Deirdre Brunton & Niki Panteli

@bruntondeirdre#Telehealth#HealthInsights

How do you manage an Online Clinical Team whilst promoting

collaboration for timely and quality care?

Online Clinical Teams for Collaboration

• Inter-dependency• Joint effort• A positive personal experience and

satisfaction• A willingness to continue working in online

collaborative work

Online Clinical Teams (the outputs)

Quality & timely Care

Learning and Know-how

Why?

Geographically dispersedProfessional DiverseMulti-disciplinaryTechnology-enabled

http://www.uhbristol.nhs.uk/patients-and-visitors/your-hospitals/bhoc/information-and-support/teenagers-and-young-people-with-cancer/

MDaT Coordinator

•Schedule•Share•Record•Educate

Online Clinical Teams(the inputs)

OutputsInputs

*ImproveQuality& delivery of Health-Care

* Improve Learning & know-how

* Technology

* Members’ Diversity

Online Clinical Teams(the process)

What do Online Clinical Teams need to collaborate and integrate

dispersed knowledge?

• Content (organizational embeddeness and embeddeness in practice)

• Connections (relational embeddeness; structural embeddeness)

OutputsInputs

*ImproveQuality& delivery of Health-Care

* Improve Learning & know-how

* Technology

* Members’ Diversity

Online Clinical Teams

TASK:Shared goalsCoordinationTraining

SOCIAL:TrustIdentity

OutputsInputs

*ImproveQuality& delivery of Health-Care

* Improve Learning & know-how

* Technology

* Members’ Diversity

TASK:Shared goalsCoordinationTraining

SOCIAL:TrustIdentity

Leadership Online(direct, coordinate, facilitate)

Creating A New Service for Teenagers and Young Adults with Cancer

across the South West of England

NICE: Improving Outcomes Guidance

• The needs of Teenagers and Young Adults with Cancer should be met holistically;

• Healthcare of this population should address the psychological and social needs, recognising the impact of a cancer diagnosis at a crucial stage of development and it should be delivered in an appropriate and accessible way.

NICE , IOG for Children and Young People , August 2005

Geographical Diversity

TYA South West ServicesSouth West of England TYA Professionals

Diversity

Partnership WorkingBuilding Trust

CYP/TYA Network

TYA HCP’s

Commissioners

MDaT WorkingAll HCPs

IM &T Agreement

Procurement

Information Governance

Voluntary SectorCharities

Charity Grants

Research

SW TYA Shared care

MDaT - The TeleHealth Solution

MDaT Courier Service - IG requirements

Patient been provided with information Place of care (choice)Keyworker (Site Specific)Diagnosis and Treatment planClinical trialsConsultant in charge of each part of the treatmentHolistic Assessment

Specialist Nurse/and Social Worker referral

Fertility and options to preserve fertility

Need for additional age-appropriate support/referral

Outcomes shared- recorded -reviewed

Agreed date of further review in MDaT

TYA MDaT – The Output www.uhbristol.nhs.uk/tya

Multiprofessional Team Online identify, record, agree , plan care :

Social Connection/ Building Trust

• Inform the patient/create a social network

• Patient/staff/ public website

• Visit each hospital/team

• Create FtF SW TYA Network meeting

Social Connection/ Building Trust

• TYA Specialist Nurses SW online weekly• Team building FtF for TYA Specialist Nurses• Multidisciplinary Team Meetings FtF weekly• Multi professional Team Building FtF sessions• Attend each specialist cancer MDT group FtF• Celebrate through an annual SW TYA

Conference for all

“To evaluate the implementation of the TYA MDAT integrated care approach and explore its perceived impact on patient

care”

• What is the perceived impact on TYA care of new MDAT service?

• How well does the new service/team function

• What should the purpose of the team be?

“To evaluate the implementation of the TYA MDAT integrated care approach and explore its perceived impact on patient care”

The study set out the evidence to support online working. It concluded that the MDaT approach for clinicians is possible and could benefit patients’ care and potentially improve outcomes. The concept of the MDaT as a tele health approach to site specific multidisciplinary teams with a diverse geographical requirement is a viable option.

Daniels J, Brunton D 2011 Oncology News Identifying Primary Functions, Goals and Objectives of a Virtual Multi-Disciplinary Advisory Team for Teenagers and Young Adults with Cancer: A Delphi Study. Vol 6 Issue 2 may/june www.oncologynews.biz/pdf/may_jun_11/57-59_ONMJ11_Daniels.pdf

‘The TYA MDaT tele health solution is a vehicle for ‘challenging’ some of the practice around caring for young people with cancer.’

‘I don’t underestimate the task of going out there and encouraging the other centres to engage.’

‘The motivation to have good team functioning is there but I don’t think the framework for us to do it exists.’

Quotes from the Delphi Study (2010)

Leadership

What are the skills required to innovate tele health?

TYA Project

What are the lessons learned? •The Leader is uniquely the ideas person. The followers are the implementers putting it all in place for sustainability.•Always recognise, support and value the role of the followers.•Remember the tele solution is the vehicle. It is the the driver that needs to know how to drive it and get to the destination of choice.

What would you do differently?• If I knew what it would entail -I would not have

done it!• Get organisational buy in at an Executive level

Identify a named ‘Champion’• Recognise, value and support the followers at

every level of the process• Innovation requires passion, drive and courage.

The unknown is an integral part of the journey. It all comes at a price. Be kind to yourself!

eHealth Teams: The way ahead ?

An interdisciplinary clinical team online is a consistent grouping of people from relevant clinical disciplines, ideally inclusive of the patient, whose interactions are guided by specific team functions and processes to achieve team-defined favorable patient outcomes.

Teamwork supported by properly designed eHealth applications could help create more effective systems of care for chronic disease.

The Internet is a logical platform for supporting interdisciplinary clinical teamwork.

Research is needed to better understand how interdisciplinary eHealth teammembers can work together in everyday practice and to guide the development of effective and efficient eHealth software applications to support greater clinical teamwork.

eHealth Teams

The interdisciplinary eHealth team: chronic care for the future.John Wiecha, Timothy Pollard Distance Education for Health, Department of Family Medicine,Dowling 5 South, 1 Boston Medical Center Place,Boston University Medical Campus, Boston, MA 02118, USAJournal of Medical Internet Research 2004 6(3):e22. DOI:10.2196/jmir.6.3.e22 Source: PubMed

ehealth – Is it a Movement?

http://www.ted.com/talks/derek_sivers_how_to_start_a_movement

Any Questions?

https://www.linkedin.com/pub/niki-panteli/14/724/305https://www.linkedin.com/in/deirdrebrunton

@bruntondeirdre#Telehealth#HealthInsights