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Telehealth




Mainstream Telehealth in Northern Ireland
A Service Provider Perspective
                                            Jim O’Donoghue
Copyright © S3 Group 2011                   S3 Group
Northern Ireland Chronic Disease
                                                                                                             2/3s of over
                                                                                                                 75s


                                                   Population 1.8M                                          60% of all GP
                                                                                                               visits
                                                    H&SC budget
                                                       £4.3Bn
                                                  Rising to £4.66Bn
                                                    in 2014/2015                                             72% acute
                                                                                                              bed days


                                                                                                            69% of health
                                                                                                            & social care
                                                                                                               spend

Department of Health (2008 ) Raising the profile of long term conditions care
INIsPHO (2010) Making Chronic Conditions Count

                                                                                Copyright © S3 Group 2011             Slide 2
Remote Telemonitoring Service for Northern
Ireland (RTNI)
  • 6 year contract awarded March
    2011

  • Procurement, service definition
    and implementation process led
    by ECCH – a part of Public
    Health Agency

  • 1 Service Definition, 5 customers

  • 3,500 patients per annum

  • 12 condition categories

  • 2 - 52 week monitoring periods

  • >2.8m monitored days

  • £18m investment




                                        Copyright © S3 Group   Slide 3
Unique Elements of RTNI
Commercial Model Options


                                                                                                              Managed Service - Outcome
                        Provider Responsibility & Risk                                                           Based Risk/Reward




                                                                               Flexibility and Scalability
Contract Complexity




                                                         Partnership Working
                                                                                                               Managed Service - PAYG
                                                                                                             Customised / integrated service



                                                                                                             Combined Technology Purchase
                                                                                                                  + Service Purchase



                                                                                                             Technology Purchase + Service
                                                                                                                 purchased separately




                                                                                                                                  Copyright © S3 Group   Slide 4
Unique Elements of RTNI
  RTNI Managed Service Model
Provider Responsibilities
                                          Managed Service - Outcome Based
• Responsible for meeting                 Risk/Reward
  defined service requirements

                                   RTNI
• Responsibility for all aspects          Managed Service - PAYG Customised
  of providing a joined up                /Integrated Service
  service and solution

• Responsibility for providing            Combined Technology + Service
                                          Purchase
  appropriate technology on an
  ongoing basis

                                          Technology Purchase + Service
• Incentivised to generate                purchased separately
  service delivery efficiencies


                                                            Copyright © S3 Group   Slide 5
Unique Elements of RTNI
                 Managed Service Model
           Service and Quality Level Monitoring
    RTNI
• 221 Authority
  requirements

• Service levels and
  associated penalties
  (20 for ‘core’, 8 for
  ‘additional’)

• 19 quality markers

• Extensive reporting,
  automated
  performance
  monitoring


                                         Copyright © S3 Group   Slide 6
Scope of the RTNI Managed Sevice
   TF3 Managed Service Overview
                          Service Elements

                         • Clinical Triage
                         • Service Desk
                         • Clinician On-Line
                           Portal
                         • Patient Portal
                         • Referral to
                           Discharge
                         • Clinical, activity
                           and service level
                           reporting
                         • ICT Infrastructure
                         • Service
                           Integration
                         • Additional
                           Services


                            Copyright © S3 Group   Slide 7
Stages of Telehealth Service Development
 Service Requirements

        RTNI Service                 RTNI Service              RTNI Service
        Requirements                   Design                   Operation




                                                    Define Model &
                              Define Desired                                   Assess
Identify Drivers of Change                          Implementation
                                 Benefits                                    Cost/Benefits
                                                      Approach


                         Clinical Outcomes     Service Model            Clinical outcomes
  National               Patient Experience    Roles/Responsibilities   Financial benefits
                         Clinical Staff        Pathway Changes          Implementation costs
  Local                  Financial             Delivery model

                                                                        Copyright © S3 Group   Slide 8
Stages of Telehealth Service Development
Service Design

     RTNI Service                   RTNI Service             RTNI Service
     Requirements                     Design                  Operation




                            Design                                                     Service
                                          Setup Service     Setup Service
 Service Planning           Service                                                   Readiness
                                            Delivery         Governance
                        Infrastructure                                                 Testing

