Remote and rural health care in an online world

  • woman using laptop for remote conversation
NSW Rural Doctors Network
Dr John Curnow, Chair

The COVID-19 pandemic has brought into sharp focus the need for an increased rural health workforce, and for innovation in health care delivery. Whether it’s pivoting to digital modalities to deliver care or the introduction of new Medicare telehealth item numbers, the Australian health workforce is adapting and should be commended for its resourcefulness. Whilst we cannot pretend there has not been significant disruption to services, together we have demonstrated versatility, flexibility and a commitment to delivering continuity of care in an ever-changing landscape.

The use of digital technologies has been critical to this. Some have even heralded their rapid rollout as a revolution in health care; however in reality, rural health has driven elements of technology-enabled services for decades.

Those practising in remote and rural communities know all too well that online health care delivery doesn’t just happen at the push of a button. It isn’t a magic program that can be rolled out in a one-size-fits-all fashion. And it is no substitute for face-to-face care.

We must all remember that community-led responses to health care are created by listening to those who deliver and receive it. Adapting models of practice and service delivery to meet specific local requirements is key. We must ensure we never lose sight of the need for technology to be embraced as part of a whole-of-care response, to be integrated with other delivery systems and other innovation, and not to be an end in itself. We must support local practice as the face of service to community.

We hear general practices and primary care providers when they say that although positive about developments, the logistical and administrative requirements of these burgeoning online ecosystems can be daunting. A practice needs the right business infrastructure in place to implement tele-practice such as equipment and software systems. Clinical governance, staff training, risk management, privacy and security are also critical considerations. No two practices have identical needs or technical capabilities, and guidance to integrating online capability must respect this diversity, and safeguard against the predatory behaviour of some private corporations promising silver bullets in the telehealth space.

However, with the right approach and the right support, these online developments have the capacity to bring long-lasting benefits to the health and wellbeing of Australia’s remote and rural communities.

To help the rural health workforce adjust, NSW Rural Doctors Network (RDN) has launched several new initiatives, all ever-evolving as we develop a clear idea of need.

The Virtual Health Workforce Register and Matching Service connects appropriate candidates with practices to provide additional or replacement workforce coverage via telehealth and upholds the principle of locally-driven solutions to maintain patient access. The Register now holds more than 1000 registrations from GPs, nurses, allied health professionals, specialists, practice managers and administrators.

We have moved our professional development and training opportunities online and expanded their availability to meet demand. RDN hosted more than 60 events for 5000 health professionals over three months.

We remain receptive to new ideas and the use of new tools that bring improved health outcomes for our remote and rural populations.

The needs of our rural workforce are evolving and RDN is responding to these new needs. While telehealth is nothing new, the scale at which it is now being implemented requires new and adaptive thinking. We must never be afraid to embrace change. However, in doing so, we must always remember that our patients are people, our health workforce is human and how we offer care must be community-led. We need to keep listening and remain aware that technologies will only be successful with appropriate preparation and the support of logistical and administrative infrastructure. There is no magic switch.

Dr John Curnow is Chair of NSW Rural Doctors Network (RDN). RDN is a not-for-profit, non-government charitable organisation and is the Australian Government’s designated Rural Workforce Agency for health in NSW.

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