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Define the study cohort/confirmation of selection critera and exclusions
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Admitted to hospital for their condition at least twice in the previous year, or ≥ 4 times in previous five years
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Hospital health roundtable records - obtained from local hospital for previous five years.
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• Date admitted
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Exclusions are mental health and cancer patients
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• Date discharged
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• Reason for admission (ICD 9/10 Codes)
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• Procedures carried out
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Establish if telehealth
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Number of unscheduled admissions to hospital for their condition
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MBS Flag (In hospital) Health roundtable record
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Improves patient outcomes/reduced hospitalisation
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• Date admitted
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• Date discharged
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• Reason for admission (ICD 9/10 Classification)
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• Medication administered
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• Procedures carried out
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Establish If telehealth improves patient outcomes/reduced use of clinical services (Impact on clinical workforce availability and deployment)
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Number of visits to/by GP
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MBS records
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Number of visits to/by specialists
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MBS records
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Number of visits by community nurse
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MBS records
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Number of visits to/by allied health (ie occupational therapist)
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MBS records (If reimbursable from Medicare)
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Changes in prescription history
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PBS
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Communication with CCC
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CCC Logs from CSIRO Portal
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Organisational change management and impact on workplace culture
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Administrative/operational changes implemented/required in order to implement the Telehealth service.
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Questionnaires and structured interviews.
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• Within first three months
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• Every six months thereafter
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Useability of monitoring equipment
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Compliance with monitoring schedule, recorded daily.
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TMC Logs
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Extra measurements taken by patient (When? Which?)
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TMC Logs
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Compliance with questionnaire administration (When? Which?)
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TMC Logs
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Use of video conferencing
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TMC Logs
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Overall data usage
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iiNET provided logs
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Useability/acceptability
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Ease of use
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Questionnaires delivered via TMC
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For patients of monitoring Equipment
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Quality of training received
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• One month after first deployment
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Patient embarrassment if visitors know they are being monitored
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• Midpoint of trial
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Acceptability as an item of furniture
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• At end of trial
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Easy or hard to take measurement
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Important/not important in patients' self management
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Responsiveness of clinical care coordinator in responding to changes
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Quality of training received
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Patient embarrassment if visitors know they are being monitored?
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Easy or hard to take measurement
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Carers experience with telehealth (Community nurse/carer)
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Ease of use of (i) equipment and (ii) Clinician website
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Questionnaires and structured interviews of community nurses
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Changes to previous clinical models of care
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• One month after first deployment
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Effectiveness in improving ability to deliver care
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• Midpoint of trial
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Impact on workload
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• At end of trial
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Carer's experience with telehealth (Relative or other carer)
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Effect on carer stress
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Questionnaires and structured interviews
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Effect on carer workload
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• At first deployment
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Effectiveness in improving ability to deliver care
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• Midpoint of trial
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Access to clinician web site
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• At end of trial
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Gp experience with telehealth
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Ease of use
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Questionnaires and structured interviews of Patients' GP
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Changes to clinical models of care
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• Within 3 months of first deployment
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Effectiveness in improving ability to deliver care
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• Midpoint of trial
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Impact on workload
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• At end of trial
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Useability, acceptability of clinician web interface
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Ease of use?
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Questionnaires and structured interviews
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Quality of training received
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• One month after first deployment
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How many hours required
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• Midpoint of trial
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Value and ease of use of Video conferencing
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• At end of trial
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Health economic outcomes
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Daily cost of hospitalisation
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Health roundtable data
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Cost of procedures carried out whilst in hospital
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Health roundtable data
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Cost of visits to/by GP
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MBS Data
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Cost of visits to/by Allied Health (ie Chiropodist or OT)
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MBS Data
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Cost of visits by community Nurse/carer
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MBS Data
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Cost of travel to GP
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MBS Data
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Loss of earnings if patient is still employed, from days taken off for illness or visits to health professionals
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Use Google Maps to determine distance travelled from home address to address of service location, then apply standard costing model. Ie flag fall + km charge.
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Estimate from patient salary and time spent on each visit
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Cost of delivering telehealth services
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Cost of clinical care coordinator(s)
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Health service provider and logs recorded
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Cost of clinical nurses/carers
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Health service provider and logs recorded
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Cost of providing network services
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iiNET billing at commercial rates
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Cost of providing Telehealth monitoring services
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TMC commercial daily subscription costs
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Depreciated costs of capital equipment
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Our own project records
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Estimate of cost of space for monitoring centre at each site
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Estimates from Health service Provider
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