What Have We Learned from the CSIRO National NBN Telehealth Trial?

The CSIRO National NBN Telehealth Trial investigated the effects of introducing at home telemonitoring of vital signs for the management of a heterogeneous group of chronically ill patients. Patients suffering from a wide range of chronic conditions who were frequently admitted to hospital, were selected from nominated hospital lists. The impact of telemonitoring was analysed using a wide range of health and wellbeing outcomes as well as numerous health economic metrics derived from Medicare Medical Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) data and Hospital Health Roundtable data. Data was also recorded from the telemonitoring system used in the trial, and the administration of questionnaires. The impact of this intervention on the patients, carers and clinicians involved in their care was quantitatively and qualitatively analysed and documented. There were no significant differences between test and control patients at baseline. Test patients were monitored for an average of 276 days with 75% of patients monitored for more than 6 months. Test patients 1 year after the start of their intervention showed a 46.3% reduction in rate of predicted medical expenditure, a 25.5% reduction in the rate of predicted pharmaceutical expenditure, a 53.2% reduction in the rate of predicted unscheduled admission to hospital, a 67.9% reduction in the predicted rate of LOS when admitted to hospital, and a reduction in mortality of between 41.3% and 44.5% relative to control patients. Control patients did not demonstrate any significant change in their predicted trajectory for any of the above variables. In addition, this project reports on the effect of workplace culture and capacity for innovation and organizational change management in successfully integrating a new model of care with long established service models.