Impact Of Telehealthcare Model On Diabetes Management Amongst The Aboriginals Assessment Answer

Introduction 

Telehealth is an interchangeable concept with telemedicine that is known for utility addressing collection as well as the exchange of information. This exchange of information occurs in between the allied healthcare, doctor and patients through asynchronous and synchronous modes. Telehealth in Australia has been placed in support of the major clinical programs that include mental health, diabetes, mental health and various other regional concerns that includes rehabilitation, including outpatient and relief support. The current presentation will explore the impact of telehealthcare model on diabetes management amongst the Aboriginals and Torres Strait Islanders.  The purpose of the presentation is to understand the extent telehealth can improve the quality of Care through better support of the disease management and implementing best practices.  In order to reach the rural as well as the remote areas in Australia, the clinical service have been utilizing the telehealth technology so that they can extend their resources to these remote locations.  

Priority Patient population and Care 

Type 2 diabetes is one of the chronic conditions in Australia that have been spreading fast. The Aboriginals and the Torres Strait Islanders are found to be at high risk for Type 2 diabetes compared to the other population. The indigenous population suffer from various complications related to diabetes that includes eye disease, kidney disease, stroke, heart attack, limb amputation and nerve damages (Caffery et al., 2017). An increasing number of people within the indigenous population were found to be impacted by the high rate of obesity dietary changes and a higher ageing population. The westernized lifestyle has impacted the Aboriginals traditional lifestyle, which has impacted on their metabolism. Food that is less expensive is low in fibre content while rich in sugar and fat content contributes to the sedentary lifestyle of the population.  This has caused weight increase with associated conditions like diabetes, heart disease and high blood pressure (Nguyen, Subhan, Williams & Chan, 2020). In order to improve the health status of the population, there needs to be lifestyle modification of the population which includes dietary changes, increase in physical activity and weight loss. Monitoring of the blood glucose with the use of oral hypoglycemic medicines is some of the treatments that are suggested for the diabetic population amongst the Aboriginals. 

Telehealth model comparison and contrasting 

With the increase in the prevalence of chronic condition like diabetes, it was important for the healthcare professional to implement a certain integrative plan for the management of diabetes. The plan for the management of diabetes needs to be measured such that the quality of life is improved with its cost-effectiveness.  Especially in areas of remote and rural areas, the delivery of clinical services is a challenge as they are rarely cost-effective. This poor accessibility of health care is maximum for the indigenous Australians. One of the telehealth models that has been explored for the management of diabetes amongst the Aboriginal population is telemedicine. Telemedicine model involves in a face-to-face consultation. The patients with the help of telecommunication system communicated and interact with the doctor so that they manage their diabetes condition effectively. One of the methods that have been adopted by Pludwinski, Ahmad, Wayne & Ritvo (2016 ), in the management of diabetes is the use of glycated haemoglobin. One of the advantages of the telemedicine is for the patients in the rural and remote areas where the patient does not need to travel for consultation and hence can save travel expenses. The second type of telehealth model that has been discussed by Dawson et al., (2020), is the utilization of smartphone as well as self-monitoring software to keep in track of the type 2 diabetes condition. The smartphone-based monitoring device will help the patient to adhere to the lifestyle so that the glycemic control can be improved. This smartphone-based software could be utilized in the behavioural tracking of the patients with the personal monitoring, self-management and feedback from the medical professionals. It also provided coach generated reminders that helped the patients to remain adhered to their routine to keep their glycemic level in check. Among the two models, it can be said the telemedicine will allow the patients to be able to consult with their doctor on a regular basis so that the patients can effectively manage their diabetes condition. The doctors will play a health coach remotely providing support and dedicated suggestions for the improvement of their diabetic condition.

Overview of the Issues faced 

In spite of the increase in the popularity of telehealth, the uptake of the telehealth models has been limited amongst the population of Aboriginals. One of the main reasons is the lack of adequate accessibility of broadband internet. As stated by Huemer, Wagner and Sim (2020), with the assistance of medical service Alliance, LHS or the Laynhapuy Aboriginal Community Health Services and eMerge, which is a local communication company, a regional broadband connection have been established in three regions of the Aboriginal communities (Fraser et al., 2017). The building of the satellite infrastructure is expensive, with the monthly connectivity is $12000 for the three sites. This has created difficulty for the Aboriginal population in accessing video conferencing with the availability of high video quality. Initially, these consultations were only done through audio calls carried out by the nurses, registrars or hospital staffs. However, in case there was a need of higher-level consultations the patients had to travel to the medical centres due to the lack of proper internet connectivity (Furman, Harild, Anderson, Irish, Nguyen & Wright, 2018). In addition, Aboriginal residing in the remote areas and who are located in diverse geographical locations needed consultations and practice group that would befit their cultural norms.  In any of the decision-making process for the Aboriginal patient, it was crucial the clinical practitioners take into consideration the inclusion of the family. Hence for instance, if any operation needs to be conducted, it is important for the family to be included in the decision-making process of the surgery of the patient.

