Australia needs a national telehealth plan to improve health outcomes and save health dollars and it must include the needs of rural, remote and indigenous communities from inception, says a rural emergency room doctor.
Dr Shannon Nott, a junior doctor who was one of the founding co-chairs of Future Health Leaders in 2011, spent four months in 2014 researching telehealth in rural and remote Alaska, Canada and Brazil including indigenous communities as part of his Churchill Fellowship.
He is a currently working as a locum in the emergency department in Broken Hill and spent the three years before his study tour working in the Orange Health Service in central-west NSW following extensive work as a student in rural and remote health centres.
Speaking ahead of his presentation at next month’s Australian Telehealth Conference where he will present learnings from the trip abroad, Dr Nott said Australian Governments needed to focus on the growing international evidence that telehealth programs work.
“There needs to be a telehealth plan put in place in Australia. We need to start looking at and say this is something we should seriously invest in,” Dr Nott told Australian Ageing Agenda.
“We need to look at it and get it right from the start; that includes getting it right for indigenous communities [and] getting it right for rural and remote communities,” he said.
Telehealth programs will need to fit each community’s circumstances, he said.
“We know from lessons learnt from non-telehealth programs that we can’t do a one-size-fits all type of thing for rural and remote communities.”
There are many strategies within telehealth that Australia could implement in rural and remote healthcare in homes, communities, GP clinics, hospitals and aged care that will improve patient health outcomes and save money within the health system.
“For instance, in Alaska for every dollar that they spend on telehealth software and programs they save $10.50 in travel alone in terms of healthcare costs. Not to mention the hospital admissions avoided, the GP admissions avoided.”
Dr Nott said we needed to look at solutions that improved health outcomes, avoided expensive hospital treatment and supported people in their community, which was difficult in rural and remote areas.
“Telehealth bridges that gap … this is something we need to commit to and start having some co-ordination of telehealth because at the moment it is being done in pockets.”
It could be facilitated through community hubs, or virtual hospital networks, or in homes through a resident’s own computer because expensive software was not required, he said.
Dr Nott said he found teleheath in the home was one of the key effective implementations from his study tour that could be applied in Australia with older people to help self-manage chronic illnesses.
“You are able to see trends in time … and implement interventions that are able to avoid bad outcomes at a later date. They allow people to feel supported to live at home with these diseases that will essentially be with them for the rest of their lives.”
In indigenous communities, Dr Nott said community empowerment and engagement was one of the key elements Australia could adopt.
“In Canada and Alaska they liaise very well with the community and get community leaders well-engaged and involved at a grassroots level. There is no paternalistic top down approach to it. There is real discussion and ownership of telehealth programs within communities.”
Telehealth also needed to be delivered in a culturally appropriate manner through local telehealth co-ordinators, which will also support community member involvement, he said.
“Being able to allow telehealth co-ordinators who are local members of indigenous communities is a step in the right direction because that allows streamlined telehealth appointments within rural and remote communities.”
For instance in Canada, some of those co-ordinators, who were technically administrators, also acted as interpreters and the person who picked the patient up for appointments, he said.
The HISA Australian Teleheath Conference 2015 is taking place on 23 – 24 April in Sydney.
AAA Technology Review is the conference media partner.