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Increasing the impact of teleophthalmology in Australia: Analysis of structural and economic drivers in a state service
Author(s) -
Razavi Hessom,
Copeland Stephen Paul,
Turner Angus Warwick
Publication year - 2017
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12277
Subject(s) - telehealth , outreach , capital expenditure , medicine , telemedicine , government (linguistics) , audit , service (business) , business , optometry , nursing , health care , economic growth , finance , economics , marketing , linguistics , philosophy , accounting
Problem Despite its potential to improve service provision for country patients, teleophthalmology is currently underused in Australia. There is an associated lack of cost‐effectiveness data for teleophthamology. Design Retrospective and prospective hospital‐based clinical audits of 5456 patients; descriptive survey of available telehealth equipment in 129 regional facilities; cost calculations for teleophthalmology, patient transfers and outreach services. Setting Primary (optometry, general practice [ GP ], Aboriginal Medical Service [ AMS ]) and secondary (hospital) sites in regional Western Australia; a tertiary hospital in Perth. Key Measures for Improvement Proportion of patients suitable for teleophthalmology; proportion of regional practices with telehealth technology; capital expenditure to equip regional practices for teleophthalmology; total savings from increased utilisation of teleophthalmology. Strategies for Change Advocacy for funding, regulatory, training and infrastructure recommendations, in order to support efficient models of teleophthalmology. Effects of Change A total of 15% and 24% of urgent patient transfers and outreach consultations, respectively, were found to be suitable for teleophthalmology, equating to a potential total cost saving of $1.1 million/year. Capital expenditure required for basic telehealth equipment was negligible for optometrists, compared to $20 500 per GP / AMS practice. Successful advocacy led to funding, training and policy changes to support optometry‐led teleophthalmology for country patients in Australia. Lessons Learnt Public–private partnerships can result in significant cost‐savings for the Australian health system. Targeted, evidence‐based advocacy can inform government health reforms.