A Paediatric Perspective The National Centre for Inherited Metabolic Disorders Dr Joanne Hughes Consultant in Inherited Metabolic Diseases Anne Clark Dietitican Manager Celine Stenson ID: 916418
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Our Telehealth JourneyA Paediatric Perspective:The National Centre for Inherited Metabolic Disorders
Dr Joanne Hughes, Consultant in Inherited Metabolic Diseases
Anne Clark,
Dietitican
Manager,
Celine
Stenson
and Olivia Walsh Clinical Nurse Specialists
Jennifer Doyle, Clinical Informatics Manager &
Telehealth
Lead
Slide2Agenda
What we did
How
Outcomes (Patients and Services)
Enablers
Barriers
Lessons Learned
Discussion
Slide3Service Profile: NCIMD
The National Centre for Inherited Metabolic Disorders (NCIMD) is also known as the Metabolic Unit.
NCIMD is the tertiary care referral centre for the investigation and treatment of individuals suspected of having a metabolic disorder in Ireland.
NCIMD Temple Street provides care to approximately 1550 patients nationwide. The service is predominantly outpatient based.
The management of metabolic disorders is complex and requires input from the multidisciplinary team led by a Metabolic Consultant. A holistic and family centred approach is used by our team, which includes input from medical, nursing, dietetic, psychology, social work, laboratory staff and play specialist.
Slide4Dietician
Nursing
Medical
Social Work
Psychology
Pathology
Play
Specialist
Slide5Our Telehealth Roadmap
Policies, Procedures & Guidelines:
CIT develop checklists &
supporting documentation.
CIT contribute to CHI SOP
Specialty Deployment:
Extend to NCIMD
Lessons Learned
Planning:
Meet NCIMD MDT & Operations Teams
Identify & Map Workflow
Identify & Deploy Hardware
Training & Testing:
MDT complete Attend Anywhere Training
MDT & CIT complete testing against identified
workflow
CIT monitor bandwidth
Site Deployment
Proof of Concept:
MDT
identify & contact Patient Cohort for POC.
Consent
Contingency Plans
Lessons Learned
Slide6Outcomes
Patients
Reduced requirement to travel to site and incur associated costs
Patients more relaxed in home environment
Clinicians have more time with patients
Continuity of Care
Personalised service – Home visit
Service
Enhanced quality of consultation
Continuity of care
Reduction in DNA & CNA rates
75% of all Nurse/Dietetics PKU clinic appointments are virtual video. This in turn has freed up physical space for face to face consultations
Slide7Enablers
Intuitive tool – easy to use
No requirement for patients to download application
No digital footprint
Clinician engagement
ICT
Parents are technologically competent
Availability of Attend Anywhere content on
www.cuh.ie
(in progress)
Communication of
url
via SMS for appointment reminders (in progress)
Slide8Barriers
Firewall issues
Impact on bandwidth
Access to hardware
Lack of signed off SOP
Clear message on use of Attend Anywhere on personal devices
(Section 38 & 39 Hospitals)
Automated link between completion of training and issue of licence
Parental access to technology cannot be assumed
Parental access to appropriate private space for consultation
Ability to screen share on mobile phone
Slide9Lessons Learned
Importance of clear and consistent messaging on policies, procedures and guidelines.
Clinician Engagement, Operations Support and ICT are intrinsic to success.
Patients are required to be physically present for virtual video consultations.
Contingency Plans are essential.
Technological challenges firewall, training videos, screen sharing extensions can negatively impact on adoption.
The importance of saying ‘Thank You’.
Slide10Questions