Transcript Tasmanian Health Assistance Package

Tasmanian Health Assistance
Package
Tasmanian Health Conference
26-27 July 2014
Presented by Phil Edmondson, CEO
Tasmania Medicare Local gratefully acknowledges the financial and other support of the Australian Government Department of Health
Tasmanian Health Assistance
Package - what’s happening
and what’s still to come?
THAP Element A
Social Determinants of Health &
Health Risk Factors
Funding and Resourcing
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$13.3 M over 3 years.
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3 principal components to contract:
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Health Risk Factors Project
Exercise Treatment Initiative (part of risk factors)
Social Determinants Activity
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
Social Determinants of Health
The “causes of the causes” including poverty, poor housing, disrupted/undereducation, poor literacy, inadequate access to nutritious food, inadequate
transport.
Project Approach
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Applying a place based approach to address the social determinants of
health
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9 communities with lowest SEIFA receiving $350,000 each over 2 years
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$50,000 for developing partnerships and detailed project plans, further
$300,000 on submission of detailed plan and budget
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Capacity building to support partners to deliver projects effectively
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Rigorous evaluation to measure outputs, outcomes and whether this
approach worked
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
Social Determinants of Health
Nine collaborative projects involving
43 partner organisations:
Capacity Building elements
already delivered:
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community houses
employment agencies
schools (primary and secondary)
TasTAFE
local councils
health, welfare and medical agencies
child and family centres
community cultural organisations
community bank
housing providers
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Bridges Out of Poverty
Evaluation strategies
Partnering, governance,
collective impact
Contract management
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
Social Determinants of Health
What is still to come
Implementation phase of 9 community projects
• See fact sheets for individual project details
Statewide capacity building activities including:
• Project management and support
• Best practice community engagement
• Project governance, strategic planning budgeting and advocacy training
• Asset mapping for community decision making
• Evaluation
• Bridges Out of Poverty
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
Health Risk Factors
Five projects over three years:
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Smoking reduction to 15% by 2016 - $900,000
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Poor nutrition, diet and obesity (Healthy Food Access Tasmania) - $1,200,000
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Exercise Treatment Initiative (Strength2Strength) - $2,500,000
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Alcohol and smoking reduction in youth (#switchitround) - $420,000
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Health literacy strategy for community practitioners - $300,000
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
Health Risk Factors
Smoking reduction to 15% by 2016 (Partner: QUIT)
• Establishment of partnership with DHHS to increase funding for social media
campaign
• TARPS (target audience rating points) have increased to 700 each month
• Recent QUIT ad campaign focuses on “real Tasmanians”
• ↓ smoking rates have been recorded since project inception – though
attribution difficult at this level
Targeting Tobacco
• Working with community service providers to influence policies to encourage
decreased smoking rates with workers and increase skill level of workers to
assist clients to quit smoking.
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
Health Risk Factors
Healthy Food Access Tasmania (Partners:UTAS & Heart Foundation)
Health Food Basket survey completed across Tasmania (UTAS) showing that:
• Some Tasmanian families need to spend more than 40% of their household
budget to eat for good health.
• Of the shops in Tasmania where you can buy fresh fruit and vegetables, only
5% are located in low income areas.
• Healthy Food Access Tasmania project will be offering a total of $480,000 to
fund initiatives across Tasmania in communities that are most impacted by
the study findings.
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
Health Risk Factors
Exercise Treatment Initiative - North (June 2013 - June 2014)
• 384 referrals to date – those with high risk of hospitalisation
• Approx. 200 patients have now completed the program
• 100 are currently actively engaged with the program
• Data analysis on the first 2 cohorts shows similar improvements
across most measures including waist circumference, both systolic
and diastolic blood pressure, sit to stand test time, timed up and go
test, walking distance and all quality of life scores (overall, mental and
physical health).
THAP Element A
Social Determinants of Health &
Health Risk Factors cont’d
What is still to come
• Exercise Treatment Initiative rolling out to North West
• Health Literacy implemented through TML and partner
organisations to undertake audit and education sessions to
increase partitioner capacity to create/impart “best practice”
health information
• Alcohol and smoking - young people to be engaged in
developing peer driven social media strategies
• Health Food Access Tasmania project rolling out small grants
program to establish communities partnerships between
retailers, growers and consumers.
THAP Element B
Care Co-ordination for People with
Chronic Disease & Aged Care Clients
Funding & Resourcing
• $35.2 Million over 3.5 years
– $4.7 Million for Tasmanian HealthPathways
– $30.5 Million for Care Coordination
THAP Element B
Funding Received
• $4.7 Million over three years to deliver a “system roadmap” of at least
130 pathways, including the key areas of cardiovascular diseases,
diabetes, Chronic Obstructive Pulmonary Disease (COPD) and
neurodegenerative conditions.
• $1.1 Million over three years for independent project evaluation.
THAP Element B cont’d
Where it has already provided assistance
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21 localised Tasmanian pathways for cardiology and other clinical
areas, another 88 under active workgroup development.
