Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

The reported benefits of telehealth for rural Australians

Jennifer J. Moffatt A B and Diann S. Eley A

A The University of Queensland, School of Medicine, Rural Clinical School, Locked Bag 9009, Toowoomba DC, QLD 4350, Australia. Email: d.eley@uq.edu.au

B Corresponding author. Email: j.moffatt@uq.edu.au

Australian Health Review 34(3) 276-281 http://dx.doi.org/10.1071/AH09794
Submitted: 14 June 2009  Accepted: 4 November 2009   Published: 25 August 2010

Abstract

Objective. A literature review was conducted to identify the reported benefits attributed to telehealth for people living and professionals working in rural and remote areas of Australia.

Data sources. Scopus and relevant journals and websites were searched using the terms: telemedicine, telehealth, telepsychiatry, teledermatology, teleradiology, Australia, and each state and territory. Publications since 1998 were included.

Study selection. The initial search resulted in 176 articles, which was reduced to 143 when research reporting on Australian rural, regional or remote populations was selected.

Data synthesis. A narrative review was conducted using an existing ‘benefits’ framework. Patients are reported to have benefited from: lower costs and reduced inconvenience while accessing specialist health services; improved access to services and improved quality of clinical services. Health professionals are reported to have benefited from: access to continuing education and professional development; provision of enhanced local services; experiential learning, networking and collaboration.

Discussion. Rural Australians have reportedly benefited from telehealth. The reported improved access and quality of clinical care available to rural Australians through telemedicine and telehealth may contribute to decreasing the urban–rural health disparities. The reported professional development opportunities and support from specialists through the use of telehealth may contribute to improved rural medical workforce recruitment and retention.

What is known about the topic? An extensive international literature has reported on the efficacy of telehealth, and to a lesser extent the clinical outcomes and cost-effectiveness of telemedicine. Systematic reviews conclude that the quality of the studies preclude definitive conclusions being drawn about clinical and cost-effectiveness, although there is some evidence of effective clinical outcomes and the potential for cost-benefits. Little attention has been paid to the benefits reported for people who live in rural and remote Australia, despite this being a rationale for the use of telehealth in rural and remote locations.

What does this paper add? Patients in rural and remote locations in Australia are reported to benefit from telehealth by increased access to health services and up-skilled health professionals. Health professionals are reported to benefit from telehealth by up-skilling from increased contact with specialists and increased access to professional development. The review findings suggest that one strategy, the increased use of telehealth, has the potential to reduce the inequitable access to health services and the poorer health status that many rural Australians experience, and contribute to addressing the on-going problem of the recruitment and retention of the rural health workforce.

What are the implications for practitioners? The use of telehealth appears to be a path to up-skilling for rural and remote practitioners.


References

[1]  Roine R Ohinmaa A Hailey D 2001 Assessing telemedicine: a systematic review of the literature. CMJA 165 6 765 71

[2]  Hersh WR Hickam DH Severance SM Dana TL Pyle Krages K Helfand M 2006 Diagnosis, access and outcomes: update of a systematic review of telemedicine services. J Telemed Telecare 12 Suppl. 2 3 31
doi:10.1258/135763306778393117

[3]  Whitten PS Mair FS Haycox A May CR Williams TL Hellmich S 2002 Systematic review of cost effectiveness studies of telemedicine interventions. BMJ 324 7351 1434 7 doi:10.1136/bmj.324.7351.1434

[4]  Hailey D Ohinmaa A Roine R 2004 Study quality and evidence of benefit in recent assessments of telemedicine. J Telemed Telecare 10 6 318 24 doi:10.1258/1357633042602053 Pubmed Abstract [Review]

[5]  Norton SA Burdick AE Phillips CM Berman B 1997 Teledermatology and underserved populations. Arch Dermatol 133 2 197 200 doi:10.1001/archderm.133.2.197 Pubmed Abstract

[6]  Chandrashekhar AK 1992 Telemedicine in Gulf War. Aviat Space Environ Med 63 2 135 7 [Comment 1998; 69(9): 918].

