Telemedicine has been broadly defined as the provision of medical opinion, evaluation or management services at a distance using information and communication technologies. It incorporates both synchronous (real-time eg. telephone and videoconferencing) and asynchronous (store-and-forward eg. teleradiology and teledermatology) technologies. Telemedicine has provided a solution to assist in health management where predominantly geographic but also socio-economic and weather-related barriers exist.
In Australia, geographic barriers reduce access to specialist care for people living in rural and remote areas. This is one contributor to an excess standardised mortality rate for people living in rural and remote areas compared with people living in major cities and inner regional areas. The federal government has provided incentives through Medicare item numbers to promote specialist consultations via videoconferencing. There is a limited literature that has examined the clinical outcomes and safety of diabetes management provided by endocrinologists utilising videoconferencing. I’ll present the outcomes of a non-inferiority randomised controlled trial which was designed to evaluate the reliability of videoconferencing for remote consultation of people with diabetes.
Compared with physician delivered telemedicine, there is a greater amount of evidence in the literature that has assessed the role of telemedicine in diabetes self-management. Under Professor Brian Oldenburg’s leadership, we have successfully piloted in people with Type 2 diabetes a self-management programme that utilises voice recognition and conversational technology. With a NHMRC partnership grant, this programme is about to be assessed in an implementation trial across three states in Australia.
Telemedicine can be a valuable, cost effective tool to narrow the gaps in clinical care for people living in rural and remote areas of Australia compared with those living in major cities.