Human resources (TML)
– Project management team (Leader, Manager, Support Officer)
– 6 part-time GP clinical leaders/editors across 3 regions
– E-health support services
Contractors (External)
– Streamliners NZ: web development and technical writing service
– THOs: participation/advice of clinical champions in each region,
other specialist staff, access to data/information and support
– KPMG independent evaluator
THAP Element B
What is still to come
Launch of live Tasmanian HealthPathways website
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Proposed 17 September 2014
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Access for all Tasmanian clinicians to a password protected portal
» Inclusive of ~40 pathways (plus resource pages) for cardiology,
diabetes and others
» 90 pathways by June 2015 (likely to be over 150)
» 130 pathways by June 2016 (likely to be over 220)
– Current work areas: respiratory (including COPD), Parkinson’s
Disease, cognitive impairment/dementia, stroke/TIAs, immunisation
– Future areas include: palliative care, orthopaedics, gasroenterology,
ENT
THAP Element B
Care Co-ordination for People with
Chronic Disease & Aged Care Clients
What have we been doing with the Care Coordination funding?
• Implementation of Care Coordination Program (CCP) statewide using various
models, sectors, multidisciplinary referral processes and access points.
• Funding to organisations already providing care coordination (CC) to increase
their capacity. As at 30 June 2014 we have commissioned 17 organisations
(11.65 FTE) providing unique needs based access through:
– 11 general practices (some multiple practices/sites
– 4 aged care facilities
– 2 community organisations
Plus TML Regional Backup Team - 4.4 FTE providing:
• In-reach hospital model with acute sector referrals to TML program
• outreach services – Scottsdale and Georgetown
• Supporting acute sector and specialist outpatient services to increase their
capacity to provide their specialist services and be the ‘link’ to general practice
THAP Element B
Care Co-ordination for People with
Chronic Disease & Aged Care Clients cont’d
Where it has already provided assistance:
• Assisted 838 clients state-wide during the initial implementation phase Jan
- June 2014
• Average; funded orgs- 54 active pts/FTE over a 3-5 month period
• TML CC’s - 47 active clients/FTE Jan - Jun
• Rural collaboration models: Coverage of a region, especially in rural areas,
accessible by all service providers through a multidisciplinary referral
process in a small regional area
• Disease specific CC’s – Dementia related diseases, COPD and Motor
Neurone Disease.
• Increased communication and collaboration with General Practice
Care Coordination
Services and Gaps
As of July 2014
THAP Element B
Care Co-ordination for People with
Chronic Disease & Aged Care Clients cont’d
What is still to come
Stage two rollout: July 2014
• 31 contracted organisations providing care coordination services (24.05 FTE)
• 19 General Practices, 5 ACFs, THO NW x 2, Community Orgs – 5
Aim - 150 clients/FTE in 12 months = 3600 clients over 12 month period.
Workforce Development:
• Develop vocational training module – Care Coordination
• Provide Endorsed / accredited sector specific education and training
Evaluation: comprehensive ongoing evaluation of program
Sustainability:
Working with individual organisations to review long term sustainability and
modelling finances, health outcomes, and locally/region/sectoral integration
Embed process
THAP Element C
Streamlined Care Pathways
What money was received is being spent
• $11.5M funding over 4 years.
• System redesign to improve people’s transition between the acute, primary
and aged care sectors.
• Focus is on working with the existing system to do things differently.
• Critical elements: system integration, professional provider interactions,
consumer engagement.
• Strong partnership approach:
– Primary health care providers (general practice, nursing, allied health)
– Aged and Community Services Tasmania
– Tasmanian Health Organisations (THO)
– Private hospital system
– Consumer groups
– Department of Health and Human Services
THAP Element C
Streamlined Care Pathways cont’d
Where it has already provided assistance
• Australian Primary Health Care Research Institute partnership to build the
evidence base
• Talking Points – Best Practice Guidelines for Transition Care developed in
partnership with key stakeholders
• Service redesign to improve complex care delivery in community based
settings:
– Kingborough/Huon Community Nursing – Future Directions in Primary
Health Care (THO-South)
– Launceston Community Health Nursing – Better Access to Community Care
(THO-North)
• Shared Electronic Discharge Summary and Outpatient Clinic Summary (THO
– statewide)
THAP Element C
Streamlined Care Pathways cont’d
What is still to come
Targeted initiatives working with the existing service delivery system to
streamline and improve transition of care.
• System Integration:
– Talking Points Guidelines across acute, primary and aged care
– Uniform communication protocols and transition decision making tools, including
electronic systems
– Develop post hospital pathways – condition specific and co-morbidity
(linked with Tasmanian Health Pathways)
• Professional Provider Interactions:
– Continue service re-design initiatives (e.g. community nursing)
– Demonstrate integrated community based models in rural areas
– Develop community based ‘in-reach’ models to the acute care system to assist with
timely discharge
– Workforce development strategy
• Consumer Engagement:
– Consumer resources to support improved understanding and self-management of
care transition.
Key Contacts
Social Determinants of Health & Health Risk Factors & Tasmanian Health Pathways
Elvie Hales, Director, Primary Health Systems
E: [email protected], P: 6425 8500
Maree Gleeson, Manager, SDOH & Health Risk Factors
E: [email protected], P: 6425 8500
Paul Shinkfield, Project Leader, Tasmanian Health Pathways
E: [email protected], P: 6213 8200
Catherine Spiller, Project Manager, Tasmanian Health Pathways
E: [email protected], P: 6213 8200
Care Co-ordination for People with Chronic Disease & Aged Care Clients
Mark Broxton, Director, Clinical Services
E: [email protected], P: 6341 8700
Lynette Purton, Manager (Operations) Care Coordination
E: [email protected], P: 6425 8500
Jane Barrow, Manager (Projects) Care Coordination
E: [email protected], P: 6213 8200
Streamlined Care Pathways
Susan Powell, Director, Population Health Programs
E: [email protected], P: 6213 8200
Rosie Beardsley, Manager, Streamlined Care Pathways
E: [email protected], P: 6213 8200