Queensland Health has recently published a decade-long strategy to digitally transform the state's healthcare services in rural and remote areas. 

WHAT IT'S ABOUT

The Digital Strategy for Rural and Remote Healthcare is a result of a consultation process involving over 400 clinical, business, and patient representatives across Queensland's hospital and health services.

It has identified infrastructure and technology challenges, including:

• Less access to technology, slower internet, less connectivity

• Data-silos and lack of interoperability

• Extremes of heat, dirt, dust, salt and weather with significant impact on technology

• Scarcity of local, skilled technicians and experienced ICT operators

• Less reliable and advanced ICT infrastructure, connectivity. Less funding for contemporary technologies

• Long lead times when technology needs repair or replacement 

Some health services challenges were also highlighted, such as the difficulty in sharing information and accessing community care services; paper-based medications history and physical distance creating a "barrier" to efficient prescribing and delivery of medications; and "distant and time-consuming" medical imaging. 

Confronted with such issues, stakeholders in the Queensland health ecosystem came up with a strategy that focuses on four areas: digital foundations, personalised care, integrated care, and virtual care.

Some of its digital foundations include:

• 24/7 dedicated rural and remote ICT support providing local technology troubleshooting and advice

• Point of care clinical and practice management solutions supporting the real-time capture of patient information regardless of organisation or care setting

• Decision support tools and video conferencing units

• Artificial intelligence and predictive analysis that enables access and delivery of appropriate healthcare and health education

• Integrated workforce management

• Enhanced data analytics

• Improved information sharing between providers

Moreover, it was noted that all rural and remote health services will support "highly mobile and digitally-enabled workflows, with ubiquitous telehealth, virtual and integrated care supporting an increased scope in local facilities and at home".

The decade-long strategy is guided by the principle of "leaving no one behind," which means bringing care close to home and providing decision support at the point of care in the rural and remote settings.

It was mentioned that the strategy's programme of change will require a clinically-led assessment and a phased implementation, supported by a governance framework. The strategy also comes with a detailed roadmap, details on delivery, organisations' accountabilities, and measures of success.  

Queensland Health said it counts on the commitment and collaboration of all stakeholders in realising the 10-year changes in the rural and remote health landscape.

WHY IT MATTERS

About 70% of Queensland is rural and remote with 38% of its population living in these areas. The people's mortality rate here is said to be 2.3 times higher than those living in major cities; avoidable hospitalisations are higher by half; residents' disease risks are greater by 40%; and suicide rates are 2.1 times higher compared in metropolitan areas. 

These health outcomes are influenced by limited infrastructure and siloed information. To deliver meaningful change, Queensland Health said, access to health services is crucial to meet people's needs and that these health services must also have access to the right technologies.

"Over the next 10 years Queensland’s health system will move from digital ready to digital by default, and our rural and remote communities must be supported to ensure that they are not left behind by these ongoing advances," the strategy report read.

Ultimately, health officials envision a future of rural and remote healthcare where patients are at the centre of the ecosystem, "enabled and empowered through digital interactions across the continuum of care". Healthcare providers and their partners, on the other hand, "will be supported to deliver better care to patients at the right time and at the right place, whether that be within the hospital or in the home".

THE LARGER CONTEXT

The strategy expands on the 2016 digital health strategic vision for Queensland. 

In 2020, Queensland Health engaged HIMSS in a health system-wide project which leveraged the Digital Health Indicator. Through the engagement, Queensland Health sought to identify a baseline to show the level of digital health maturity of health services across the state and determine how far they had progressed in their 2016 vision.  

ON THE RECORD

"This strategy is for all Queenslanders—to deliver better care for our patients, support clinicians with the right tools for real-time clinical information, and to provide better care and coordination with our healthcare partners. It will allow us to make significant improvements to our rural and remote patients, giving them the best personalised care and integrating that care across the health system, delivering better care for all Queenslanders today and into the future," Queensland Health CIO Damian Green said in the report's foreword.