Immediate pathology results now available for all remote Northern Territorians
Immediate pathology results now available for all remote Northern Territorians Conference Paper
14th National Rural Health Conference: A World of Rural Health
- Author(s): Spaeth, B, Shephard, MD, Auld, M, Omond, R
- Secondary Author(s): Coleman, Leanne
- Published: 2017
- Publisher: National Rural Health Alliance
Abstract: Introduction: The Northern Territory (NT) Point-of-Care Testing Program commenced in 2008 in over 30 selected remote health centres in the NT. Using the Abbott i-STAT point-of-care testing (POCT) device, pathology results are immediately available at the health centre enabling immediate diagnosis and treatment or monitoring of a wide-range of acute and chronic conditions. Background: In 2015, under the direction of the NT Department of Health, the program was expanded to every remote health service providing equity of access to this diagnostic tool for all remote Territorians. The large scale rollout, doubling the program’s size to 72 remote health services, required careful planning and innovation. Methods: The rollout was coordinated by a team of scientists, professional practice nurses and doctors who make up the NT POCT Program Management Committee. Strategies to rollout the program included: accessible training options including weekly teleconference training sessions; development of a website providing 24/7 Territory-wide access to training materials including videos; on-site visits to provide initial device set-up, training and coordination; and the development of an innovative method for monitoring the number and type of tests performed to assist with consumable ordering (a primary obstacle for remotely located health centres). A cost effectiveness evaluation of the program was conducted, funded through a grant from the Emergency Medicine Foundation. Patient cases from 6 remote health centres where the availability of POCT ruled out the need for an emergency medical retrieval were reviewed to determine cost savings. Results were extrapolated using prevalence data for each condition to give an NT-wide estimate of cost savings. Clinical effectiveness of POCT was also examined. Results: In the initial 6 months of the rollout, 158 new remote staff were trained as device operators with survey respondents expressing high satisfaction with the quality of training. The analytical quality of POCT results in this primary care setting remained stable during the rollout period and was of equivalent standard to a laboratory. Improvements in outcomes for acutely ill remote patients were identified through POCT enabling more rapid diagnosis and treatment. Indicative cost savings through preventable medical evacuations using POCT are substantial (millions per annum), with final results to be released in October 2016. Conclusion: This POCT program serving remote communities can be translated to other areas of remote Australia and internationally due to its significant cost savings through prevention of unnecessary medical retrievals and positive impact on patient outcomes and increased patient safety.
- Urls: http://www.ruralhealth.org.au/14nrhc/sites/default/files/Spaeth%2C%20Brooke_A4.pdf Available from, http://www.ruralhealth.org.au/14nrhc/program/concurrent-speakers Download site
- Publisher Location: Cairns