Implementation of a Clinical Telemedicine Program at a Large Multi Site Community Hospital

Riddell, Karen B

Monday, 18 November 2013

Karen B Riddell, RN, BScN MBA
Department of Professional Practice, Windsor Regional Hospital, Windsor, ON, Canada

Learning Objective 1: The learner will be able to discuss the challenges of implementing a TM program at a community hospital.

Learning Objective 2: The learner will be able to discuss strategies for overcoming challenges in the development of a successful TM program.

Windsor Regional Hospital (WRH) a large multi site community hospital located in Windsor Ontario Canada received funding from the Ministry in February 2012 to expand its Telemedicine capability with the addition of five telemedicine nurses. Benefits of telemedicine include reduction of time/distance barriers, stress, expense, wait-times and improved patient satisfaction. A readiness assessment completed prior to implementation identified key challenges including clinical space, camera and peripheral availability, and multiple hospital sites requiring service. Additional challenges include provider buy in, fear of technology, lack of experience and resources, technology downtime and lack of standardization.

A WRH VP was assigned as project sponsor, a clinical lead assigned to lead the development of the program and a steering committee struck to provide oversight. A recruitment strategy was initiated and working closely with the regional government the infrastructure, orientation, training, and goals to support telemedicine were developed.

Data has been collected and analyzed to identify where our patients are coming from and where they are required to go to access healthcare services. Focused department specific goals and priorities have been identified. Communication strategies to ensure internal and external stakeholder engagement, staff, physician, patient and family education have been developed. The primary focus during these initial phases has been on the development of a strong infrastructure supported by standard operating procedures to ensure quality and safety are inherent in all processes.

Partnerships with other providers, membership in communities of practice and development of program team task forces have been formed.

Prior to implementation 2011-2012 there were approximately 40 clinical visits conducted utilizing telemedicine technology. Since implementation telemedicine services have expanded in bariatrics, children’s mental health, orthopaedic care and cancer care. In December 2012 and January 2013, 25 clinical visits have been hosted. Our target for clinical visits is 25 visits per week per nurse.

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