Harnessing telehealth for rural and remote Australia

The problem: More than 100,000 children in rural, regional and remote Australia cannot access the developmental health services they need, because of where they live.

There are large gaps in country children’s health services, the demand is rising, children are presenting with increasingly complex issues, there is a serious shortage of allied health professionals, and despite investment from governments and partners, challenges with workforce recruitment and retention persist.

These all contribute to poorer outcomes for many country children compared to their city counterparts, and has long-term implications for jobs, services, infrastructure and development in regional Australia.

Working in partnership towards solutions: In 2014 children’s charity Royal Far West (RFW) responded to the need for innovation in rural service delivery by harnessing technology to fill critical service gaps.

Where persistent local gaps exist, telehealth provides opportunities for children and families to access consistent and appropriate services.

RFW’s globally recognised Telecare for Kids program gives children across Australia access to specialised paediatric health services. Working in partnership with preschools, primary schools, parents and local health professionals, RFW provides screening, assessment, therapy and professional capacity-building across Speech Pathology, Occupational Therapy and Clinical Psychology.

Typically, a 30-45-minute session involves a child connecting to clinicians in Manly from their school or home via video link. The session also requires a ‘therapy aide’ who can be a school principal, teacher, learning and support coordinator, teacher’s aide, parent or guardian, and specially designed engagement tools.

Acknowledging the importance of Telecare, RFW’s new Centre for Country Kids, with substantial funding support from the State and Federal Government and philanthropy, has doubled its Telecare capacity, with 20 purpose-built Telecare pods ensuring the best experiences and outcomes for children and clinicians. The Australian Government’s Department of Health’s 2019 budget commitment to support the scale-up of RFW’s Telecare services is further acknowledgement of telehealth as a solution to critical health workforce gaps in rural and remote Australia.

Contributing to the evidence base on the effectiveness and value of telehealth: RFW collaborates on and leads research into the benefits, feasibility, effectiveness and cost-effectiveness of its telehealth program.

A study funded by the National Health and Medical Research Council (NHMRC), led by Professor Mark Dadds at The University of Sydney in partnership with RFW, was designed to test the efficacy of an online, telehealth clinician-supported parenting intervention compared to traditional in-person delivery.

The results show that a therapist-assisted online version of an evidence-based parenting program was at least as effective as intensive face-to-face treatment in reducing child conduct problems for rural families.

RFW also co-authored and published a peer-reviewed journal article with its University of Sydney colleagues Professor Alexandra Martiniuk (NHMRC TRIP fellow) and Dr Seye Abimbola which reviewed telehealth’s value, including the need to think about additional measures of value on top of clinical outcomes, especially to rural and remote communities. Examples include reduced transaction costs to users for accessing a service (cost of fuel, accommodation, time off work and the stress of travelling long-distances to services), time saving potential for clinicians and maximising capacity in the health system.

Conclusion: Telehealth is not a silver bullet for the challenges facing children and families in rural and remote Australia trying to access vital services. But when developed in partnership with communities, government, universities and other key regional partners, and underpinned by rigorous research, telehealth can be a disruptive force for good to help ensure that country kids, their families and communities have the opportunity to reach their full potential.