Telemedicine in the Northern Territory: An assessment of patient perceptions in the preoperative anaesthetic clinic

Roberts, Simon; Spain, Brian; Hicks, Chelsea; London, James B.; Tay, Stanley

doi:10.1111/ajr.12140

Cited by 46 publications

(67 citation statements)

References 11 publications

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“…10,22,23,28 Two studies explored the Indigenous patient's perspective on the use of telehealth. One study reported a 75% preference for teleconsultations over face-to-face consultations, 34 whereas Mooi et al 25 reported that 100% of Indigenous patients preferred telehealth. The higher preference in the latter study may be explained by service type.…”

Section: Discussionmentioning

confidence: 99%

“…Store-and-forward services were used in screening programs for ear health, [22][23][24]28 and diabetic eye disease. 29,30 Video conferencing was used to: provide medical consultations, 25,26,[31][32][33][34][35] for the supervision of chemotherapy administration, 25,26,35 and for the delivery of speech rehabilitation therapy. 36 Remote telehealth monitoring was used for in-home/ in-hub monitoring of chronic diseases in the Staying Strong pilot project.…”

Section: Telehealth Service Characteristics and Patient Interactionsmentioning

confidence: 99%

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Outcomes of using telehealth for the provision of healthcare to Aboriginal and Torres Strait Islander people: a systematic review

Caffery

Bradford

Wickramasinghe

et al. 2017

Australian and New Zealand Journal of Public Health

102

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Objective: To examine reported outcomes of health services delivered by telehealth to Indigenous Australians.Methods: Systematic review of the literature. Searches were conducted to identify articles that reported a telehealth service used to provide clinical services to Indigenous Australians. Articles were screened for inclusion using pre-defined criteria. Findings were synthesised narratively and reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.Results: 14 articles, describing 11 distinct telehealth services, were selected based on the inclusion criteria. Authors of included studies report that telehealth has improved social and emotional wellbeing, clinical outcomes and access to health services for Indigenous Australians. Further, it has reduced travel and improved screening rates. Indigenous people report positive perceptions of their telehealth interaction. Conclusion:Telehealth is used to address poor accessibility to health services and for targeted screening programs for at risk populations. Reported outcomes from existing services demonstrate the potential of telehealth for health service delivery for Indigenous Australians. Confidence in the findings of this review is reduced by the predominance of descriptive studies and small sample sizes in many of the included articles.Implications: Telehealth models of care facilitated through partnerships between Aboriginal community-controlled health services and public hospitals may improve both patient outcomes and access to specialist services for Indigenous people.

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Section: Discussionmentioning

confidence: 99%

Section: Telehealth Service Characteristics and Patient Interactionsmentioning

confidence: 99%

Outcomes of using telehealth for the provision of healthcare to Aboriginal and Torres Strait Islander people: a systematic review

Caffery

Bradford

Wickramasinghe

et al. 2017

Australian and New Zealand Journal of Public Health

102

View full text Add to dashboard Cite

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“…1 The positive patient responses have certainly inspired me to continue to advocate for this technology. 1 The positive patient responses have certainly inspired me to continue to advocate for this technology.…”

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confidence: 99%

“…1 The community rehabilitation team I lead is participating in a regional stroke telerehabilitation project, utilising a hub and spoke model. 1 Additionally, these patients may already be unwell and have considerable distances to traverse. Patients have not only been willing to participate enthusiastically but they also report better care coordination and communication, reflecting this study's outcomes.…”

mentioning

confidence: 99%

“…Patients have not only been willing to participate enthusiastically but they also report better care coordination and communication, reflecting this study's outcomes. 1 One possibility not discussed is that patients may simply not want to continue with the recommended health care. 2 Telemedicine has cost benefits to the patient in terms of savings related to travel expenses and time.…”

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confidence: 99%

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Patients give us thumbs up for telehealth…but are we convinced?

Mavridis

2017

Australian J Rural Health

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An Intraoperative Telemedicine Program to Improve Perioperative Quality Measures

King,

Gregory,

Fritz

et al. 2023

JAMA Netw Open

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ImportanceTelemedicine for clinical decision support has been adopted in many health care settings, but its utility in improving intraoperative care has not been assessed.ObjectiveTo pilot the implementation of a real-time intraoperative telemedicine decision support program and evaluate whether it reduces postoperative hypothermia and hyperglycemia as well as other quality of care measures.Design, Setting, and ParticipantsThis single-center pilot randomized clinical trial (Anesthesiology Control Tower–Feedback Alerts to Supplement Treatments [ACTFAST-3]) was conducted from April 3, 2017, to June 30, 2019, at a large academic medical center in the US. A total of 26 254 adult surgical patients were randomized to receive either usual intraoperative care (control group; n = 12 980) or usual care augmented by telemedicine decision support (intervention group; n = 13 274). Data were initially analyzed from April 22 to May 19, 2021, with updates in November 2022 and February 2023.InterventionPatients received either usual care (medical direction from the anesthesia care team) or intraoperative anesthesia care monitored and augmented by decision support from the Anesthesiology Control Tower (ACT), a real-time, live telemedicine intervention. The ACT incorporated remote monitoring of operating rooms by a team of anesthesia clinicians with customized analysis software. The ACT reviewed alerts and electronic health record data to inform recommendations to operating room clinicians.Main Outcomes and MeasuresThe primary outcomes were avoidance of postoperative hypothermia (defined as the proportion of patients with a final recorded intraoperative core temperature &gt;36 °C) and hyperglycemia (defined as the proportion of patients with diabetes who had a blood glucose level ≤180 mg/dL on arrival to the postanesthesia recovery area). Secondary outcomes included intraoperative hypotension, temperature monitoring, timely antibiotic redosing, intraoperative glucose evaluation and management, neuromuscular blockade documentation, ventilator management, and volatile anesthetic overuse.ResultsAmong 26 254 participants, 13 393 (51.0%) were female and 20 169 (76.8%) were White, with a median (IQR) age of 60 (47-69) years. There was no treatment effect on avoidance of hyperglycemia (7445 of 8676 patients [85.8%] in the intervention group vs 7559 of 8815 [85.8%] in the control group; rate ratio [RR], 1.00; 95% CI, 0.99-1.01) or hypothermia (7602 of 11 447 patients [66.4%] in the intervention group vs 7783 of 11 672 [66.7.%] in the control group; RR, 1.00; 95% CI, 0.97-1.02). Intraoperative glucose measurement was more common among patients with diabetes in the intervention group (RR, 1.07; 95% CI, 1.01-1.15), but other secondary outcomes were not significantly different.Conclusions and RelevanceIn this randomized clinical trial, anesthesia care quality measures did not differ between groups, with high confidence in the findings. These results suggest that the intervention did not affect the targeted care practices. Further streamlining of clinical decision support and workflows may help the intraoperative telemedicine program achieve improvement in targeted clinical measures.Trial RegistrationClinicalTrials.gov Identifier: NCT02830126

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Telemedicine in the Northern Territory: An assessment of patient perceptions in the preoperative anaesthetic clinic

Abstract: Our study confirms the acceptability of telemedicine in the remote assessment of preoperative patients in the Northern Territory, with positive perceptions in all four domains.

Cited by 46 publications

References 11 publications

Outcomes of using telehealth for the provision of healthcare to Aboriginal and Torres Strait Islander people: a systematic review

Outcomes of using telehealth for the provision of healthcare to Aboriginal and Torres Strait Islander people: a systematic review

Patients give us thumbs up for telehealth…but are we convinced?

An Intraoperative Telemedicine Program to Improve Perioperative Quality Measures

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