First published May 27, 2016
Many of us may not know how telehealth is actually used in patient care. Whether in a metropolitan hospital or clinic setting, we may not be exposed to telehealth in Australia unless our clinical team has partnered with a rural healthcare provider using telehealth. Without this exposure, how are clinicians able to advocate for telehealth?
The Australian Telehealth Conference provided many examples of how telehealth is used in clinical settings. Here’s a summary of some of the highlights below.
Prof Mohamed Khadra at the Australian Telehealth Conference 2016. Photo: The Medical Startup
Prof Mohamed Khadra, Consultant Urologist and author, spoke of home dialysis monitoring through his colleague’s “My Home Hemo App,” allowing patients to log their haemodialysis sessions for their doctors and nurses to view remotely. Telehealth is also used for Aged Care Outreach, where nurses can update clinical notes and pictures when they perform home visits, and patients can spend more time at home rather than in transit to appointments. In theatre, Prof Khadra spoke of double consoles for robotic surgery; the robot extends the range of the human wrist 360 degrees, providing immense help with surgery.
What does he think helped his Local Health District implement new programs and embrace change? “Having that model of people who are dedicated to the project,” he said. Telehealth-specific rooms and Telehealth staff members have been implemented in hospitals across the country to focus on these programs. Prof predicts that digital health can improve anaesthetic monitoring; medical and nursing student training; and post-op patient monitoring. Wearables may also grow into the mainstream; Prof Khadra imagined a sensor on OpSites (surgical wound dressings) which alerts the clinician when there’s a leak or increased warmth, so assessment and antibiotics can be started earlier.
A/Prof Andrew Kornberg (Paediatric Neurologist), and Susan Jury (Telehealth Program Manager) of the Royal Children’s Hospital discussed how attendance rates at child psychiatry clinics dramatically improved when conducted through telehealth. Children usually feel more comfortable at home, and thus are more likely to open up to their clinician. Being home also means the clinician can meet siblings and other family members they wouldn’t have seen otherwise, and see this interaction firsthand. Telehealth clinics are held in a dedicated Telehealth Clinic room, or in the specialist’s rooms.
Prof Kornberg also mentioned how Telehealth consults are performed by Anaesthetists at Pre-Admission Clinics; attendance rates are impacted as 20% of the RCH’s patients are from regional areas. Physiotherapists at the RCH also conduct HITH (Hospital in the Home) consults for cystic fibrosis sufferers. A lifelong condition, cystic fibrosis patients and their families are subject to countless appointments each year, and juggling this with school, work and other family members can take its toll.
For diabetic patients, screening for diabetic retinopathy can be challenging when working in isolated rural communities, like the mines of the Goldfields in Western Australia. Prof Yogi Kanagasingam of CSIRO has successfully used tele-assessment of retinal images to screen Goldfields residents for diabetic retinopathy (DR). 82 of the 1088 patients screened in his study had DR; 8 of these had severe, sight-threatening DR that needed immediate attention. His software, Remote-I, is able to grade the images according to severity of retinopathy.
Dr Shannon Nott, junior doctor (RMO) and founder of Future Health Leaders, explained how telehealth clinics in western NSW save thousands of kilometres in travel each year. “COPD (emphysema) patients make up 41% of bed days in hospitals,” he said, showing potential cost savings if early discharge programs could be developed with telehealth follow-up for patient convenience. What does he advise if you’ve got an idea for a telehealth program? A Churchill Fellowship recipient, Shannon emphasised the importance of teamwork, passion and keeping data in mind when dreaming up solutions: “As I’m designing this, how can I collect the data that can sustain this program? Find your champions in Clinical, IT and Administration; enthusiasm is like an infectious disease, one of the most potent infectious diseases out there.”
Learning about these uses for telehealth helps us imagine a future where barriers to accessing quality healthcare are reduced. With Australia’s vast geography, some regions will be exposed to telehealth more than others, and the challenge will be to deliver the services to those who need it most, at minimal cost. We learnt a lot from attending the ATC, and similarly, clinicians and non-clinicians alike can learn from attending conferences like these for the future of medicine. For those who attended, full presentations can be viewed for a very limited time via the Armchair Mobile App for online lectures.
The Health Informatics Society of Australia is led by Dr Louise Schaper, a former Occupational Therapist and now CEO of HISA. HISA runs education programs and events online and across Australia for anyone interested in health informatics and the future of healthcare. We thank HISA for providing us access to the Australian Telehealth Conference, and for those who couldn’t attend, their annual conference on Digital Health and Innovation, HIC 2016 and their Hacking Health hackathon, will be held in Melbourne in July.