Staying Strong Telehealth Better Health Outcomes for Older Indigenous Australians 1.1March 2014 Indra Arunachalam – Strategic Projects Manager

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 1 1.1

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 2 1.1

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 3 1.1

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 Slide 4

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 Slide 5

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 6 1.1

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 7 1.1

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 *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

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

Baseline Attitude to Technology March 2014 Slide Staying Strong participants reported greater confidence with technology

Baseline Social Connectedness March 2014 Slide To measure how NBN enabled older participants to connect with local school children in a way that improved their social connectedness, enhanced cultural awareness and increased respect for indigenous history and heritage

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

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

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 March 2014 Slide

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

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 GP involvement is important Asset Register for telehealth equipment and peripherals Strong internet connection is needed March 2014 Slide Funding bodies should take this into consideration

Strategic Partnerships March 2014 Slide

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

Contact Details Indra Arunachalam References: Cartwright C, Wade R, Shaw K: The Impact of Telehealth and Telecare on Clients of the Transition Care Program (TCP), May 2011 Lee, Richard M, Robbins, Steven B: Measuring Belongingness: The Social Connectedness and the Social Assurance Scales. Journal of Counselling Psychology, Vol 42(2), Apr 1995, March 2014 Slide