[7]  Mair F Fraser S Ferguson J Webster K 2008 Telemedicine via satellite to support offshore oil platforms. J Telemed Telecare 14 3 129 31
doi:10.1258/jtt.2008.003008 Pubmed Abstract

[8]  Yellowlees P McCoy WT 1993 Telemedicine. A health care system to help Australians. Med J Aust 159 7 437 8 Pubmed Abstract

[9]  Humphreys JS 2009 Key considerations in delivering appropriate and accessible health care for rural and remote populations: discussant overview. Aust J Rural Health 17 1 34 8 doi:10.1111/j.1440-1584.2008.01034.x Pubmed Abstract

[10]  Margolis SA Ypinazar VA 2008 Tele-pharmacy in remote medical practice: the Royal Flying Doctor Service Medical Chest Program. Rural Remote Health 8 2 937 Pubmed Abstract

[11]  Department of Health and Ageing. Report on the audit of health workforce in rural and regional Australia. Canberra: Australian Government Department of Health and Ageing; 2008.

[12]  Brear M 2006 Evaluating telemedicine: lessons and challenges. HIM J 35 2 23 31 Pubmed Abstract

[13]  Smith AC Gray LC 2009 Telemedicine across the ages. Med J Aust 190 1 15 9 Pubmed Abstract

[14]  McDonald I , Hill S , Daly J , Crowe B . Evaluating telemedicine in Victoria: a generic framework. Melbourne: Victorian Government Department of Human Services; 1998.

[15]  Smith AC Youngberry K Christie F Isles A McCrossin R Williams M et al 2003 The family costs of attending hospital outpatient appointments via videoconference and in person. J Telemed Telecare 9 Suppl. 2 58 61 doi:10.1258/135763303322596282

[16]  Buist A Coman G Silvas A Burrows G 2000 An evaluation of the telepsychiatry programme in Victoria, Australia. J Telemed Telecare 6 4 216 21 doi:10.1258/1357633001935383 Pubmed Abstract

[17]  Cowain T 2001 Cognitive–behavioural therapy via videoconferencing to a rural area. Aust N Z J Psychiatry 35 1 62 4 doi:10.1046/j.1440-1614.2001.00853.x Pubmed Abstract

[18]  D’Souza R 2000 Telemedicine for intensive support of psychiatric inpatients admitted to local hospitals. J Telemed Telecare 6 Suppl. 1 26 8 doi:10.1258/1357633001934834 Pubmed Abstract

[19]  Cregan P Stapleton S Wilson L et al 2005 The ViCCU Project – achieving virtual presence using ultra broadband internet in a critical clinical application – initial results. Stud Health Technol Inform 111 94 8 Pubmed Abstract

[20]  Doessel DP Travers H Hunter E 2007 The use of touch-screen technology for health-related information in indigenous communities: some economic issues. Prometheus 25 4 373 92 doi:10.1080/08109020701689227

[21]  Trott P 1996 The Queensland northern regional health authority telemental health project. J Telemed Telecare 2 Suppl. 1 98 104 doi:10.1258/1357633961929457 Pubmed Abstract

[22]  Gelber H Alexander M 1999 An evaluation of an Australian videoconferencing project for child and adolescent telepsychiatry. J Telemed Telecare 5 Suppl. 1 21 3 doi:10.1258/1357633991933297 Pubmed Abstract

[23]  Starling RN O’Connell C Couzos C 2005 NACCHO GP network – enhancing communication in Aboriginal health. S. Aust Fam Physician 34 10 849 50 Pubmed Abstract

[24]  Blignault I 2000 Multipoint videoconferencing in health: a review of three years’ experience in Queensland, Australia. Telemed J 6 2 269 74 doi:10.1089/107830200415216 Pubmed Abstract

[25]  Dillon E Loermans J Davis D Xu C 2005 Evaluation of the Western Australian Department of Health telehealth project. J Telemed Telecare 11 Suppl. 2 19 21 doi:10.1258/135763305775124803

[26]  Lessing K Blignault I 2001 Mental health telemedicine programmes in Australia. J Telemed Telecare 7 6 317 323 doi:10.1258/1357633011936949

[27]  Greenwood J Williams R 2008 Continuing professional development for Australian rural psychiatrists by videoconference. Australas Psychiatry 16 4 273 6 doi:10.1080/10398560801982994 Pubmed Abstract

[28]  Hayward T Mitchell JG 1999 Renal case conference using teleradiology and videoconferencing between Adelaide and Alice Springs. J Telemed Telecare 5 3 205 7 doi:10.1258/1357633991933530 Pubmed Abstract

[29]  McColl I 2003 Dermatology education on the web. J Telemed Telecare 9 Suppl. 2 33 5 doi:10.1258/135763303322596200 Pubmed Abstract

[30]  Yellowlees P Kennedy C 1996 Telemedicine applications in an integrated mental health service based at a teaching hospital. J Telemed Telecare 2 205 9 doi:10.1258/1357633961930086 Pubmed Abstract

