Queensland Telepaediatric Service: A Review of the First 15 Years of Service

Abstract

In November 2000, the Queensland Telepaediatric Service (QTS) was established in Brisbane, Australia, to support the delivery of telehealth services to patients and clinicians in regional and remote locations. The QTS was built on a centralized coordination model, where telehealth services could be effectively managed by a dedicated telehealth coordinator. In doing so, telehealth referral and consultation processes were efficient and clinicians felt better supported as they adjusted to new processes for engaging with patients. We have conducted a retrospective review of activity associated with the QTS and summarized key activities which have arisen from this extensive program of work. Telehealth service records and associated publications were used to describe the evolution of the QTS over a 15-year period. From November 2000 to March 2016, 23,054 telehealth consultations were delivered for 37 pediatric clinical specialties. The most common service areas included child and youth mental health, neurology, burns care, surgery, and ear nose and throat services. A range of different telehealth service models were developed to align with different clinical service needs and location of services. Whilst most work involved video consultation between hospitals, some services involved the delivery of telehealth services into the home, schools or community health centres. Despite its longevity, the QTS was not immune to the usual challenges associated with telehealth implementation, service redesign and sustainability. Experience reported from the QTS will be useful for other health services seeking to develop comprehensive telehealth services in a rapidly changing healthcare environment.

Keywords: digital health; indigenous; models of care; regional and remote health services; specialist health care; telehealth; telemedicine; telepaediatrics.

Figure 1

Wireless (robot) videoconference system used for bedside consultations in regional pediatric wards.

Figure 2

QTS main referral sites in Queensland and New South Wales.

Figure 3

Number of QTS consultations per specialty, from November 2000 to March 2016.

Figure 4

All QTS consultations over time (November 2000 to March 2016). Milestones: (A) mobile videoconferencing systems deployed for regional paediatric ward rounds; (B) mobile ENT surveillance service established; (C) QTS operational budget reduced; (D) staged closure of the RCH; and (E) transfer of the QTS to the new Queensland Children's Hospital in Brisbane.

Figure 5

(A) Mobile screening van used for surveillance of Aboriginal and Torres Strait Islander children at risk of ear disease and (B) child being screened by an experienced Aboriginal Health Worker.