Terms of Reference
In a general sense, the Forum is accountable to the New Zealand health sector represented in this case by the National Health IT Board. However the Forum is required to act as an independent centre with day to day leadership provided by NIHI, at the University of Auckland. It is recognised however that other governance options may in due course present themselves and additional accountabilities may arise based on funding and sponsorship sources for the Forum's programme of work.
The role of the Forum is to:
- identify and promote the role of telehealth services in helping address the challenges faced by the NZ healthcare sector
- educate clinical, policy and funding organisations and to encourage their active support for and involvement in telehealth initiatives
- instigate specific initiatives that utilise telehealth and demonstrate their impact on the health system
- develop collaborations with international healthcare organisations to adopt and adapt their telehealth experience
- drive a cohesive national approach; to ensure that standards are developed and adopted; to drive cost effective service provision from suppliers
- research the issues and barriers to adoption, such as non-alignment of payments with new modes of service; technology integration; user (clinician and patient) resistance; privacy and confidentiality issues
- act as a clearing house for available resources and to support the building of business cases for the use of telehealth
- enable the creation of centres of excellence in the use of telehealth.
The scope of the Forum (and its work programme) is based on the Forum's definition of telehealth as the collective term for:
healthcare delivery, or closely related processes, when participants are separated by distance, and information and communications technologies and infrastructures are used to overcome that distance.
- the use of both store and forward and real time technologies for remote diagnosis, treatment and prevention of disease and injuries, as well as health care related education, research and evaluation (traditionally referred to as telemedicine)
- remote management between a patient in their domestic settings and their care providers (telemonitoring)
- the use of mobile devices to deliver healthcare and to support healthy lifestyle services.
When considered as a subset of "e-health" the boundaries of telehealth can become blurred and can include applications such as the interactive portals (websites) currently in use in the mental health sector in New Zealand and overseas. Telehealth applications can also include robotics, help lines, and alarms (telecare), but these are likely to be a lower priority to the key focus areas for the Forum: support for small / rural hospitals and integrated family health centres (IFHCs), telemonitoring, improved support for clinical networks (especially videoconferencing), and telehealth standards.
Forum structure and responsibilities
The Forum will comprise a Chair, a Telehealth Leadership Group (TLG) and an Operations function which will carry out Secretariat and consulting activities. It is also expected that an Executive will be established to oversee the Forum's agenda, work programme and finances.
Collectively the Forum will have a strong clinical focus, with the following expertise and attributes:
- knowledge and experience in the theory and practice of telehealth as described above
- knowledge of the enabling technologies
- knowledge of New Zealand's current health services delivery in public and private settings
- an ability to think in terms of innovative solutions that can transform the traditional service delivery models
- experience in having a governance role in similar organisations
- the passion and commitment to ensure that the Forum succeeds in its objectives.
The Telehealth Leadership Group includes members selected from an Expression of Interest process and appointed members to ensure that the telehealth sector as a whole is represented, including clinical disciplines, consumers, policy makers, planning and funding managers, ICT experts and industry suppliers. There will also be representation covering geographic and cultural communities of interest. The role of the TLG is to:
- advise on requirements and priorities for telehealth deployments to support rural and provincial hospitals, integrated care centres , home monitoring and clinical networks
- advise on matters relating to environmental considerations, e.g. barriers to uptake, technical considerations, protocols and guidelines, and standards
- provide advice and support for projects undertaken by the Forum
- contribute to the achievement of the overall objectives of the Telehealth Leadership Group to the maximum extent practicable.
The Chair will be a clinical leader with a declared interest in utilising telehealth solutions and developing clinical networks. The Forum's Chair will be appointed by the Chair of the NHITB.
Telehealth Leadership Group members will be recruited by a formal Expression of Interest process. Additional members may be co-opted at any time. Membership will be for an initial period of one year.
Responsibilities of Telehealth Leadership Group
- Members will be expected to make an effort to attend all relevant meetings and allocate sufficient time to relevant pre-reading and providing feedback.
- In the event that Members cannot make a meeting, they will be asked to ensure that any specific inputs they have, or have been asked for, are provided by phone or email.
- If a Member is absent from three consecutive meetings a replacement will be sought from the sector.
- Members do not represent specific organisational interests, although they will be expected to provide input in areas of their expertise.
- If Members attend workshops, meetings or conferences as a Leadership Group Member, they are requested to submit a brief report to the Forum highlighting any specific issues that may require attention or further guidance.
Meetings, agenda and quorum
Meetings of the Telehealth Leadership Group will be held quarterly with the option to call for a special meeting if appropriate. Sufficient notice will be given for optimum attendance. Agendas, minutes and any reports will be sent electronically a minimum of 5 working days prior to the meeting. The minutes from the previous meeting will be approved at the beginning of each meeting.
A quorum shall consist of 50% of the Telehealth Leadership Group membership.
The Chair of the Forum will be the primary spokesperson. Telehealth Leadership Group members are not authorised to speak on behalf of NIHI, the NHITB or Ministry of Health.
The National Health IT Board will require regular quarterly reports from the Forum's Chair.
It is expected that all Telehealth Leadership Group members will report back to their various stakeholder groups and organisations on progress.
Attendance fees / remuneration
Telehealth Leadership Group members will not be paid by the Forum for their involvement with the Forum. In exceptional circumstances, reasonable costs of travel to and from Telehealth Leadership Group meetings or for meetings members are asked to attend on behalf of the Forum, will be reimbursed by the Forum, as long as prior approval to attend has been given by the Chair.
Occasionally Telehealth Leadership Group members may become aware of information that is not in the public arena. In such circumstances they are expected to use discretion and good judgement and not disseminate or publicise such information.
Conflicts of interest
Telehealth Leadership Group members must perform their functions in good faith honestly, and impartially, and avoid situations that might compromise their integrity or otherwise lead to conflicts of interest. When members believe that they have a conflict of interest on a subject that will prevent them from reaching an impartial decision or undertaking an activity consistent with the Forum's functions, they must declare that conflict of interest and withdraw themselves from the discussion and / or activity.