There are a variety of settings in Australia underserviced by health professionals. The CRE have identified the following areas where telehealth may have a benefit:

Small rural hospitals

Over 75% of Australia’s hospitals are located in regional or remote areas. They constitute 100% of Australia’s small acute hospitals, and 85% of small non-acute hospitals. 

The lack of a full range of specialist services means that patients are often transferred to regional or metropolitan hospitals, which, over time creates a downward spiral of capability and challenges the hospital’s viability. A variety of telehealth strategies would provide some of this much-needed expertise, with the result that some transfers might be avoided and that the quality of care improved. 

This could enable more people to be treated closer to home and reverse the trend away from non-viability. 

Residential aged care

Over 150,000 older Australians live in government subsidised residential aged care facilities (RACFs). This population has a high level of disability and unstable health status. Access to specialist service providers is constrained by the:

  • inability of the resident to travel,
  • high cost of providing an escort, 
  • intermittent nature of demand for specialist services in aged care facilities 

The MBS now includes item numbers to facilitate video-consultation into RACFs, yet to date very few working models have been developed. There are also no robust evaluations beyond single disease or syndrome consultations. 

The CRE aims to improve the use of video-consultation into RACFs to:

  • Avoid the stress of travel for an older person
  • Reduce the costs by reducing the need for an escort
  • Offer specialist services as needed

With the limited resources, inevitable population ageing and minimal growth in the workforce, telehealth can be of benefit to people living in RACFs. 

Home care

Care at home is often preferred by patients, and can be seen by governments as less expensive because care by patient’s family is provided at no obvious cost. However, the real costs of home based care should look at long term challenges such as the availability of informal carers and the effect on the family budget. 

Telehealth can make a positive contribution in this setting through:

  • distance monitoring of health measures,
  • the use of safety monitoring devices, 
  • home-based rehabilitation, 
  • providing effective communication at a distance  by video-consultation.

Indigenous communities

The poor health of Australian Aboriginals and Torres Strait Islander people has been reported for decades. Although indigenous infant mortality rates have been declining, life expectancy has not changed because of continued high adult mortality rates (due largely to high death rates from chronic diseases in middle age).

Chronic disease, with preventable cause, is becoming increasingly prevalent in the Aboriginal and Torres Strait Islander population with progressively younger age of onset. Indigenous communities are often disadvantaged due to lack of access to culturally appropriate medical service, in both metropolitan and rural communities. 

Visits to many rural communities are infrequent, sometimes irregular, expensive to undertake and often too short to allow proper follow-up of patients after surgery. New models of care need to be developed in collaboration in Indigenous communities to ensure a more consistent approach for routine community-based health services. Telehealth may assist in early detection of chronic disease and improved access to specialist treatment.