Internal Medicine Journal
Volume 44, Issue 10, 2014, Pages 981-985

Telehealth: Experience of the first 120 consultations delivered from a new refugee telehealth clinic (Article)

Schulz T.R. , Richards M. , Gasko H. , Lohrey J. , Hibbert M.E. , Biggs B.-A.*
  • a Victorian Infectious Diseases Service, Australia, Department of Medicine, Melbourne Academic Centre, Doherty Institute, The University of Melbourne, Australia
  • b Victorian Infectious Diseases Service, Australia, VICNISS Healthcare Associated Infection Surveillance System, Royal Melbourne Hospital, Australia
  • c VICNISS Healthcare Associated Infection Surveillance System, Royal Melbourne Hospital, Australia
  • d Arcitecta, Melbourne, VIC, Australia
  • e Department of Medicine, Melbourne Academic Centre, Doherty Institute, The University of Melbourne, Australia
  • f Victorian Infectious Diseases Service, Australia, Department of Medicine, Melbourne Academic Centre, Doherty Institute, The University of Melbourne, Australia

Abstract

Background: In 2011, the Australian Government introduced Medicare item numbers for telehealth consultations. This is a rapidly expanding method of healthcare provision. Aims: We assessed the demographic and disease profile of refugee patients attending a new telehealth clinic, and calculated the patient travel avoided. We examined technical challenges and assessed the performance of two videoconferencing solutions using different bandwidth and latencies. Methods: We audited the first 120 patients attending the telehealth clinic. During consultations, the patient was with the general practitioner (GP) and linked by internet videoconference using VIDYO, GoToMeeting or Skype, to the specialist at a tertiary referral hospital. Travel avoided was calculated and technical problems were assessed by the participating specialist. Bandwidth and latency variations were examined within a university broadband testing facility. Results: The two most frequently managed conditions were hepatitis C and latent tuberculosis. Twenty-nine different GP were included and 42 consultations required an interpreter. Nearly 500km of travel and 127kg of CO2 production was avoided per consultation. Technical issues were faced in 25% of consultations, most frequently sound problems and connections dropping out. A bandwidth of at least 512kbps and latency of no more than 300ms was necessary to conduct an adequate multipoint videoconference. Conclusions: Telehealth using videoconferencing adds a new component to care of refugee and immigrant patients settling in regional areas. Telehealth will be improved by changes to improve simplicity and standardisation of videoconferencing, but requires ongoing Medicare funding to allow sufficient administrative support. © 2014 Royal Australasian College of Physicians.

Author Keywords

Immigrant Telehealth Telemedicine Refugee

Index Keywords

refugee Australia economics videoconferencing human Refugees middle aged statistics and numerical data General Practitioners general practitioner Feasibility Studies Humans male latent tuberculosis female evaluation study Ambulatory Care Facilities outpatient department patient satisfaction standards feasibility study organization and management adult health care delivery Telemedicine Health Services Accessibility hepatitis C
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84913535381&doi=10.1111%2fimj.12537&partnerID=40&md5=0f8868ca5f49e48ce24a124b71f7b8d2
DOI: 10.1111/imj.12537
ISSN: 14440903
Cited by: 12
Original Language: English