Telemedicine

Bookings
Mrs Angela Casarin	Phone: Email:	+ 61 8 222 5577
Information Technology Manager
Ms. Margaret Sampson	Phone:	+61 8 8222 4000

Just prior to the beginning of 2003, the Telemedicine Centre required a significant upgrade because of how quickly technology had progressed since the Centre opened in 1996. The major change visible to users was to have a wide screen at the front and a data projector and the moving of the lectern to accommodate this. The telemedicine room still has the same range of capabilities with a remote camera and a clinic room next door, the ability to project x-rays with a camera mounted above a viewing box, pathology from a camera mounted over a microscope and the ability to either plug in a microscope or use slides or videos in audio-visual presentations.

Most of the RAH Cancer Centre multidisciplinary clinics are still held within the Telemedicine Centre and the weekly medical oncology video-conferences with Darwin which is why the centre was developed are still supporting oncology in Darwin where the clinician there can present patients to a multidisciplinary team in Adelaide and conversely can comment on the cases that are presented from Adelaide. Other regular meeting include a multidisciplinary pain meeting where the palliative care nurses from Broken Hill join us regularly and nursing education uses the facility regularly to communicate with remote nurses.

Others have used the centre for national and international meetings.

Research has been a further use of the centre. A series of workshops on communication skills to underline a research project being conducted by the University of Sydney into psycho-social communication were conducted via the video-conferencing centre.

Alice Springs:

A new video-conferencing initiative this year has been the use of a regular fortnightly video-conference with Alice Springs. Ian Olver visits Alice Springs but only every four months and does an intensive clinic there but as the patient meetings have grown with seven or eight patients per week on chemotherapy, there has been a need for more regular contact with the general physician and chemotherapy nurse who care for the patients between visits. Because that video-conference is only with a single individual instead of using the video-conferencing room, a desk-top unit is used from an office. This also functions as a back-up unit should the regular video-conferencing room develop problems. As the technology has improved the quality of the image on the desk top systems, which use the computer screen as the monitor, has improved considerably a comfortable conference can be sustained. There is less need here for projection of pathology and radiology since this is a meeting designed for the ongoing management of patients known to the clinicians in either end of the conference.

Analogue Video Phones:

Building on our experience with digital video-conferencing for oncology between the Royal Adelaide Hospital Cancer Centre and the General Hospital in Darwin which we have previously evaluated, a second NH&MRC funded program is exploring the use of analogue video-phones between rural outreach palliative care nurses in Port Pirie and more remote surrounding communities at Peterborough 95 km away and Boolaroo Centre 65 km distant. This will provide support from the specialty nurses to the more general nurses and patients who require palliative care. The video-phones can be easily transported to the patients’ homes and plugged into the normal phone line. This is not designed to replace visits but in areas logistically difficult to access frequently, it will increase contact between specialist palliative care nurses and remote general nurses in between patients and nurses between visits.

An evaluation has also has been developed for the staff and patients,. Problems to which to the program must adapt include the high turn over of staff in remote sites and small patient numbers. To date, the remote nurses reported good patient acceptance and patient communication has been aided by adding vision to the audio of a phone line. The specialist palliative care nurse was able to access the patients and their nurses more frequently and saved travelling time through difficult terrain, although there was some time spent by the remote general nurse in establishing the link. Other problems include a loss of the call signal and technical problems with the equipment, all of which can be improved. To date, the nurses are keen to explore this technology further to supplement their outreach services to remote centres and leaving the phones in the patients’ homes so that they can communicate with their nurses between visits.