A multi-stakeholder strategy for the generation of new telehealth services in rural Queensland

Introduction: The delivery of clinical telehealth services to small rural communities depends on a well-coordinated strategy, which brings together a number of stakeholders. A single technological solution (for telehealth) does not exist for small rural communities, which have limited access to specialist health services. The Health-e-Regions program was introduced in the Western Downs region of Queensland to assist with the generation of new telehealth services in three selected towns. The aim of the program was to improve access to a range of specialist health services and to reduce the need for travel. The program commenced in 2012 with a thorough scoping study; then a pragmatic strategy in 2013, which included the planning and establishment of new telehealth services in public hospitals, primary health care centres (general practice); and residential aged care facilities. Telehealth activity was compared pre- and post-implementation of the Health-e-Regions program; showing promising signs of telehealth adoption. Methods: Changes in telehealth activity were summarised over a two-year period from July 2012 to June 2014. Important factors associated with the introduction of new telehealth services have been identified by the Healthe- Regions program. Results: Since the commencement of the Health-e-Regions program in January 2013, some positive changes have been identified in regards to telehealth usage. Public hospital telehealth activity in this region, increased from 2261 consultations in 2012/13 to 4622 consultations in 2013/14. Non-hospital telehealth activity increased from 651 consultations in 2012/13 to 1313 consultations in 2013/14. Important factors associated with the introduction of new telehealth services were: increasing awareness of the use of telehealth (from the perspective of the clinicians, patients, hospital managers and the general public); developing protocols that simplify the referral process; planning telehealth services that had a sustainable funding base; and ensuring appropriate telehealth facilities were accessible to all participants. Conclusion: The establishment of sustainable telehealth services requires a carefully planned strategy that addresses important requirements from a multi-stakeholder perspective. The strategy must consider technological requirements; availability of clinical expertise; change management; business processes; education and training; and communications and marketing. The Health-e-Regions program is helping to improve access to health services for people living in the Western Downs region of Queensland - through the use of telehealth.