The feasibility of a community-based mobile telehealth screening service for Aboriginal and Torres Strait Islander children in Australia

Abstract

Objective:The increasing prevalence and earlier onset of chronic health conditions amongst Aboriginal and Torres Strait Islander people has become a concerning and significant problem. Telehealth may be a useful application for the early detection, monitoring, and treatment of chronic diseases such as ear disease and vision impairment. This study evaluates whether it is feasible to integrate a mobile telemedicine-enabled ear and eye–screening service with existing community-based services for Australian indigenous children.Materials and Methods:A collaborative service was established with the local community and delivered from a van fitted with screening equipment and telemedicine capabilities. Indigenous children (0–16 years) were assessed at school by an aboriginal health worker for conditions impacting hearing and vision. Screening data and video-otoscopic images were uploaded to a database and made accessible to specialists via a secure Web site. Those children who failed an ear-screening assessment, tele-otology clinics were conducted remotely by an ear, nose, and throat specialist, who reviewed cases and provided a diagnosis and treatment plan. Similarly, children who failed vision assessments were referred to an optometrist for follow-up care.Results:During the first 6 months, the service visited 12 of the 16 schools in the region, screening 442 of the 760 consented children (58%). Of the 183 (41%) children who failed ear screening, 59 were reviewed remotely by an ear, nose, and throat surgeon, with 9 children booked for surgery. Three hundred and four or 41% of the consenting children completed an eye assessment, in which 46 (15%) failed and required referral to the optometrist.Conclusions:It is feasible to integrate a mobile telehealth screening service with existing community-based services to provide specialist review and treatment planning at a distance. Community consultation, engagement, and collaboration in all areas of the project have been important. A collaborative service was established with the local community of Aboriginal and Torres Strait Islander people. This service was provided from a mobile van outfitted with screening equipment and telemedicine capabilities. Indigenous children (0–16 years) were assessed at school by an Aboriginal health worker for conditions that impact hearing and vision. Screenings were conducted on 442 children who attended 1 of 12 schools in the region. Of the 183 (41%) children who failed ear screening, 59 were reviewed remotely by a specialist ear, nose, and throat surgeon with 9 children booked for surgery. Three hundred four completed an eye assessment, in which 46 (15%) failed and required referral to the optometrist. The utility of a mobile telehealth screening service with existing community-based services to provide specialist review and treatment planning at a distance was effectively demonstrated.