Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations?
Abstract Background The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. T...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09265-2 |
| _version_ | 1797850177896185856 |
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| author | Supriya Mathew Michelle S. Fitts Zania Liddle Lisa Bourke Narelle Campbell Lorna Murakami-Gold Deborah J Russell John S. Humphreys Edward Mullholand Yuejen Zhao Michael P. Jones John Boffa Mark Ramjan Annie Tangey Rosalie Schultz John Wakerman |
| author_facet | Supriya Mathew Michelle S. Fitts Zania Liddle Lisa Bourke Narelle Campbell Lorna Murakami-Gold Deborah J Russell John S. Humphreys Edward Mullholand Yuejen Zhao Michael P. Jones John Boffa Mark Ramjan Annie Tangey Rosalie Schultz John Wakerman |
| author_sort | Supriya Mathew |
| collection | DOAJ |
| description | Abstract Background The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. This paper explores the perspectives of health care staff on the key elements relating to the effective use of telehealth for patients living in remote Australia. Methods Between February 2020 and October 2021, interviews and discussion groups were conducted with 248 clinic staff from 20 different remote communities across northern Australia. Interview coding followed an inductive approach. Thematic analysis was used to group codes into common themes. Results Reduced need to travel for telehealth consultations was perceived to benefit both health providers and patients. Telehealth functioned best when there was a pre-established relationship between the patient and the health care provider and with patients who had good knowledge of their personal health, spoke English and had access to and familiarity with digital technology. On the other hand, telehealth was thought to be resource intensive, increasing remote clinic staff workload as most patients needed clinic staff to facilitate the telehealth session and complete background administrative work to support the consultation and an interpreter for translation services. Clinic staff universally emphasised that telehealth is a useful supplementary tool, and not a stand-alone service model replacing face-to-face interactions. Conclusion Telehealth has the potential to improve access to healthcare in remote areas if complemented with adequate face-to-face services. Careful workforce planning is required while introducing telehealth into clinics that already face high staff shortages. Digital infrastructure with reliable internet connections with sufficient speed and latency need to be available at affordable prices in remote communities to make full use of telehealth consultations. Training and employment of local Aboriginal staff as digital navigators could ensure a culturally safe clinical environment for telehealth consultations and promote the effective use of telehealth services among community members. |
| first_indexed | 2024-04-09T18:56:12Z |
| format | Article |
| id | doaj.art-9dc94fc604e948059cc10732b8ef7adc |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-09T18:56:12Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-9dc94fc604e948059cc10732b8ef7adc2023-04-09T11:11:39ZengBMCBMC Health Services Research1472-69632023-04-0123111010.1186/s12913-023-09265-2Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations?Supriya Mathew0Michelle S. Fitts1Zania Liddle2Lisa Bourke3Narelle Campbell4Lorna Murakami-Gold5Deborah J Russell6John S. Humphreys7Edward Mullholand8Yuejen Zhao9Michael P. Jones10John Boffa11Mark Ramjan12Annie Tangey13Rosalie Schultz14John Wakerman15Menzies School of Health Research, Charles Darwin UniversityMenzies School of Health Research, Charles Darwin UniversityMenzies School of Health Research, Charles Darwin UniversityDepartment of Rural Health, The University of MelbourneFlinders Rural and Remote Health Northern Territory, College of Medicine and Public Health, Flinders UniversityPocheSA+NT, Flinders UniversityMenzies School of Health Research, Charles Darwin UniversitySchool of Rural Health, Monash UniversityMiwatj Health Aboriginal CorporationNorthern Territory Department of HealthSchool of Psychological Sciences, Macquarie UniversityCentral Australian Aboriginal CongressTop End Population and Primary Health Care, Northern Territory GovernmentNgaanyatjarra Health ServiceNgaanyatjarra Health ServiceMenzies School of Health Research, Charles Darwin UniversityAbstract Background The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. This paper explores the perspectives of health care staff on the key elements relating to the effective use of telehealth for patients living in remote Australia. Methods Between February 2020 and October 2021, interviews and discussion groups were conducted with 248 clinic staff from 20 different remote communities across northern Australia. Interview coding followed an inductive approach. Thematic analysis was used to group codes into common themes. Results Reduced need to travel for telehealth consultations was perceived to benefit both health providers and patients. Telehealth functioned best when there was a pre-established relationship between the patient and the health care provider and with patients who had good knowledge of their personal health, spoke English and had access to and familiarity with digital technology. On the other hand, telehealth was thought to be resource intensive, increasing remote clinic staff workload as most patients needed clinic staff to facilitate the telehealth session and complete background administrative work to support the consultation and an interpreter for translation services. Clinic staff universally emphasised that telehealth is a useful supplementary tool, and not a stand-alone service model replacing face-to-face interactions. Conclusion Telehealth has the potential to improve access to healthcare in remote areas if complemented with adequate face-to-face services. Careful workforce planning is required while introducing telehealth into clinics that already face high staff shortages. Digital infrastructure with reliable internet connections with sufficient speed and latency need to be available at affordable prices in remote communities to make full use of telehealth consultations. Training and employment of local Aboriginal staff as digital navigators could ensure a culturally safe clinical environment for telehealth consultations and promote the effective use of telehealth services among community members.https://doi.org/10.1186/s12913-023-09265-2First NationsAboriginal peopleTelemedicineVideo consultationRemote consultationDigital health |
| spellingShingle | Supriya Mathew Michelle S. Fitts Zania Liddle Lisa Bourke Narelle Campbell Lorna Murakami-Gold Deborah J Russell John S. Humphreys Edward Mullholand Yuejen Zhao Michael P. Jones John Boffa Mark Ramjan Annie Tangey Rosalie Schultz John Wakerman Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? BMC Health Services Research First Nations Aboriginal people Telemedicine Video consultation Remote consultation Digital health |
| title | Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? |
| title_full | Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? |
| title_fullStr | Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? |
| title_full_unstemmed | Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? |
| title_short | Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? |
| title_sort | telehealth in remote australia a supplementary tool or an alternative model of care replacing face to face consultations |
| topic | First Nations Aboriginal people Telemedicine Video consultation Remote consultation Digital health |
| url | https://doi.org/10.1186/s12913-023-09265-2 |
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