Hawaii and Pacific Is Island Telehealth Experiences Innovations - - PowerPoint PPT Presentation
Hawaii and Pacific Is Island Telehealth Experiences Innovations in Policy, Technology and Applications Christina Higa Co-Director, Pacific Basin Telehealth Resource Center Social Science Research Institute University of Hawaii Brisbane
Christina Higa Co-Director, Pacific Basin Telehealth Resource Center Social Science Research Institute University of Hawai’i
Brisbane April 3-4, 2019
Innovations in Policy, Technology and Applications
Communication Experiments by Satellite (PEACESAT) 1969-2012
Satellites (NASA’s ATS-1 & 3; NOAA’s GOES 2, 3 & 7)
✓Distance Learning ✓Emergency Management ✓Telehealth
– Royal Flying Doctors - Medical Chests
How might your service be applied to another target community (rural/urban), health discipline; or another sector completely (disaster response, education, tourism), something else? What added value can you share with the platform you are using – whether it is technical or human resources?
https://d-maps.com/m/world/centrepacifique/
Marshall Islands American Samoa Federated States
Palau Northern Mariana Islands Guam
3 COFA with US
State of Hawaii
including patient home or work;
monitoring, live consultation & mhealth
providers and a patient, appropriately;
established via telehealth by referral
Systemic Issues -- Stuck because of Policy; need to change Policy…right environment to do it. Law Does Not = Change…requires details, change takes time Co-design? Proposition of value: What is in it for each stakeholder? What’s in it for provider, patients, community, law makers?
Environment
Tiny Population/Markets, Poor Economies of Scale, Developing & Fragile Economies
Infrastructure
Vast Distances, Difficult and Expensive to Serve, High Travel Costs
Non-Communicable Disease (NCD)
Among highest NCD related deaths Regional State of Health Emergency Lack of Specialty Care, Costly Referrals
Telecommunication
Access/ Affordability/Reliable Lack of Enabling Telecom Regulation Monopoly Environments
Site Name Connection Type Provided Connection Speed Cost USD Per/Mo. FSM (Chuuk) T1 Internet 1.544 Mbps $ 320 Standard ADSL Internet 1 Mbps download $ 400 256 Kbps upload RMI (Majuro) ADSL (Residential) 256 Kbps $50 1.5 Mbps $140 ADSL (Business) 3-7 Mbps $2,100 - $4,000 FSM (Pohnpei) ADSL 1.5 Mbps $600 VDSL 8 Mbps $10,192 Palau MOH Palau Telecom (Wireless on island, Intranet Management) 3 Mbps download ~$7,000 Off island via satellite (O3B) 1.5 Mbps upload Palau MOH PNCC (Wireless on island) - Off island via satellite (O3B) 4 Mbps download
~$5,000 American Samoa DSL (Residential) DSL (Business) 2 Mbps 10 Mbps $130 $700 CNMI ADSL Internet 9 Mbps download $325 1 Mbps Guam ADSL (Residential) Internet 50 Mbps download 2 Mbps upload $100
Mbps U/D
Palau 3/1 $7,500 US Hawaii 250/250 $1,200 US GDP (2017) Small Is. $4,000 US US $59,000 US 80X bandwidth for 6x cheaper
Pohnpei (FSM)
and the Palau connection installed in late 2017 Infrastructure Improvements:
September 13 to 15, 2016 Honolulu * Hawai`i
Region IX - Office of the Assistant Secretary for Health and Regional Directors Office worked with the Office of the Assistant Secretary for Planning and Evaluation (ASPE)
In 2010 Pohnpei was connected to fiber but didn’t know what to do with it…”our eyes were opened up to the possibilities of telehealth and numerous applications.”
link 10Mbps $400 USD/mo. (form $5K)
NGO funding
workshop ✓Demonstration of Value ✓Attracts other local NGO funding
Pohnpei State: 36,000 Pop, FSM Capital, Connected to off island fiber
Mbps – Excellent Connectivity, $400/mo)
pathology for cancer diagnoses & life- saving interventions. Chuuk Pap Smears reads in Pohnpei
(Store & Forward, Complicated Echo Studies)
and Possible Follow-Up via Telehealth
Pohnpei State Hospital Tele-Pathology
Image: Kaselehlie Press, Jan. 29, 2018
Australian and New Zealand Gastroenterology International Training Association (ANZGITA) Dr. Chris Hair; Fiji School of Medicine,
Hospital, Dr. Payne Perman
(TB Case Consultation for USAPI Nurses) CDC/Australian Respiratory Council
Medical Education Mentoring Program Case Based Learning Well Received in Pacific Islands
Importance of Champions, even if cliché Infrastructure / Resource Constraints Common Telehealth issues (reimbursement,
liability, patient privacy) not yet overbearing concerns
Risk Management Assessment:
Severity of the resource constraints Dire health care needs Access to health information, consults Imperative for best care possible
Opportunities for Regional Collaboration
Challenges * What are top challenges in your initiative? * What do the stakeholders say? How do you hear from them? Opportunities * How to meet Value Propositions? * What can you do to enhance it? * Who can you collaborate with?