Two-thirds of rheumatology patients living in remote Queensland say they do not prefer a face-to-face local consultation over a telemedicine consult, a survey shows.
The findings highlight not only the feasibility but also the acceptability of running telemedicine consults in northern Queensland, the authors led by registrar and rheumatology trainee Katherine Poulsen from Townsville hospital say.
Difficulty in accessing rheumatology care in remote and rural areas of Australia is nothing new but in Queensland the situation is particularly dire, with recent figures showing there are just 35 rheumatologists, or 0.0078 of a rheumatologist per 1,000 population.
Townsville Hospital has been providing a telemedicine service to Mount Isa for over three years because the three monthly fly-in-fly-out service was unable meet patient demands, Poulsen and colleagues explain in their paper published in the Journal of Rheumatic Diseases.
A trip to Townsville to see a rheumatologist could involve a 20-hour drive or an expensive flight, the cost of an overnight stay, as well as time off work.
It’s easy to see how a telemedicine service in these circumstances is appealing but one concern is that it could compromise rapport and health outcomes, the authors say.
To gage how accepting patients were of their telemedicine service the researchers sent a survey to patients attending the Mount Isa telemedicine clinic (n=49).
They then compared the results with two control groups: patients with travel times of over three hours to get to their face-to-face appointment (n=46) and patients seen in one of the three monthly fly-in specialist clinics (n=12).
They found no statistically significant differences between the groups in how patients rated the quality of care except for a question relating to rapport, which favoured the Mount Isa face-to-face group.
Speaking to the limbic Poulsen says this finding supports the view that telemedicine may be best used in conjunction with face-to-face visits.
“We try to see patients face to face for their first appointment as this enables us to examine the patient and build rapport before we see them in a routine follow-up consult through our telemedicine service,” she says.
However, the stand out finding according to Poulsen was that less than a third of the telemedicine consultation group said they would have preferred a local face-to-face consultation to another telemedicine consult.
And almost two-thirds indicated they would rather attend another telemedicine consultation than travel to Townsville.
“This provides additional reassurance that the telemedicine consultations are were broadly satisfactory to patients and are a viable option,” they concluded.
Poulsen said she believed one of the reasons behind the success of the service was that they had a health professional attending the teleconsults in Mount Isa with the patients who had some training in rheumatic examination.
“This definitely helped us to successfully manage patients,” she said.