After being catapulted onto the MBS rebate schedule at the start of the COVID-19 pandemic, few would doubt that telehealth has now earned its place as a permanent fixture of mainstream clinical practice. Backed by some encouraging uptake statistics, Federal Health Minister Greg Hunt recently touted its benefits for people who have children, mobility issues, or less flexible workplaces.
But while the arrival of the technology has mainly been celebrated, some patient cohorts have been overlooked in reviews of its impact. Dr Lorraine Anderson, a Medical Director at Kimberley Aboriginal Medical Services (KAMS), says Indigenous communities are warming to telehealth, but warns that more work is needed to improve access and spare these groups from further healthcare disparities.
“Aboriginal residents in remote WA already experience a range of health and wellbeing disparities that stem from colonisation, historical and contemporary trauma, structural racism and other social determinants of health,” she said ahead of the National Telehealth Conference, hosted by Informa Connect.
“Telehealth may heighten these disparities. Many Aboriginal patients and clinicians in these communities are unfamiliar with the technology, do not have ready access to the technology, and lack the required support and workforce capacity to use the technology. While Aboriginal Health Workers could play a role, there is no ongoing funding for them to support patients for their telehealth consultations. Additionally, there is no clear definition for their role in some jurisdictions.
“Ensuring equitable and culturally-secure access to health services is central to facilitating good health outcomes,” she added.
Dr. Anderson notes that, while telehealth will never fully replace face-to-face consultations in primary health care, it does have the capacity to increase availability and access to health services within remote or regional areas. For this reason, a culturally-sensitive telehealth program could be of great benefit to Indigenous patients, many of whom dwell in remote communities.
“Telehealth has the potential to provide tremendous value to Aboriginal people, helping to minimise travel to urban secondary or tertiary health services and disruption to their daily lives. This can reduce family stress for Aboriginal patients when they are primary carers. Additionally, it can reduce travel costs, and increase efficiencies in clinical review and on-flow for remote/regional patients,” she said.
Areas for improvement
At present, several metrics of telehealth success require some focus, Dr. Anderson argued, including the uptake and scope of appointments. “Improving these could enhance health outcomes, patient knowledge, and the capacity to undertake technical examination for telehealth services integration [between patient data and MMEx recording],” she said.
To achieve more uptake among Indigenous cohorts, Dr. Anderson believes it is important to define cultural security in the context of telehealth. “This could increase the scope for Aboriginal Health Practitioners to properly support Aboriginal patients within telehealth services,” she said.
Additionally, health authorities should look to generate data and knowledge about culturally secure telehealth services, in a rigorous and transparent way. This will aid translation across other ACCHS and health service providers, she argued.
Work in progress
Thankfully, efforts to improve telehealth access to Aboriginal people are already underway with a range of initiatives currently being rolled out. The Kimberley Aboriginal Medical Services (KAMS) GP telehealth service is one such initiative. It exclusively targets Indigenous communities ensuring outreach efforts are culturally sensitive.
Meanwhile, a telehealth emergency health initiative has been successfully piloted by WACHS and KAMS in Bidyadanga. The local and state-wide Western Australian Health specialists have also increased their routine delivery of telehealth services, including pre-operative appointments.
While these efforts are encouraging, Dr. Anderson says it is important any initiatives are evaluated for efficacy. “Telehealth initiatives are occurring rapidly and understanding the acceptability and effectiveness of telehealth while continuing to support telehealth innovation is essential,” she said.
Hear more from Dr. Anderson at the National Telehealth Conference hosted by Informa Connect. This year’s event will be held 4-5 May at the Swissotel Sydney. Register now to secure your seat.