Telehealth diabetes clinic bridges healthcare gap
Video Conference (Stock Image)
A nurse-led telehealth diabetes clinic, between an Opotiki GP and Tauranga Hospital, enhances the specialist care offered to local patients.
Ellen Walker, an Opotiki practice nurse in Dr Jo Scott-Jones’s Church Street Surgery team, helped setup the diabetics’ telehealth clinic. Before she moved into rural primary healthcare in Opotiki, Ellen came from the Tauranga Hospital diabetes health team, 134 kilometres away.
In Opotiki, diabetes is a big health issue with approximately 470 people from a total population of 8,436 (2013 census) receiving regular treatment. 53.3 per cent of people in Opotiki District are Maori. Just under half of the resident population living in the Opotiki township and the rest of the population live in smaller communities.
“Being able to link Opotiki patients to the experts in Tauranga seemed the natural step. Having the technology and broadband available meant that it could happen”, says Ellen.
Ernie Newman, from the Telehealth Demonstration Project, helped set up the video conferencing equipment at either end. Both Ellen and Isabel Raiman, the Diabetes Nurse Practitioner, based in Tauranga, were trained to get the best out of the equipment.
Ellen says, “We run telehealth diabetes consultations with Isabel in Tauranga while the patient and I are together in Opotiki. The shared software and camera mean she can see my screens and also see the patient so she can see what I see.
“I also video conference Isabel separately about any concerns or follow-up queries I have about patients. Previously, we would talk over the phone and I could only talk about one test result for a patient at a time. Now Isabel and I can both see the full results for the patient so we can discuss the whole picture.”
Ellen says it is important to reassure patients that the video conferencing and sharing of information is secure. “It is so much safer and offers more direct communication than faxing the information as we used to.”
“It is unreal how it’s changed the way we help our patients. Telehealth has a huge role to play, not only with diabetes but other chronic conditions such as cancer.”
From the Tauranga Hospital diabetes health team end, nurse practitioner Isabel Raiman says, “Before the telehealth clinics were set up, the people in Opotiki had to travel to Tauranga or Whakatane to receive diabetes treatment.”
Once the equipment was in place, Isabel says that Ellen and she tested the equipment from their workplaces by planning how they would make the telehealth clinics run.
“We discussed how we would structure the format of the clinics, document the information and follow-up treatment, how we would involve the patient and how to communicate together.”
“Before the clinic, Ellen would take the patient’s blood pressure and get blood results and the patient’s glucose monitoring done and then upload them so we could both share these records online at the consultation.”
“It was fantastic for me to have all this information on the screen so I didn’t need to look it up. It means that I can see the latest results and any patterns that emerge on screen, without having to look them up, and yet I can interact with Ellen and the patient as I have a really good picture and good sound. At first, I was worried that the telehealth clinic would be too impersonal but it isn’t and the patients get quickly familiar with the setup and seeing and talking to me onscreen.”
Often, after the patient consultations are over, Isabel and Ellen will spend time reviewing the files of other patients so they can see if a patient’s health condition has changed or if the patient’s treatment needs changing or if they need a follow-up consultation.