Understanding the urban bias: healthcare delivery in remote settings
The COVID-19 pandemic has accelerated the growth for remote delivery of healthcare. Those that would traditionally be considered as face-to-face industries. Such as primary healthcare. Have been transformed by the emergence of virtual services and connected health devices. This is especially true for healthcare providers operating in some of the most rural and remote areas of Australia.
Dr Ewen McPhee is a past president of the Australian College of Rural and Remote Medicine (ACRRM) and a specialist in Rural Generalist Medicine. He leads a small team of clinical staff who are the main healthcare providers in Emerald. A rural town in Central Queensland with an urban population of just over 15,000.
The nearest secondary hospital in Rockhampton is a three-hour drive away. Brisbane hospital, the territory centre, is a staggering 1,000 kilometres away. Many would agree that it is not the ideal place to have a heart attack, even before the challenges of a global pandemic came into play.
According to Dr McPhee; ‘We are seeing more and more people in our community with chronic and complex illness that want to make an application for home oxygen for example. Traditionally they don’t have access to blood gasses and may need to go to the emergency department to get that test in order to make the application. That is just one example of the significant access issues people living in rural and remote settings face to getting the care they need.’
Connected health and patient monitoring systems
While services such a Telehealth have made communications between patients and doctors more accessible during the pandemic, the same cannot be said for those living in rural and remote communities. Dr McPhee believes there is a strong urban bias in the decisions made in the healthcare sector.
Dr McPhee said; ‘It is often forgotten that many parts of rural, regional and remote Australia have very poor connectivity. Both for the patient and provider. Affordability of good internet can also be an issue. Telehealth is great. The video-conferencing function is considered better for assessments and examinations. However, conducting them requires bandwidth that some rural practices do not have.’
For those operating in the connected health device and remote patient monitoring space however, it is always a good time to reach out to healthcare providers operating in rural and remote settings. In fact, connected health has always been important to physicians like Dr McPhee. It allows them to monitor their patients from afar.
Improving care in remote and rural communities
Commenting on elements that would dramatically improve the level of care given in remote and rural communities Dr McPhee said; ‘Being able to test for and provide electrolyte readings, full blood counts, troponin, ACG and microbiology through point of care testing would better inform our clinical decisions. It could mean the difference between identifying that really sick child or missing their diagnosis and therefore delaying their treatment.’
The Commonwealth, State and Northern Territory governments have developed a National Strategic Framework for rural and remote health. It presents a national strategic vision for the healthcare of those living in hard-to-reach settings.
The Framework recognises the unique challenges of providing healthcare in rural and remote areas and the importance of providing timely access to quality and safe services, no matter where somebody lives.
The outline suggests that there is appetite for medical device and medical technology companies to put forward solutions to tackling the delivery of rural and remote healthcare.
One example outlined in the Framework is the Cardiac Clinical Management in rural emergency departments of South Australia. The integrated, digital and state-wide system includes upgraded equipment to Country Health SA hospitals, a centrally supported cardiac management network and a digital system to enable transmission and assessment of ECGs.
The upgrade will assist SA hospitals to manage potentially critical situations. Achieving better health outcomes through more rapid assessment. It also reduces the necessity for inter-hospital transfers, which is a common occurrence in remote areas of the country.