Expansion of health services with Telehealth
Context
Telehealth was initiated in Australia around late 2007 (CSIRO, 2012) to reach remote areas using technology. In 2021, the mandatory uptake of the technology rendered by the pandemic in 2020 has resulted in faster uptake by health professionals and patients across Australia (2021). Telehealth also makes it easier for medical practitioners to conduct inter-jurisdictional patient consultations. Some key points according to Medical Board of Australia (2021) include:
In this scenario, a professional health services group located in rural New South Wales wishes to expand their services using telehealth across to the Northern Territory (NT), Western Australia (WA) and South Australia (SA). The group currently includes doctors (GPs), specialist nurses, physiotherapists and dental practitioners. The group wishes to include counselling and psychotherapy as services via telehealth across the two new states.
For this assessment, your group will act as a “steering committee” which will include:
The task of the steering committee (your group) would be to:
(1) Understand the context
(2) Evaluate strategies to implement telehealth practices
(3) Identify risks
(4) Prepare an action or rollout plan
The presentation will identify stakeholders from each of the groups (as above) and each member will assume a role. The presentation will require each role/member to inform the committee on requirements, risks, steps to follow and guidance.
Please note that true representation of all stakeholders is required, not on the basis of profession or current roles but in terms of diversity. The steering committee will also need to include a chairperson for the committee who will preside and also finalise on the actionable steps for each member.
Software as a Service in Aged Care Services
The Context Software which meets the definition of “medical device” or SaMD (TGA, 2021a) under section 41BD of the Therapeutic Goods Act 1989 (TGA, 2021b) must be registered on the Australian Register of Therapeutic Goods before it can be supplied. Examples of SaMD include mobile apps coupled with devices that calculate insulin doses based on a person’s blood glucose levels, x-ray image processing software and software that uses information about symptoms to make a diagnosis. Given that a device used to monitor a body function will be a medical device, the impact of regulation must be considered in the early stages of development.
Any digital health technology delivered to Australian consumers must also comply with the Australian Consumer Law (ACL).(ACL,2021) This includes a statutory guarantee that the technology will be of acceptable quality, including that it will be fit for the purpose that the supplier said it would be fit for. The ACL also prohibits a supplier from making false or misleading representations.
In addition, unfair contract terms must not be included in any standard form agreement that individual consumers may be required to agree to before they can use the technology. A supplier cannot exclude the application of the ACL to its contracts with consumers (for example, by making the user terms subject to the laws of a foreign jurisdiction). Compliance with the ACL will assist to build a supplier’s reputation and trust amongst users, which will be critical to user uptake in the digital health sector. In this scenario, a group of medical and allied health practitioners (based in Victoria) which services aged care clients are considering deployment of a contactless mobile solution to offer “contactless support” in the post pandemic situation. The solution will be used by health workers in aged care facilities to monitor and care for the senior clientele. The group has engaged a software vendor and the building management of a facility in a consultative committee to discuss a strategy. Your group is a consultative committee having representatives from:
(1) Health Service (2) Aged Care Facility
(3) Software Vendor
(4) Senior clientele champion
(5) Union representative (health workers in aged care)
To complete this assessment task, your group members must individually assume the above roles. The potential solution is to assist senior care facility workers (for example, nurses, patient care assistants) to monitor residents of a facility using an app on their smartphones. The technological infrastructure will combine a private cloud infrastructure and wearables (worn by residents), so that health workers can collect vitals at specific intervals, monitor falls and assist residents in an emergency by connecting to emergency services if needed. In the future, the solution would also enable connected residents to speak with their families or be offered telehealth services by health professionals.
Your group will need to discuss requirements, identify and assess risks, and prepare plans for the product that will be developed by the vendor and trialled in the facility. The vendor would be required to follow TGA guidelines and ACL requirements. Each of the representatives (as above) will have a role to present their perspective from that viewpoint and also offer some guidelines for others.
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