Pathway redesign     Solution design     Clinical         Program             Service Readiness
Process definition   Technology          processes        Governance          Solution Readiness
SLA planning         choices             Non-Clinical     Clinical            Technology
Stakeholder          IT Infrastructure   processes        Governance          Readiness
Engagement           design              Training         Evaluation
                                         QA Planning


                                                                       Copyright © S3 Group       Slide 9
Stages of Telehealth Service Development
Service Operation

      RTNI Service                    RTNI Service          RTNI Service
      Requirements                      Design               Operation




Patient Selection and      Service           Service         Service                       Service
     Recruitment          Operation         Monitoring      Governance                    Evolution



Enrol Patients      Triage                Issue Mgmnt    Clinical                Service Efficiencies
Patient plan        Coach                 Performance    Governance              Further Integration
Install             Educate               Monitoring     Program                 New Conditions
Train               Patient Support       Reporting      Governance              New Services
Activate            Carer Support         Asset Mgmnt    Evaluation of           New Technology
Review                                                   outcomes


                                                                         Copyright © S3 Group         Slide 10
Unique Elements of RTNI
RTNI – Why form a consortium ?
Scope of Capabilities Required
                 • Care Pathway redesign
     Clinical    • Clinical Governance
                 • Clinical Triage Service Design

                 •   Business Process Analysis
                 •   Solution development
    Technical    •   IT Infrastructure
                 •   Solution Test


    Service      • Clinical Service Delivery
                 • Clinical Service Management
    Delivery     • Patient service Delivery


   Programme     • Programme Governance
                 • Programme Management
    Delivery     • Stakeholder Communications


                 • Patient equipment
  Core Assets    • Integrated Telehealth Platform
                 • Financial Capability


                                                    Copyright © S3 Group   Slide 11
RTNI Consortium Partners


   Programme
  Management
Patient Equipment
  Care Platform
 Hosting and IT



 Service Design
 Service Delivery
  Clinical Triage



 Solution Design
Solution Integration
 Solution Testing

                           Copyright © S3 Group   Slide 12
Unique Elements of RTNI
  Lessons Learned to-date
                  to-

Building a provider consortium

• Form early – provide consistency through procurement and delivery
• Define the consortium core values
• Build relationships and trust

Managed Service Model

• Significant up-front investment on both sides to define requirements and
  operating model
• Creates a service based, technology agnostic framework for identifying
  needs and solutions
• Demands a high level of working in partnership
• Asks the provider difficult but very good questions




                                                               Copyright © S3 Group   Slide 13
Unique Elements of RTNI




                    Thank You
Contact details : jim.odonoghue@s3group.com
           Phone +353-1-291-1270
                     +353- 291-




                                  Copyright © S3 Group   Slide 14

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Jim o donoghue hull wsdan 30 june 2011

