Telehealth designed for rural, remote & Aboriginal people
Governments around the world have struggled to ensure equitable access to primary care and hospital services in rural and remote communities due to a global shortage of medical workforce.
Rural medical workforce programs established by government over 20 years ago have not addressed these shortages, and may have contributed to fewer medical graduates choosing to become GPs, particularly in rural and remote communities.
RARMS fundamentally believes that on-site GPs are critical to the health and well-being of rural, remote and Indigenous Australians.
However, RARMS also recognises that Telehealth has a role to play as part off an integrated system of delivering health care and supporting workforcee attraction and retention in rural and remote towns.
Rural and remote communities have higher levels of need for access to primary and hospital care, but often face shortages of GPs and specialists.
Telehealth can be used as a tool to promote workforce recruitment and retention by providing rural and remote GPs and VMOs with better support and work/life balance, while also assisting communities during temporary vacancies in permanent medical workforce.
In response to the growing need for more innovative solutions to address doctor shortages resulting from the failure of rural medical workforce programs, RARMS established the Remote GP Service (RGPS) in 2016.
The RGPS was built by rural and remote Australians, in rural and remote Australia and for rural and remote Australians. The RGPS is now the largest GP-led rural and remote Telehealth services in NSW servicing over 30 percent of the State.
The RGPS is unique in that it is staffed by doctors who work in rural and remote Australia, or who have substantial experience working in these communities. This provides our clinicians with the experience to engage with patients in a way that rapidly builds confidence and trust. That is why more than 90 percent of RGPS patients give the service a positive satisfaction rating.
Another key point of difference is that the RGPS is community based and GP led. There is growing evidence that primary care doctors deliver better health outcomes, lower rates of avoidable hospitalisation and reduced rates of death ensuring our health care services are good for patients. Studies have shown that hospital based GPs request more unnecessary tests compared to community based GPs, ensuring that the RGPS delivers high quality care at a significantly reduced cost.
Another key point of difference between the RGPS and other Telehealth models is that we have designed our program to support rural GP recruitment and retention. RARMS does not support the replacement of local GPs or VMOs with Telehealth under any circumstances. Local GPs remain critical to health promotion, prevention and community care, and are needed to deal with emergencies the they arise in rural and remote communities.
The success of this model is demonstrated by the fact that rural GPs and hospital clinicians have given the RGPS as 93.1 percent satisfaction rating for the quality and consistency of care that our clinicians provide.
The RGPS fully complies with the RACGP Telehealth Video Consultations Guide and ACRRM Telehealth Standards and Guidelines. RARMS monitors compliance through its Clinical Governance Committee.
RGPS processes are very mature. GPs have access to training and continuing education to maintain and upgrade skills in telehealth. The RGPS GPs are required to attend a monthly mortality and morbidity review as part of our clinical quality and safety management program. This is a peer reviewed process and it is testament to our commitment of excellence in clinical care.
Unlike many Telehealth services, the RGPS is designed to integrate into rural and remote health systems. RARMS works in collaboration with local GPs, pharmacists, local hospitals, emergency physicians, allied health practitioners and communities to ensure we are supporting continuity of care through automated transfer of patient records and e-prescribing.
This approach also ensures that money and jobs remain in rural and remote communities, and patient records are maintained and up to date.
The RGPS has been successfully deployed by the Western NSW Primary Health Network, Western NSW Local Health District, Murrumbidgee Local Health District and RSL Life Care to provide workforce support and continuity of care in rural, remote and Indigenous communities.
Telehealth can help retain rural and remote healthcare workers by facilitating contact with other providers, decreasing feelings of isolation, and offering opportunities for continuing medical education. Receiving additional support from other professionals can help rural and remote providers avoid burnout and increase the sustainability of primary health care in the local community. One study of rural doctors and hospital administrators found that telehealth helped recruit and retain general practitioners by distributing the responsibilities of being on-call for emergency services.