LTC Case study: teleDOTS

June 2016 Vol. 16 (3)

Mobile video apps for face-to-face connection: Reducing the time public health nurses spend stuck in Auckland’s traffic can only be a good thing.

Lucy Westbrooke, telehealth programme manager for the Auckland DHB, has been involved in a project doing that for the nurses working for the Auckland Regional Public Health service.

Amongst the work carried out by the public health nurses is monitoring patient adherence to medication treatments for notified diseases like tuberculosis. In some cases this monitoring involves ‘directly observed therapy’ (DOT) to ensure, for example, a full course of antibiotics is taken to prevent the risk of relapse or an increase in drug-resistant tuberculosis.

So rather than sending public health nurses by car to battle Auckland’s traffic – serving a region spread from Waiuku in the south to Wellsford in the north – the service looked to technology for an alternative way of delivering ‘face-to-face’ monitoring.

Westbrooke says the first platform for remote monitoring was video telephones, but technology was moving rapidly so after an early evaluation it quickly moved on to using a video app for electronic face-to-face DOTs or teleDOTs as they are now known.

At first the app was used purely on computers and laptops but then it downsized so mobile devices as smartphones and tablets could produce the good quality images needed to ensure a patient was taking their medication.

They addressed the digital divide – clients without their own computer and broadband connection or a mobile device with plenty of data – by supplying them with iPads and 3G cards.

Finding the right app was not as straightforward as downloading Skype or FaceTime to a device because of the need to ensure a secure private connection for clients and patient data was not stored off-shore. So they are using a New Zealand-hosted video conference provider rather than one using cloud storage.

Westbrooke says the DHB is now talking to the community long-term conditions directorate about using similar telehealth technology to support other services including hospice and community palliative care and linking its mental health sites.

She says video calls also have great potential for supporting people doing home dialysis as you can help someone having problems by saying ‘just look to your right and you will see the button you need to push’.”

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