Haematology telehealth services a success in regional Australia

Haematology telehealth services that offer regional patients the option of remote video consultations instead of travelling to the city for appointments have proved highly popular in WA.

A review of a year’s operation of the fortnightly telehealth service run out of the Albany Hospital in conjunction with haematologists at Fiona Stanley Hospital in Perth showed that it was highly acceptable to patients who deemed the video consultations as good as face-to-face appointments in most respects.

Patients said they liked having the option of a telehealth consultation, preferably after a first face-to-face review, citing reasons such as avoiding the inconvenience and costs of travel to the city and being able to have family or friends close by for support during a consultation.

The review, published in Internal Medicine Journal, was based on feedback from 93 haematology patients who took used the telehealth service in the year after it was introduced  in September 2018. About half the patients had haematological cancers such as lymphoma and leukaemia, with the remainder having non-malignant disease or yet to receive a diagnosis.

The telehealth service was introduced in a bid to expand and supplement regional access beyond the fly in/fly out clinics provided by metropolitan-based haematologists from Fiona Stanley Hospital.

When surveyed, a common theme from patients was that telehealth appointments were as good as face to face consultations, although a few patients raised technical issues about sound quality not allowing them to hear all the information from the haematologist.

More than 80% of patients agreed or strongly agreed that the telehealth service met their healthcare needs, was easy to use and had high levels of satisfaction. A similar proportion said they would use the service again, although some said they still wanted the opportunity to have a face-to-face encounter.

“… there’s a lot of convenience in being able to come here rather than go, say, to Perth or things like that for the ongoing diagnoses and checks,” said one respondent.

“The only downside to a telehealth conference is there’s no physical contact, there’s no physical examination so basically how are you feeling and that’s it. They can’t actually feel around and look at you physically.”

Patients said an advantage of telehealth service was it allowed local area treatment so they could remain in contact with their support network and avoid the disruption and inconvenience involved in travelling hundreds of kilometres to the city for a 20 minute appointment.

The telehealth model allowed haematologists to expand access to provide 768 occasions of service over 12 months with an average of 18 new referrals per month

With infrastructure and equipment set up costs of just under $10,000, the service also proved highly cost effective, saving an average of over $300 per occasion of service.

The telehealth service covered outpatient clinics and also some inpatient services with investigations coordinated by local specialist teams. Telehealth was also used to enable chemotherapy prescribing by a haematologist at the metropolitan hospital.

The report authors said further research would be desriable to investigate the impact of telehealth on clinical outcomes such as time to first consultations and to commencement of chemotherapy, unplanned admissions, complications of treatment and adherence to treatment guidelines.

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