To the Editor: The very real challenges of distance and travel facing people with disabilities in rural and remote Australia were recently highlighted by Samera in this Journal.1 Here at Katherine Hospital, the barriers to care described by Samera are being overcome through the innovative use of telehealth. For example, a 47-year-old Aboriginal woman was admitted to this hospital after suffering a right-sided intracerebral bleed, leaving her with a dense left-sided hemiplegia and severe cognitive deficits.
To facilitate community placement, the woman needed a wheelchair. Customised wheelchair design is undertaken by the Seating Equipment Assessment and Technical (SEAT) service in Darwin, which visits Katherine only once every 4 months. To overcome this, telehealth appointments were arranged by the SEAT occupational therapist at Royal Darwin Hospital, who remotely guided the occupational therapist at Katherine Hospital through the complex patient assessments that were necessary. As a result, a customised wheelchair was delivered to Katherine Hospital within 6 weeks.
What would previously have taken many months, including two dedicated aeromedical flights to and from Darwin and multiple transfers between hospitals, was all achieved while the patient remained in her room at Katherine Hospital.
Telehealth for Aboriginal patients in remote areas is an ideal model of culturally safe care. It enables a patient to use speciality services in familiar local environments and in the company of their family and trusted health care providers, resulting in greatly improved cultural and language communication and decision making.
Telehealth also overcomes the dynamic challenges of distance, travel and extreme weather that are so problematic in northern Australia, and it delivers real benefits in a highly cost-effective and sustainable manner. It is being applied to an increasingly diverse range of clinical interactions, providing highly valuable improvements in health care delivery to patients. Telehealth is rapidly becoming a community expectation, the new paradigm of equitable access to health care in remote Australia.
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