title: Use of telehealth to treat and manage chronic viral hepatitis in regional Queensland.
abstract: For regional and rural Queenslanders, chronic viral hepatitis treatment is a major unmet health need, with restricted access to specialists outside of tertiary, largely metropolitan hospitals. To increase treatment of chronic viral hepatitis in regional Queensland, a team-based telehealth model was expanded. This expansion embedded an initial nursing consultation prior to specialist telehealth consultation. We conducted a retrospective audit of the introduction and expansion of hepatology telehealth services. Activity from July 2014-June 2015 (pre-expansion) was compared with July 2015- June 2016 (post-expansion). Interviews were conducted with key staff to determine factors contributing to success of the service and identify ongoing challenges to the service model. A greater than four-fold increase in clinical consultation was observed (131 telehealth consultations pre-expansion vs 572 post-expansion; p < 0.001). The failure to attend rate decreased (13.0% vs 6.5%, pre vs post-expansion respectively; p = 0.030), suggesting engagement with the service increased. Staff cited nurse-conducted primary assessment prior to specialist consultation and personalised patient treatment packs as key contributors to increased patient flow and engagement. This expanded team approach appears effective in delivering specialised treatment to an underserved area in regional Central Queensland. It may serve as a model to further expand telehealth management of chronic disease for regional Queenslanders.
authors: School of Medicine, University of Queensland, Australia kandice.keogh@gmail.com.
authors: Kandice
authors: K
authors: Keogh
authors: QIMR-Berghofer Medical Research Institute, Australia.|Princess Alexandra Hospital, Metro South Health, Australia.
authors: Paul
authors: P
authors: Clark
authors: School of Medicine, University of Queensland, Australia.|QIMR-Berghofer Medical Research Institute, Australia.
authors: Patricia C
authors: PC
authors: Valery
authors: Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.|Centre for Functioning and Health Research, Metro South Health, Australia.
authors: Steven M
authors: SM
authors: McPhail
authors: Blood Borne Virus and Sexual Health Service, Queensland Health, Australia.
authors: Candise
authors: C
authors: Bradshaw
authors: Blood Borne Virus and Sexual Health Service, Queensland Health, Australia.
authors: Melany
authors: M
authors: Day
authors: Centre for Online Health, The University of Queensland, Australia.
authors: Anthony C
authors: AC
authors: Smith
mesh_terms: D019694:Hepatitis B, Chronic / Q000451:nursing / Q000628:therapy*; D019698:Hepatitis C, Chronic / Q000451:nursing / Q000628:therapy*; D006801:Humans; D011793:Queensland; D019114:Remote Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017216:Telemedicine / Q000706:statistics & numerical data*; D055817:Telenursing / Q000706:statistics & numerical data
keywords: Remote consultation; hepatitis; telehealth