Let’s look at how technology can make a difference
to you, and your patients, and how we can work together
to provide better results for clinicians, for patients and for the whole health system.
Across South Australia, from the city to the most remote of locations,
clinicians are using technology to deliver faster diagnoses,
ensuring those who need treatment get it, but also helping patient flows so that we
are only admitting people to hospital who really need to be there.
In the area of renal disease, and in particular dialysis services
in country South Australia, we’ve got well over 100 patients scattered
over a dozen dialysis units, many 7, 8, 9 hours’ drive from Adelaide.
So what teleconferencing and telemedicine allows us to do is engage with those patients
and the staff treating them at a distance, so from my office here at the Royal Adelaide Hospital
I can see individual patients, I can talk to staff members,
we can look at individual patients
either as a whole person or in close up, we can share screens, for example, of results
and x-rays, and what that effectively allows us to do
is deal with at problems from a distance,
save the patient perhaps having to come to Adelaide
and help get things happening.
Also the other way, it also allows us to identify issues early
and set in train perhaps investigations either locally
or make plans for subsequent trips as they are needed.
That’s the whole point of it, is to allow not having to drag people down to Adelaide.
The idea of someone driving for 7 or 8 hours to Adelaide
to sit and see me for 20 minutes, and then drive 7 or 8 hours to go home again
is just silly if we can deal with the issues over video conferencing.
I was playing cards when I had the stroke.
I finished playing cards at midnight and went to walk out the door and that was it.
The next thing I know I woke up in hospital.
Often the specialists are not located in the local area,
so they need to be sourced in Adelaide, which is where telehealth can assist.
So the nurse is there to support the client through the telehealth assessment,
and I am on the other end and we can proceed through interpretation of those assessments
done with the nurse.
Chatting to Zoe over the telehealth is just like talking to
somebody across the table from me.
There was no stress, it was just like having a normal conversation with another person,
she just made you feel at ease.
Being able to access the clinic via telehealth allows the clients to access specialist
assessments in a timely way, they are not having to incur the costs or
the stress associated travel or being away from home.
We think it is really important to collect client feedback,
and what we are seeing is that clients feel that
they are receiving the same level of care as they would on a face to face,
and that the majority of clients would be happy
to recommend or repeat a telehealth assessment.
If we haven’t had the teleconference down here,
it would have meant that I would have had to travel to Adelaide, make an appointment,
the family would have to come and get accommodation, it would have been astronomical…
just too much stress.
The latest developments of tablet-based home services
such as tele-monitoring and home based tele-rehab, along with advancements in point of care testing,
is changing and improving lives.
We can be in Adelaide, talking to patients and monitoring them,
to assist the local team in providing care safely,
close to people’s homes.
Technology aids early detection of patient deterioration
leading to treatments being started sooner.
This may prevent the need for the patient to be moved to the city.
It also lets us identify which patients really do need to be transferred
so that they can access services they require more rapidly.
One of the great benefits of telehealth is that
we can provide specialist expertise to everyone in the whole state,
rather than just people in metro Adelaide.
It is well demonstrated that if you have an expert
assessing a stroke patient the decision about treating or not treating
is made much quicker.
We are on call 24 hours of every day, and we have telehealth links to
nearly every hospital in the state.
This way we can have a look at the patient directly and determine
“Are they the sort of patient who needs to be retrieved,
or the sort of patient who can stay in the country town?”
So regardless of the time of day or night, if someone with stroke-like symptoms
presents to a country hospital, we can dial in
and examine them remotely via our phone or laptop
to assess whether they are having a stroke and what sort of treatment they might need.
Each minute in stroke, 1.9 million brain cells are lost.
So if we make these decisions faster and treat patients quicker
we can save millions of their brain cells.
This means people can get back to work, they can get back to their hobbies,
they can care for their families, we reduce the burden on society and
reduce the disability for these patients long term.
Technology is integral for how we do our work.
The ability to send a retrieval team takes time,
and it takes an asset like a helicopter or a fixed wing plane,
all of that takes time to get going.
We want to be able to give advice and clinical advice
to the right people in the right time frame.
Using such things are video conferencing allows us to link up immediately,
see the patient, know what we are dealing with
and give the answers to the clinicians who are
looking after the patients in a very short time frame.
The picture paints a thousand words, is probably the best way to put it.
If you are listening on the telephone line, you don’t sometimes understand what
kind of severity you are dealing with with the patient.
By seeing the patient on the screen, it just gives us that understanding of what
needs to happen, and when it needs to happen.
An example of how the system has helped is in the case of Stuart, a farmer who sustained
burns injuries on a property near Maitland.
I had a farming accident on the fourth of April,
last year, west of Maitland on a friend’s property, helping him burn canola rows.
And I was sitting on a trailer, he had the ute
and a trailer with a fire unit on it, just bouncing along
with a homemade CFS drip torch lighter and that had a half diesel half fuel mix in it,
and we were bouncing along and I was holding it dripping out flames and the next thing
all I had was the handle in my hand and it actually snapped – and the whole
canister, we’d just filled it up, hit the ground,
and as I jumped off the trailer the wheel ran over it
and squirted me head to toe full of fuel.
So I was alight within about a second, and it burnt from the bottom up.
Maitland Hospital was really good but they didn’t have the facilities,
they only had enough to sustain me and get me pain relief and dress my dressings,
because they were swelling up with fluid at the time,
and then the Royal Flying Doctors air evacuated me
out of Maitland Airport to Adelaide, to the Adelaide Airport, and then by ambulance
to the Royal Adelaide to the Burns Unit.
And that night I was in theatre, and I don’t remember much
until I woke up the next morning, and um, I’m pretty lucky to be alive.
I went back to Maitland Hospital on Yorke Peninsula
and the staff there we’d organised before me going home
to talk to me about it, about telehealth, and we’re doing that every day with my dressings
as well, because we’re using silver dressings
to keep the infection out, and it was easy.
We just organise it by date, and I go with my wife shopping
and telehealth would be on this time on a huge big TV.
We could see them, they could see us and I could turn around, and they could zoom
in on my burns and check out how they were all healing,
the colour of the actual scabbing on it, how the skin was healing.
I was very lucky to go through the Royal Adelaide Burns Unit.
Their compassion over that time was the big thing to get it through.
These guys are experts.
They knew exactly what they were doing for my injuries
and yeah, I was just lucky.
Very, very lucky.
We are seeing amazing results from all over the state.
There are more than 60 public hospitals across South Australia.
We really need to be smarter about how we deliver our services,
and using technology to make one-on-one contact has already made huge improvements
to patient care.
From acute consults, to outpatients, to rehabilitation services,
the possibilities; are endless.