Dunedin Hospital expands use of telemedicine

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Picture: Southern DHB paediatric endocrinologist and paediatrician Ben Wheeler in a telehealth conference with patients

eHealthNews.nz editor Rebecca McBeth

A telemedicine service set up to deliver diabetes clinics to children and adolescents from the southern region has been extended, tripling the number of patients receiving virtual care.

Southern DHB paediatric endocrinologist and paediatrician Ben Wheeler set up a telemedicine service in 2015.

The first clinic was established at Dunstan Hospital and the service has since been extended to Oamaru and Wanaka. Wheeler has also run telemedicine clinics to Queenstown when required and has, on some occasions, linked to endocrinology patients in their own homes.

He says the very large geographical area of Southern DHB traditionally meant children with diabetes and their families were having to travel for up to five hours each way for a face-to-face appointment at Dunedin Hospital three to four times a year.

However, the appointments are often not about physical examinations, but about providing support and education and dose adjustments, which means “telemedicine was nicely designed for helping to deliver diabetes care,” Wheeler says.

Since telemedicine clinics have been introduced, patients now only have to travel as little as once every two years and otherwise have their care delivered much closer to home.

Patients go to a local clinic where members of their multidisciplinary team – dietitians and diabetes nurse specialists – join them for the telemedicine appointment with Wheeler in Dunedin Hospital and perform any measurements or tests that need to be done.

Wheeler says this approach better utilises staff based locally who provide ongoing support to patients in their region.

Patients are also keeping their day-to-day glucose monitoring data in cloud-based systems and can share this information online for him to review prior to a telemedicine appointment.

Wheeler says his days now involve a patient list where some patients are sitting outside in the waiting room, while others are on the end of a video conference link. He has gone from running a telemedicine clinic once every three months, to at least one a month.

“We run a hybrid model where we alternate through the clinic with both telemedicine and in-person consultations,” he explains.

He says the telemedicine clinics are better at running on time and the link does a surprisingly good job at retaining a human connection to his patients, but he would not want all of his appointments to be delivered remotely.

“If you replace the personal contact completely, we may decrease the quality of medicine we are delivering as well,” Wheeler says.

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