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In-Home Telemonitoring for Veterans Trial

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Overview

The In-Home Telemonitoring for Veterans Trial enhances services provided under the Coordinated Veterans’ Care (CVC) Program, which provides ongoing, planned and coordinated care, led by a GP with a nurse coordinator.

The trial makes it possible for eligible CVC participants to have their health monitored by their GP without leaving home. Telemonitoring does not replace emergency care.

The trial aims to test if in-home telemonitoring is a safe, effective and efficient complement to face-to-face GP consultations, whether telemonitoring can improve CVC participants’ quality of life and their ability to live in their own home for longer, and reduce unplanned hospital admissions. There are already a number of exciting case studies demonstrating the positive effects of telemonitoring interventions, benefiting patients currently on the trial.

The trial commenced in June 2013 at the first trial site in the New England region, NSW, and was due to finish in June 2015. Other trial sites include the North Coast, NSW, the Darling Downs in Queensland, and Bayside, Victoria. Only general practices in the four trial sites have been eligible to participate in the trial. 

As part of the 2015-16 Budget the Minister for Veterans’ Affairs announced an 18 month extension until December 2016. The extension involves no further recruitment to the trial, with all other aspects, including equipment, service providers and clinical engagement, remaining the same.

Trial Benefits

Benefits for general practices participating in the trial include:

  • a more complete picture of participants’ health - more regular vital sign readings can assist in trend analysis and management of patients' condition/s
  • dashboard view of all participating patients on the trial can assist practice triage and workflow
  • video-conferencing can aid more regular contact with patients, especially those with transport or mobility issues
  • efficiencies in case load management of chronically ill Gold Card holder patients
  • financial resources for the practice.

How does in-home telemonitoring work?

Instead of going to the GP for a check up to take routine readings such as blood pressure, blood glucose and oxygen levels, trial participants measure their own vital signs using the latest equipment, which DVA installed in their home at no cost.

The telemonitoring equipment is lightweight, portable, and simple to use and sends readings to the veteran’s GP and nurse coordinator who can arrange an appointment if anything is out of the ordinary, either by videoconference using the telemonitoring equipment or face-to-face at the practice.

The equipment consists of a tablet computer and video camera which interface into the Tunstall Healthcare monitoring system. The tablet runs a health interview to prompt the collection of vital sign data from paired Bluetooth peripheral devices, and to assess the patient’s general health state. The interview and equipment are tailored to the patient’s individual condition and needs, and the CVC telemonitoring care plan. The peripherals could include a blood glucose monitor, single-lead ECG, pulse oximeter, spirometer, sphygmomanometer, scales and/or thermometer.

Data is presented to the GP and practice nurse via a user-friendly internet portal called icp triagemanager.  Multiple patients’ events are listed in decreasing order of importance and important results are highlighted.  icp triagemanager also warns if a patient has missed taking their readings so the practice can follow this up with the patient.  Information from icp triagemanager can be copied into the practice's own electronic medical record.

Tunstall Healthcare provides technical support to practices and participants on the trial. Connection to the Internet for patients uses the most appropriate broadband technology available, whether that is the National Broadband Network, ADSL, other broadband, or a 3G or 4G dongle. 

Telemonitoring trial payments

This table shows the total payments available to a general practice and GP for a patient on the In-Home Telemonitoring for Veterans Trial. CVC Program payments are included because a Gold Card holder must be enrolled in the CVC Program to be on the In-Home Telemonitoring for Veterans Trial.

Summary of payments for the CVC Program & the In-Home Telemonitoring for Veterans Trial
Payment type Item Number Initial Incentive Payment 1st
quarterly care payment
2nd
quarterly care payment
3rd
quarterly
care payment
4th
quarterly care payment
TOTAL payable over 12 months*
CVC Initial Incentive Payment for GP WITH practice nurse UP01 $424.15         $424.15 (* if not previously enrolled on CVC)
CVC quarterly care WITH practice nurse UP03 n/a $442.65 $442.65

$442.65

$442.65 $1,770.60
DVA PIP-TM
Practice payment upfront arranged by DVA when practice enrols on the trial and has received the training
No item number $600.00         $600.00
Telemonitoring GP first quarterly payment - claim after the last day of the quarterly period & use the same date of service as the UP01 or UP03 claim UP20   $306.00       $306.00
Telemonitoring GP subsequent quarterly payment - claim after the last day of the quarterly period and use the same date of service as the UP03 claim UP21     $306.00 $306.00 $306.00 $918.00
TOTAL PAYMENTS FOR BOTH CVC AND TELEMONITORING   $1,024.15 $748.65 $748.65 $748.65 $748.65 $4,018.75

Fees last updated 1 July 2014

Payments to GPs

GPs receive a Quarterly Telemonitoring Care Payment for each participating patient – $1,224 per year

In-Home Telemonitoring for Veterans Trial items are DVA-only items and do not appear on the MBS Schedule. Payments are 100% of the listed fee.

  • UP20: First quarterly payment claimed in line with the CVC payment for the same patient.
  • UP21: Subsequent quarterly payments for 90 days of telemonitoring treatment. When claiming after the 90 day period, the date of service is the first day of the previous quarter.

Telemonitoring payments will only be processed if the GP has also claimed CVC payments for the same patient.

Visit the CVC Program page for more information on CVC claiming.

Contacts

For general enquiries about the trial and claiming queries, contact the DVA project team
Phone: 1800 026 185 and ask to speak to a member of the Telemonitoring Trial team
Email: Health Innovation 

For technical help for trial participants contact Tunstall Healthcare
Free Call: 1800 603 377
Email: Tunstall Healthcare 

In-Home Telemonitoring Facebook page

Practices registered on the trial have access to a trial Facebook page which is regularly updated with tips and information about the trial. This invitation-only closed group allows practices involved in the trial to support each other and freely exchange experiences, lessons learnt and feedback in order to make the trial as successful as possible. DVA values open communication and this social networking platform allows us to interact with service providers, providing tips and resources and offering support where needed.

Clinical Oversight and Support for the Trial

Clinical oversight is provided for both the CVC Program and the In-Home Telemonitoring for Veterans Trial. This includes a Clinical Reference Group to provide ongoing advice and feedback, and a Safety Monitoring Committee which exists to identify any unsafe or potentially dangerous patterns emerging from the trial.   

The Australian Medical Association, the Royal Australian College of General Practitioners and other peak medical and nursing bodies supported DVA in the implementation of the trial.  The trial has also received support from other parts of the general practice sector.

Resources

A number of useful resources are available. Please note that recruitment for the trial closed in September 2014 and these documents are for historical reference only.

Information for veterans

Information for providers

For information about the telemonitoring equipment or Tunstall Healthcare please visit the Tunstall Healthcare website.

To learn about the Tunstall Healthcare telehealth system and the myclinic@home interview using the wireless telemonitoring equipment, you can view the tutorial film on YouTube

Learn more about how to perform a video conference on YouTube

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