Telehealth increasing early detection in outback Australia

Indigenous patients' eyes are examined in the outback with a retinal camera and the images are reviewed by specialists in Melbourne.

Indigenous patients' eyes are examined in the outback with a retinal camera and the images are reviewed by specialists in Melbourne.

Indigenous Australians at risk of permanent blindness caused by diabetes are receiving world-class health care thanks to a new initiative funded by The Fred Hollows Foundation.

Tele-retinal imaging, which aims to prevent disease through early detection, has been set up in health clinics in remote parts of Australia, such as Miwatj, in East Arnhem Land, about 1,000 kilometres east of Darwin. Routine screening has also started in Alice Springs and Katherine.

Brian Doolan, CEO of The Fred Hollows Foundation said: “This technology is the next big jump in the delivery of health services to Indigenous Australians since Fred’s time. It puts the best of technology right into the hands of Aboriginal health care workers, the people right on the front line.”

When patients come into the health clinic, their eyes are examined with a retinal camera. The images are sent and examined at a reading centre in Melbourne. Rather than wait weeks – and in some cases, months – the results are sent back to doctors within two days.

“This dramatically improves the turnaround time of the results,” says Alicia Jenkins, Professor of Diabetes and Vascular Medicine at The University of Sydney and one of the experts who has developed the technology.

“Sometimes it can be even faster if there is a major concern.

“This is a wonderful use of technology to overcome the remote location and shortage of doctors in the region,” she says. “There has been a huge need for this for some time.”

The imaging process is just one aspect of the $3 million TEAMSnet program being rolled out by The Fred Hollows Foundation in partnership with The University of Sydney, The University of Melbourne, and other Australian institutions.

The project also features a high-tech electronic medical record system aimed at preventing chronic disease. As soon as the doctor or health worker enters a patient’s name, every test the patient has undergone is displayed. This can range from cholesterol levels, to blood pressure, X-rays, and any recommendations made by dieticians or health workers about their health and weight. 

Sven-Erik Bursell, Professor of Tele health at The University of Sydney, is another key driver behind the project. He says telehealth goes “above and beyond the sort of traditional care you’d receive from a GP.”

Professor Bursell said he was prompted to act because there had been “only incremental improvements in preventing blindness in patients with diabetes in Australia’s Indigenous population.”

“More than 50 per cent of Indigenous people with diabetes are not getting access to appropriate eye care to prevent blindness,” he said.

“When you use telehealth in this way, you can get through a lot more in 15 minutes because the doctor doesn’t have to spend that time asking basic questions. They can spend the time talking and learning more about the patient.”

This type of system has been successfully trialled in more than 100 sites in the US with the Native American health service.

“We’ve ‘Australianised’ the system ... tailoring it specifically towards the Indigenous population,” Professor Bursell said.

The technology will alert the patient and doctor to lifestyle factors that might affect their health such as smoking, nutrition and physical activity.

“It helps GPs make the right choice about a patient,” he said. “It’s a tremendous tool in the fight against diabetic retinopathy.”

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Fred Hollows in Vietnam in 1992. Photo: Michael Amendolia

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