title: E-Health readiness in outback communities: an exploratory study.
abstract: BACKGROUND
  E-health has been a recurrent topic in health reform, yet its implementation, ultimate role and feasibility are yet to be clearly defined. Organisations such as the Royal Flying Doctor Service South East Section (RFDS SE) are in a position to utilise technology to enhance the effectiveness of existing clinical services for remote communities. The study aim was to explore the readiness of the remote population of far-west New South Wales, Australia, and RFDS SE as a monopoly service provider to take up e-health innovations.
  
  
  METHODS
  A convenience sample of patients sequentially attending 15 remote fly-in clinics conducted by RFDS SE medical officers were invited to participate in a semi-structured telephone survey using an established survey tool to gather quantitative and qualitative data. RFDS SE health staff and managers were also surveyed.
  
  
  RESULTS
  The overall core-readiness to embrace new e-health technologies was at a moderate level; barriers were mainly technical competence and technology availability. Enablers were willingness to learn and engage. The majority of patients did not feel isolated and had their health needs met; albeit there was interest in change if this improved outcomes. Video consultations for mental health and access to specialists were particularly welcome, although responses also indicated concern that video links might replace existing face-to-face services. Health staff saw the need for new technology to assist in healthcare provision but technology availability and support were flagged as key points. Organisational views as elicited from managers identified internal needs for workplace readiness to assist with adoption of new technology.
  
  
  CONCLUSIONS
  Patients, healthcare providers and RFDS SE as an organisation are interested in engaging in e-health to improve the level of healthcare delivery. There are challenges around the technical capacity and the structural and organisational support for an e-health venture in an outback setting. Specific patient, healthcare provider and organisational needs have been identified and allow for the development of a tailor-made implementation strategy particularly to overcome technical challenges.
authors.affiliation: Central Clinical School, Division of General Practice, School of Medicine, University of Sydney, Sydney, New South Wales, Australia. drfabianschwarz@gmail.com.
authors.forename: Fabian
authors.initials: F
authors.lastname: Schwarz
authors.affiliation: Health Services Department, Royal Flying Doctor Service, South East Section, Broken Hill, New South Wales, Australia; Present address: Public Health Medicine, WA Country Health, Perth, Western Australia, Australia. Jeanette.Ward@health.wa.gov.au.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Ward
authors.affiliation: Deparment of General Practice, Central Clinical School, Division of General Practice, School of Medicine, University of Sydney, Sydney, New South Wales, Australia. simon.willcock@sydney.edu.au.
authors.forename: Simon
authors.initials: S
authors.lastname: Willcock
mesh_terms: D001291:Attitude of Health Personnel; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008511:Medicine / Q000458:organization & administration; D008605:Mental Health Services / Q000458:organization & administration; D009517:New South Wales; D010361:Patients; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration*
keywords: Administrator; Allied Health; Australia/Pacific; Community Participation; Consumer perspectives; Evidence-based Care; General/Family Practice; Health Needs Assessment; Health Service reform; Indigenous Health Worker; Medical; Public Health