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Remote health

Meeting 1. E-Health Conference, Revolutionising Australia’s Health Care

An invitation only two day seminar on e-Health was held in Melbourne on November 30 and December 1st. Apparently a “draft concept” of the shared e-health record concept was shown. It seems like there is $55 million splashing about for projects based on the personally controlled e-health record (more about money later on).

The Minister for Health and Ageing, Nicola Roxon gave the opening address. Here is part of what she had to say.

Part of our job in embracing this change and exploring further opportunities is to explain to the wider public the benefits of this big step into the future.
Let’s consider some of the situations that face clinicians and patients today.

Take the case of a young mother whose two children suffer from asthma.

The children might have tried many asthma drugs on and off, and keeping track of what each child has tried is challenging – for parents, for doctors, for hospitals.
Or consider the case of a Melbournian retiree escaping to Darwin for a holiday, becoming sick and being raced to hospital by ambulance.

He arrives without his current tablets and is not in a condition to talk about his medical history. What does the ED team need to know to make the treatment effective?

Or let’s think about a carer’s perspective for a moment. Hundreds of thousands of Australians care for a loved one, many of whom can’t participate in their own care which might involve a GP, then local pharmacist, the district nurse, specialists and the local hospital.

There’s a constant worry that the wrong medication might be taken at the wrong time. These fears are well grounded – medication errors currently account for 190,000 admissions to hospitals each year (my italics).

And take the case of the hundreds of thousands of Australians with chronic disease. Many of whom want to better manage their diseases, but lack the connection over their information that can make this happen.

These scenarios reflect the kinds of real-life situations that occur all around Australia every day.

national electgronic health transition authority

Let me digress a bit here. It does have something to do with the second meeting.

Pharmacists reviewing medication histories and more pharmacists in wards in hospitals reduce error rates. And an electronic patient record should reduce them even further.

Aboriginal Community Controlled Health Organisations (ACCHO) are where Aboriginal Australians wish to receive their healthcare. There are five pharmacists I know of that work full time for an ACCHO.

Meeting 2. 28th June 2010 No title, attended by stake holders in remote Indigenous Health

This meeting was called after a presentation and some networking at the National Medicines Symposium. It was to discuss the lack of dispensing software, tools and training for remote area S100 ACCHOs and other Aboriginal Health Services.

  • Dispensing is usually done by Aboriginal Health Workers, Doctors and Remote Area Nurses who in the main have have no specific training for this task and may under-appreciate its importance in Quality Use of Medicines. In some states this may be illegal
  • Dispensing systems either stand alone or incorporated into electronic patient management systems for tasks such as labelling, recording of supplied medication and stock control are for the most part primitive or non-existent. Indeed in many cases medicines are dispensed with handwritten, incomplete, or no labels at all.
  • Yes, that’s right. We are spending millions on eHealth but in remote Australia we still can’t print a legible label for a patient’s medication. Does it surprise anyone that there seems to be no money to rectify this lack of not only dispensing, but no pharmacist involvement?

    Is it too far a stretch to think we are building a whizz bang house, but out bush it is on very poor foundations?

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    Cook – Aged Care

    Personal Care Assistant

    Gardener / Maintenance

    Enrolled Nurse – (Medications Endorsed) Aged Care

    Kungkarrangkalpa is a 18-bed Aged Care facility located in Wanarn, a small Indigenous Community, in the central desert region of Western Australia. It is highly desirable to have the following:

    - Recent Aged Care experience
    - Experience in working with Indigenous Clients
    - Demonstrated ability to work in a team environment
    - A food handling certificate or related qualification
    - Ability to prepare, cook and serve meals and prepare special meals as required.

    Remote Area Nurse

    We are seeking a Registered Nurse with remote nursing experience to work with our team of professional Remote Area Nurses, Aboriginal Health Workers, Doctors and other health staff. It is highly desirable to have the following:

    · Recent acute experience
    · Primary health care experience
    · Recent remote nursing experience

    This position may require regular remote travel.

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    Alice has 2nd highest fuel prices in country was the headline of an ABC article on Monday. Fuel in the Alice costs $1.48 a litre. I assume this is unleaded though diesel would be sold far more frequently than in most other centres.

    The Australian average regional price according to the Australian Institute of Petroleum was $1.31 week ending 21st November. (It looks like this page is updated each week so click on the picture for the figures I am comparing).

    click for full picture

    I live in remote Western Australia. The average regional WA price for diesel in this time period was 135.6 cents a litre.

    In Broome fuel is apparently $1.49 a litre.

    Out bush in remote WA I am paying $2.00 a litre for diesel.

    Let’s briefly put this into a remote health/Indigenous Health context.

    Expenditures on health for Aboriginal and Torres Strait Islander peoples 2004-05

    The expenditure on health for those in remote and very remote areas is higher than all other areas. But as I demonstrated, fuel costs by themselves can be a third higher. This impacts as an example on what tradies charge to maintain and repair infrastructure, the cost of attending a motor vehicle accident and freighting out medical supplies.

    I do wonder what the direct spend on staff and equipment per population in remote areas to that in other parts of Australia would be. My feeling that stripping out the costs (essential to provide a service, but not the service itself) would see less paid on direct patient care for a population group with a higher amount of illness in whatever disease you want to look at.

    References:
    Australian Institute of Petroleum website accessed 28 Nov 2011
    AIHW Expenditures on health for Aboriginal and Torres Strait Islander peoples 2004-05

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    News

    Improving Indigenous health http://bit.ly/deM1Mz

    Top End communities face golden staph threat unless better showers and washing machines provided to communities http://bit.ly/9QHNRN

    A recent spate of mainly Indigenous suicides in the Northern Territory has sparked calls for urgent action. http://bit.ly/cBOtEU

    What does the evidence say about how to improve Indigenous health? A challenge to current policy – @croakeyblog http://bit.ly/8XLqW8

    More programs needed to build Aboriginal children’s sense of identity to address high suicide rates http://bit.ly/cL21qw

    Indigenous suicide ‘a silent epidemic’ NT Liberal Senator will push for government inquiry http://bit.ly/cwe6QK

    The Indigenous News Updates are sourced from news and other articles from around the country that I have posted on Twitter.



    The categories I use for Indigenous News Updates can be found here.

    Image source: OpenClipArt.org, public domain.

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