[31]  Kennedy C Blignault I Hornsby D Yellowlees P 2001 Videoconferencing in the Queensland health service. J Telemed Telecare 7 5 266 71 doi:10.1258/1357633011936516 Pubmed Abstract

[32]  Smith AC Scuffham P Wootton R 2007 The costs and potential savings of a novel telepaediatric service in Queensland. BMC Health Serv Res 7 35 doi:10.1186/1472-6963-7-35 Pubmed Abstract

[33]  Trott P Blignault I 1998 Cost evaluation of a telepsychiatry service in northern Queensland. J Telemed Telecare 4 Suppl. 1 66 8 doi:10.1258/1357633981931515 Pubmed Abstract

[34]  Eedy DJ Wootton R 2001 Teledermatology: a review. Br J Dermatol 144 4 696 707 doi:10.1046/j.1365-2133.2001.04124.x Pubmed Abstract

[35]  Australian Institute of Health and Welfare. Rural, regional and remote health. Indicators of health status and determinants of health. Report No. 9. Canberra: Australian Institute of Health and Welfare; 2008.

[36]  Swanson B 1999 Information technology and under-served communities. J Telemed Telecare 5 Suppl. 2 3 10 doi:10.1258/1357633991933468 Pubmed Abstract

[37]  Barry CJ Constable IJ McAllister IL Kanagasingam Y 2006 Diabetic screening in Western Australia: a photographer’s perspective. J Vis Commun Med 29 2 66 75 doi:10.1080/01405110600890459 Pubmed Abstract

[38]  Dillon E Loermans J 2003 Telehealth in Western Australia: the challenge of evaluation. J Telemed Telecare 9 Suppl. 2 15 9

[39]  Mitchell BR Mitchell JG Disney AP 1996 User adoption issue in renal telemedicine. J Telemed Telecare 2 2 81 6
doi:10.1258/1357633961929835 Pubmed Abstract

[40]  Mathews KA Elcock MS Furyk JS 2008 The use of telemedicine to aid in assessing patients prior to aeromedical retrieval to a tertiary referral centre. J Telemed Telecare 14 6 309 14 doi:10.1258/jtt.2008.080417 Pubmed Abstract

[41]  Hall G Hennessy M Barton J Coroneo M 2005 Teleophthalmology-assisted corneal foreign body removal in a rural hospital. Telemed J E Health 11 1 79 83 doi:10.1089/tmj.2005.11.79 Pubmed Abstract

[42]  Ellis I 2005 The clinical champion role in the development of a successful telehealth wound care project for remote Australia. J Telemed Telecare 11 Suppl. 2 26 8 doi:10.1258/135763305775124687 Pubmed Abstract

[43]  Faulkner K McClelland L 2002 Using videoconferencing to deliver a health education program to women health consumers in rural and remote Queensland: an early attempt and future plans. Aust J Rural Health 10 1 65 72 doi:10.1046/j.1440-1584.2002.00434.x Pubmed Abstract

[44]  Phillips JL Davidson PM Newton PJ Digiacomo M 2008 Supporting patients and their caregivers after-hours at the end of life: the role of telephone support. J Pain Symptom Manage 36 1 11 21 doi:10.1016/j.jpainsymman.2007.08.017 Pubmed Abstract

[45]  St George I Cullen M Gardiner L Karabatsos G 2008 Universal telenursing triage in Australia and New Zealand – a new primary health service. Aust Fam Physician 37 6 476 9 Pubmed Abstract

[46]  D’Souza R 2000 A pilot study of an educational service for rural mental health practitioners in South Australia using telemedicine. J Telemed Telecare 6 Suppl. 1 187 9 doi:10.1258/1357633001934627 Pubmed Abstract

[47]  Harris V Smith AC Armfield NR 2007 Education for regional health professionals using mobile videoconferencing. J Telemed Telecare 13 Suppl. 3 44 7 doi:10.1258/135763307783247275

[48]  Chan FY Soong B Taylor A Bornick P Allen M Cincotta R et al 2003 Fetal endoscopic telesurgery using an internet protocol connection: clinical and technical challenges. J Telemed Telecare 9 Suppl. 2 12 4 doi:10.1258/135763303322596138

[49]  Morris DG 2000 Using telemedicine to facilitate training in cardiotocography (CTG) interpretation. J Telemed Telecare 6 Suppl. 1 53 5 doi:10.1258/1357633001934140 Pubmed Abstract



Export Citation