title: Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital.
abstract: BACKGROUND
  The Princess Alexandra Hospital Telehealth Centre (PAH-TC) is a project jointly funded by the Australian national government and Queensland Health. It seeks to provide a whole-of-hospital telehealth service using videoconferencing and store-and-forward capabilities for a range of specialities. The aim of this study was to investigate whether the introduction of a new telehealth coordination service provided by a tertiary hospital centre increased telehealth activities of a tertiary hospital. Evaluation included service delivery records and stakeholder satisfaction.
  
  
  METHODS
  Telehealth service delivery model before and after the establishment of the centre is described as well as the project implementation. The study retrieved data related to the number and scope of previous, and current, telehealth service episodes, to ascertain any change in activity levels following the introduction of the new telehealth coordination service. In addition, using a cross-sectional research design, the satisfaction of patients, clinicians and administrators was surveyed. The survey focused on technical utility and perceived clinical validity.
  
  
  RESULTS
  Introduction of a new centralised telehealth coordination service was associated with an increase in the scope of telehealth from five medical disciplines, in the year before the establishment, to 34 disciplines two years after the establishment. The telehealth consultations also increases from 412 (the year before), to 735 (one year after) and 1642 (two years after) the establishment of the centre. Respondents to the surveys included patients (27), clinicians who provided the consultations (10) and clinical or administrative staff who hosted the telehealth consultations in the remote site (8). There were high levels of agreement in relation to the telehealth option saving time and money, and an important health service delivery model. There was evidence from the remote site that modifying roles to incorporate this new service was challenging.
  
  
  CONCLUSIONS
  The introduction of a centralised coordination for telehealth service of a tertiary hospital was associated with the increase in the scope and level of telehealth activity of the hospital. The project and model of health care delivery described in this paper can be adopted by tertiary hospitals to grow their telehealth activities, and potentially reduce costs associated with the delivery of services at a distance.
authors.affiliation: Centre for Online Health, The University of Queensland, Brisbane, Australia. m.martinkhan@uq.edu.au.|Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia. m.martinkhan@uq.edu.au.
authors.forename: Melinda
authors.initials: M
authors.lastname: Martin-Khan
authors.affiliation: Centre for Online Health, The University of Queensland, Brisbane, Australia. ffatehi@gmail.com.|School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. ffatehi@gmail.com.
authors.forename: Farhad
authors.initials: F
authors.lastname: Fatehi
authors.affiliation: Centre for Online Health, The University of Queensland, Brisbane, Australia. marina.kezilas@uqconnect.edu.au.
authors.forename: Marina
authors.initials: M
authors.lastname: Kezilas
authors.affiliation: Centre for Online Health, The University of Queensland, Brisbane, Australia. karen.lucas@uq.edu.au.
authors.forename: Karen
authors.initials: K
authors.lastname: Lucas
authors.affiliation: Centre for Online Health, The University of Queensland, Brisbane, Australia. len.gray@uq.edu.au.|Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia. len.gray@uq.edu.au.
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Gray
authors.affiliation: Centre for Online Health, The University of Queensland, Brisbane, Australia. asmith@uq.edu.au.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002497:Centralized Hospital Services; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008875:Middle Aged; D017146:Models, Organizational; D011793:Queensland; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000458:organization & administration* / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers; D049269:Videoconferencing; D055815:Young Adult