2008-2012 ‘diabetes complications’ was the leading cause of potentially preventable hospitalisations across all seven regions; with a non-Aboriginal rate significantly higher than the state average. Limited regional capacity for diabetes education and long travel distances greatly limits access, resulting in poor health outcomes.
Service gap locations were identified through data analysis and regional consultation. Partnering with Diabetes WA, in March 2015 the Diabetes Telehealth for Country WA Service commenced. The service is delivered via videoconference (or phone if required), and addresses gaps in diabetes education and clinical support for consumers and increases regional capacity through provision of professional development for health professionals in the management of diabetes.
Delivering timely triaged, assessed and individualised education sessions, referral to other services and direct links to local diabetes educators, the service can be provided at home and outside of traditional business hours to support consumer needs. Professional development sessions are delivered in the workplace.
Lessons learned have been applied to subsequent telehealth service development. Flexibility to support tailoring of the service to the specific and unique requirements of each region is integral. Working closely with health professionals and private practices to demonstrate the triage process with referral back to existing services on the ground, ensuring private business models are supported, has been key to service acceptance. Building trust and establishing shared care roles via a virtual multidisciplinary team has resulted in GP and health professional acceptance – with 56% of referrals coming from GPs.
The service is now available across all seven WACHS regions. Since commencement there have been over 1315 occasions of service, with 68 referrals for Aboriginal people. Over 43 hours of health professional upskilling has been delivered. An external evaluation is being finalised. Initial indications are $120,000+ service delivery savings for WACHS whilst saving consumers over 113,000 travel kilometres, with over 90% of consumers saying that using telehealth saved them time and money.