Estimación del umbral económico de daños (UED) en el control

The Australian health system has been under a lot of pressure due to the increase in rates of chronic illnesses, its ageing population and its insuf- ficient healthcare workforce. Therefore the Government is making large investments in telehealth. By July 2015, the Department of Health and Ageing is expecting 495,000 telehealth consultations to have been deliv- ered to remote, rural and outer metropolitan areas of Australia, and by the year 2020, the department expects 25% of all the specialist practitioners to have participated in the delivery of telehealth consultation to patients in remote Australia [58].

The National Broadband Network’s (NBN’s) Telehealth Pilot Program was set up to demonstrate the NBN infrastructure and the provision of high-speed broadband, which can enable better access to higher quality healthcare services and healthcare education by means of telehealth. This program is a new government initiative in response to the Government’s Digital Economy Goal for health and aged care. It was created to enable provision of funds ($20.6 million) to successful proposals for pilot projects that develop and deliver telehealth services to NBN-enabled homes and focus on aged, palliative care services, cancer care services and advanced care planning services [59].

The following are some of the objectives of this program in terms of development and trial services [59]:

• Delivery of telehealth services to homes by new and innovative meth- ods that are enabled by high-speed and reliable broadband provided by the NBN.

• Increase in accessibility of healthcare services in regional, rural, re- mote and outer metropolitan areas of Australia.

• Reduction in the need for healthcare related transportation. • Reduction in unnecessary hospitalization of patients.

• Improvement in the quality of care and health outcomes by collab- oration and communication between the customer (patient) and the healthcare provider.

• Telehealth services are scalable and are able to provide an increased volume of care without a corresponding increased cost.

• Reduction in location dependent and regional healthcare workforce skill shortage.

• The use of the NBN infrastructure may increase access to healthcare and it may also reduce social isolation.

4.2. CURRENT TELEHEALTH PROJECTS 49 • Improvements may occur in communications during health emer-

gencies.

The following are some telehealth projects deployed in the Australian territories [?]:

• New South Wales: The telehealth initiatives in this territory began in 1996 and since then the telehealth network has developed into a state wide network consisting of 240 healthcare facilities. These facilities provide the remote and rural communities with readily available ac- cess to healthcare services. These healthcare services may include adolescent and adult mental health services, oncology, sexual health, diabetes foot care, pediatric, radiology, rehabilitation, perinatal HIV counselling, chronic pain management, hematology, surgical review, genetics services, ophthalmology and emergency services.

• Northern Territory: The Northern Territory (NT) telehealth program began in July 2010 with a focus on delivering healthcare and eLearn- ing to the remote and rural areas of the Northern Territory. Although this program is in its infancy stage, it has managed to deliver tele- health services to a number of regional hospitals [?].

The Health eTown project was set up to deliver and provide rural and remote communities of the Northern Territory (predominantly the indigenous populations) with improvements in health and edu- cation. Currently, this project has been set up in 17 different remote towns in the Northern Territory.

The project aims to deliver specialist healthcare services to these re- mote and indigenous communities by assisting doctors and health- care providers. This assistance is made possible by video, audio and data sharing facilities, and remote monitoring and consultation [?]. • Queensland: Telehealth services have been operating in the Queens-

Queesland Health and the Centre for Online Health (COH) at the University of Queensland.

The COH is located in Brisbane at the Royal Children’s Hospital. In the last ten years, the collaboration of the COH and the Royal Children’s Hospital has led to the development of telehealth services such as the centralised paediatric referral centre. This service is avail- able on 82 different sites throughout Queensland and even Northern parts of New South Wales.

According to a government report dated June 2009, the Queensland Health’s StateWide Telehealth Services has managed to set up 656 videoconferencing systems across Queensland, and 67% of these sys- tems are being used for clinical activities such as patient consulta- tion, case management and follow-ups (with the main area of use being patient care for mental health) [?].

In 2008-2009, 50,609 videoconferences were conducted, this number was a 33.4% increase from the previous year (2007-2008) [?].

• South Australia: Telehealth services have gained popularity in South- ern Australia since the 1990s. Services like videoconferencing for the purpose of clinical activity and videoconferencing for the purpose of education are some of the main telehealth services offered in this ter- ritory. These services are provided between Adelaide and the remote hospitals and health centres mainly focusing on mental health. An estimated 1800 to 2000 mental health consultations take place each year using these telehealth services [?].

• Tasmania: The telehealth services active in Tasmania are known as the Telehealth Tasmania Network (TTN). This network has been in operation since 1998 and provides videoconferencing services through a mix of high-speed broadband and high-speed digital phone line. The TTN is used to deliver telehealth services such as remote mon-

4.2. CURRENT TELEHEALTH PROJECTS 51 itoring, tele-consultation, clinical education and multi-disciplinary case reviewing [?].