telehealth services Average age: 62 years Mostly female (70%) 33% single and 30% married 69% living with spouse and/or other family members 66% lived in a house; 34% in a flat or unit 38% had a primary (non-professional) carer March 2014 Slide 14 1.0

16. Conditions Affecting Participants Diagnosis% of cases* High blood pressure67 Type 2 diabetes48 High blood cholesterol40 Asthma28 Angina17 Heart attack12 Emphysema11 Chronic bronchitis7 March 2014 Slide 15 1.0 *Participants may have more than one condition so numbers do not add up to total number of participants 67% have 3 or more health conditions At least 30% have been hospitalised once in the last year 50% who have high blood cholesterol also have high blood pressure 80% who have angina also have high blood pressure

17. Baseline Personal Wellbeing Index March 2014 Slide 16 1.0 The normative range for Australians is 73.4 to 76.4 points

18. Baseline Attitude to Technology March 2014 Slide 17 1.0 Staying Strong participants reported greater confidence with technology

19. Project Challenges Project timeframes National Broadband rollout Recruitment of telehealth nurses Stakeholder engagement Participant recruitment March 2014 Slide 18 1.0

20. Stakeholder Engagement - What Worked Early consultation Investment of time Responsive communications Partnership Agreements Working groups and involvement in project activities Awareness of local politics March 2014 Slide 19 1.0

21. Participant Recruitment - What Worked ‘Cups of tea’ and a yarn Culturally appropriate communications collateral Referral pathways involving Aboriginal and Torres Strait Islander organisations/people Support of local Elders/bush telegraph Awareness of local politics Promise of on-going support March 2014 Slide 20 1.0

22. Project Successes Expansion of integratedliving presence and partnership development at trial sites Organisational experience in the delivery of telehealth services Probable aversion of heart attack/reduction in hospitalisation Supplementary nursing support March 2014 Slide 21 1.0

23. Lessons Learnt Community engagement with Aboriginal and Torres Strait Islanders takes time Remote telehealth monitoring for Indigenous communities needs to be complemented with face-to-face contact Clinical Management of Telehealth RN GP involvement is important Asset Register for telehealth equipment and peripherals Strong internet connection is needed March 2014 Slide 22 1.0 Funding bodies should take this into consideration

24. Strategic Partnerships March 2014 Slide 23 1.0

25. Final Evaluation Report Completed by June 2014 Acquitted by September 2014 What are the enablers and barriers to older Aboriginal and Torres Strait Islanders using telehealth? Did telehealth deliver better health outcomes? Did it improve their quality of life? March 2014 Slide 24 1.0

26. Bringing Technology into Care Objectives: Use scarce resources to service increasing demand ✔ Find alternative ways of delivering services to rural and remote communities ✔ Building capacity in consumers to be techno-savvy ✔ Increase productivity and efficiency – many learnings March 2014 Slide 25 1.0

27. Contact Details Indra Arunachalam 0437 900 237 indra@integratedliving.org.au References: Cartwright C, Wade R, Shaw K: The Impact of Telehealth and Telecare on Clients of the Transition Care Program (TCP), May 2011 March 2014 Slide 26 1.0