An audit of process and outcomes from a pilot telehealth spinal assessment clinic: a South Australian story

Matthew Beard1, Joseph Orlando1, Saravana Kumar2

1Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, 5000, Joseph.Orlando@sa.gov.au
2International Centre for Allied Health Evidence (iCAHE), University of South Australia, North Terrace, Adelaide, South Australia, 5000.

Background

There is consistent evidence that people in rural and remote areas have limited access to health care and poorer health outcomes. Innovative models of care such as telehealth are one way of addressing this inequity. The aim of this pilot trial was to determine the feasibility, appropriateness and access of a telehealth clinic.

Methods

A prospective audit was conducted on a Spinal Assessment Clinic telehealth pilot trial for patients with spinal disorders requiring non-urgent surgical consultation. Data was recorded from all consultations via videoconference between the Royal Adelaide Hospital and Port Augusta Community Health Service, South Australia between September 2013 and January 2014. Outcomes included analysis of process, service activity, clinical actions, safety and costs. Data was compared to a Spinal Assessment Clinic outreach trial to the same area between August and December 2012.

Results

There were 25 consultations with 22 patients in the telehealth trial. Spinal disorders were predominantly of the lumbar region (88%); the majority of initial consultations (64%) were discharged to the general practitioner. There were few requests for further imaging, minor interventions and other specialist consultation. Patient follow-up post telehealth trial revealed no adverse outcomes. The total cost of AUD$11,187 demonstrated 23% reduction in favour of the telehealth trial with the greatest savings in staff travel costs. Savings in patient travel were equally demonstrated by telehealth and outreach trials.

Conclusion

The telehealth model of care improved access and demonstrated safe and efficient management of patients with spinal disorders in rural regions requiring non-urgent surgical consultation.

Biography

Joseph Orlando is a physiotherapist at the Royal Adelaide Hospital. He works in the Spinal Assessment Clinic with a team of advanced practice physiotherapists to identify patients who may benefit from potential spinal surgical intervention or patients with serious spinal pathology. He is also a Branch Councillor for the Australian Physiotherapy Association, South Australia.