  • 1. Telehealth Mainstream Telehealth in Northern Ireland A Service Provider Perspective Jim O’Donoghue Copyright © S3 Group 2011 S3 Group
  • 2. Northern Ireland Chronic Disease 2/3s of over 75s Population 1.8M 60% of all GP visits H&SC budget £4.3Bn Rising to £4.66Bn in 2014/2015 72% acute bed days 69% of health & social care spend Department of Health (2008 ) Raising the profile of long term conditions care INIsPHO (2010) Making Chronic Conditions Count Copyright © S3 Group 2011 Slide 2
  • 3. Remote Telemonitoring Service for Northern Ireland (RTNI) • 6 year contract awarded March 2011 • Procurement, service definition and implementation process led by ECCH – a part of Public Health Agency • 1 Service Definition, 5 customers • 3,500 patients per annum • 12 condition categories • 2 - 52 week monitoring periods • >2.8m monitored days • £18m investment Copyright © S3 Group Slide 3
  • 4. Unique Elements of RTNI Commercial Model Options Managed Service - Outcome Provider Responsibility & Risk Based Risk/Reward Flexibility and Scalability Contract Complexity Partnership Working Managed Service - PAYG Customised / integrated service Combined Technology Purchase + Service Purchase Technology Purchase + Service purchased separately Copyright © S3 Group Slide 4
  • 5. Unique Elements of RTNI RTNI Managed Service Model Provider Responsibilities Managed Service - Outcome Based • Responsible for meeting Risk/Reward defined service requirements RTNI • Responsibility for all aspects Managed Service - PAYG Customised of providing a joined up /Integrated Service service and solution • Responsibility for providing Combined Technology + Service Purchase appropriate technology on an ongoing basis Technology Purchase + Service • Incentivised to generate purchased separately service delivery efficiencies Copyright © S3 Group Slide 5
  • 6. Unique Elements of RTNI Managed Service Model Service and Quality Level Monitoring RTNI • 221 Authority requirements • Service levels and associated penalties (20 for ‘core’, 8 for ‘additional’) • 19 quality markers • Extensive reporting, automated performance monitoring Copyright © S3 Group Slide 6
  • 7. Scope of the RTNI Managed Sevice TF3 Managed Service Overview Service Elements • Clinical Triage • Service Desk • Clinician On-Line Portal • Patient Portal • Referral to Discharge • Clinical, activity and service level reporting • ICT Infrastructure • Service Integration • Additional Services Copyright © S3 Group Slide 7
  • 8. Stages of Telehealth Service Development Service Requirements RTNI Service RTNI Service RTNI Service Requirements Design Operation Define Model & Define Desired Assess Identify Drivers of Change Implementation Benefits Cost/Benefits Approach Clinical Outcomes Service Model Clinical outcomes National Patient Experience Roles/Responsibilities Financial benefits Clinical Staff Pathway Changes Implementation costs Local Financial Delivery model Copyright © S3 Group Slide 8
  • 9. Stages of Telehealth Service Development Service Design RTNI Service RTNI Service RTNI Service Requirements Design Operation Design Service Setup Service Setup Service Service Planning Service Readiness Delivery Governance Infrastructure Testing Pathway redesign Solution design Clinical Program Service Readiness Process definition Technology processes Governance Solution Readiness SLA planning choices Non-Clinical Clinical Technology Stakeholder IT Infrastructure processes Governance Readiness Engagement design Training Evaluation QA Planning Copyright © S3 Group Slide 9
  • 10. Stages of Telehealth Service Development Service Operation RTNI Service RTNI Service RTNI Service Requirements Design Operation Patient Selection and Service Service Service Service Recruitment Operation Monitoring Governance Evolution Enrol Patients Triage Issue Mgmnt Clinical Service Efficiencies Patient plan Coach Performance Governance Further Integration Install Educate Monitoring Program New Conditions Train Patient Support Reporting Governance New Services Activate Carer Support Asset Mgmnt Evaluation of New Technology Review outcomes Copyright © S3 Group Slide 10
  • 11. Unique Elements of RTNI RTNI – Why form a consortium ? Scope of Capabilities Required • Care Pathway redesign Clinical • Clinical Governance • Clinical Triage Service Design • Business Process Analysis • Solution development Technical • IT Infrastructure • Solution Test Service • Clinical Service Delivery • Clinical Service Management Delivery • Patient service Delivery Programme • Programme Governance • Programme Management Delivery • Stakeholder Communications • Patient equipment Core Assets • Integrated Telehealth Platform • Financial Capability Copyright © S3 Group Slide 11
  • 12. RTNI Consortium Partners Programme Management Patient Equipment Care Platform Hosting and IT Service Design Service Delivery Clinical Triage Solution Design Solution Integration Solution Testing Copyright © S3 Group Slide 12
  • 13. Unique Elements of RTNI Lessons Learned to-date to- Building a provider consortium • Form early – provide consistency through procurement and delivery • Define the consortium core values • Build relationships and trust Managed Service Model • Significant up-front investment on both sides to define requirements and operating model • Creates a service based, technology agnostic framework for identifying needs and solutions • Demands a high level of working in partnership • Asks the provider difficult but very good questions Copyright © S3 Group Slide 13
  • 14. Unique Elements of RTNI Thank You Contact details : jim.odonoghue@s3group.com Phone +353-1-291-1270 +353- 291- Copyright © S3 Group Slide 14