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DHBs discuss the all-too-human impediments to telemedicine

Sathya Mithra Ashok | Dec. 17, 2013
Dr John Garrett, liaison paediatrician for Canterbury and West Coast DHBs talks about the continuing investment in video conferencing technology, even as he draws a picture of underutilisation that needs to be overcome.

While telemedicine and health-related video conferencing is becoming more common in the country, there is still a significant degree of variation in adoption and delivery and quite a lot of under-utilisation.

"Relative to the country's size and population, I think we use telemedicine infrequently. The Canterbury and West Coast DHBs (district health boards) are two that have the most activity in telemedicine in the country," says Dr John Garrett, liaison paediatrician for Canterbury and West Coast DHBs.

Telemedicine in the two DHBs have been enabled by Polycom equipment, which has been slowly phased in to the functioning of the boards over the last few years.

"Here (Canterbury and West Coast DHBs) we have a number of services using telemedicine actively at the moment in a number of different ways. They include patients being seen for outpatient appointment, that is patients from the Coast being treated from Christchurch," says Garrett.

The support that is provided remotely includes speciality care for acutely unwell people, and has been extended to cover retrieval services as well.

"Christchurch provides a retrieval service for adult patients who need to be brought over here for high level care and for neonatals who need to come everyday. And both of those services have a video conferencing element that they can include in going to pick up a patient. At the moment that's not happening anywhere else in NZ.

"We are at a stage now where we know that the networks and the systems work and deliver what we want them to do. We are at the stage where we are going to try and expand the work that is being done because it's relatively small in terms of numbers at the moment. There is a lot more we can do with telemedicine," says Garrett.

Change in practice

Canterbury DHB has about 35 video conferencing units, and a number of software-based units. The Westcoast DHB has a little over 30 video conferencing units, and equipment additions continue for both of the health boards. However, factors for under-utilisation go beyond the presence of technology.

"It demands a change of practice from clinicians...We are used to seeing people face-to-face and providing them care. That's the traditional way of doing things.

"There is an expectation that we try and provide everyone with equal access to care. That's an ideal but it is not possible, because there are some people who live a long way away from where the specialists are. We are trying to find a way to even out the access to care. And it is just a matter of allowing everyone to see that that's possible with telemedicine.

 

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