 The Appropriate telehealth care for the population

The telemedicine helps in facilitating the best telehealth care for the Aboriginal population. The medical professional who communicates information about the management and treatment of diabetes condition follows a culturally appropriate care plan keeping in perspective the cultural and social norms of the Aboriginal community (Madjedi & Daya, 2016).  The healthcare that is provided to the Aboriginal population needs to consider the social, economic and political factors while providing This type of health care healthcare services. The care plan is developed considering the dignity, safety and privacy of the healthcare professionals so that the discrimination in between community can be reduced (Fraser et al., 2020). The telemedicine will not only cater to the community a culturally appropriate care service but also recognize the identity with shared respect, knowledge and meaning of the patients. It will take into consideration the cultural competence of the Care provided by the doctor considering the behaviour, policies and attitudes of the Aboriginals (Aranha et al., 2017). However, the same effect will not be achieved by a smartphone-based software. As this software will not be able to provide the customized services and health plan considering the cultural needs and support for the community. 

Outlining the telehealth model in relation to Diabetes management

Telemedicine is an alternative platform where the patients suffering from a chronic condition like diabetes with be provided with face-to-face consultations. The telecommunication system will be utilized in delivering healthcare at a certain distance, aiming to improve healthcare outcomes. The telemedicine aims in improving the outcome of the diabetes care maintaining equity of the healthcare accessibility as well as with its associated costs.  The three aspects that are accessed by the telemedicine health care is patient communication with the proper distribution of education related to diabetes and monitoring of the health condition.  As mentioned by McLean et al., 2019), limited evidence that is available regarding the effectiveness of telemedicine, however, the small number of researches highlights telemedicine to have a higher impact on the Care of the diabetes patient than the conventional Care.  The patients are found to be more satisfied with the management of diabetes through the utilization of telecommunication technology.  Even though the concept of telemedicine has been widely communicated and document wins different parts of Australia, however, the feasibility of the treatment is yet to be verified by comparing the video conferring in between the doctor and the patient with the face-to-face consultation with the patients. 

Identification of telehealthcare model for patient's empowerment and engagement

With the utilization of telemedicine, the accessibility of healthcare services has become far easier than before. This has also resulted in reducing the disparity in the healthcare status of the Indigenous population. This effort to enhance the accessibility of healthcare is targeted by the ACCHS or the Aboriginal Community-controlled Health service so that the community can access speciality services.  Eventually, it was observed that the Aboriginals could access the mainstream services of healthcare that encompasses both specialists as well as primary Care (Spurr, Bullin, Bally, Trinder & Khan, 2018).  The Indigenous-specific health care services enhanced with the telemedicine as they were less expensive and followed an alternative model of service delivery. The telemedicine is similar to the real-time consultation that allows the doctor to review the patient history and the results of the various diagnostics test based on which he provides the health plan to the patients. The data like weight, blood glucose and the blood pressure level can be accessed by the clinical through the remote monitoring process providing better Care to the community. This ensures that the main purpose of the telemedicine is achieved, these are patient knowledge, better clinical outcome and empowerment of the patient by providing appropriate screening, adherence to the standards of clinical practice and high quality of care. 

The multidisciplinary approach of telehealth model

Telemedicine is a type of telehealthcare model utilizing remote use of telecommunication technology so that there is an appropriate exchange of medical information. This includes proper prevention diagnosis, administration, examination, research, evaluation, follow up treatment and education of the patients.  Thus, telemedicine needs to be included in all the stages of the clinical settings that include primary, tertiary and secondary (Fraser et al.,2020). The multidisciplinary team comprises of different specialists from different medical fields and often to provide a proper care plan the medical professional may need the involvement of the multidisciplinary team so that the final expert opinion of the patient’s condition can be provided (Moo, Batchelor, Silva & McMillan, 2019). The informant of the multidisciplinary team results in the revolutionizing the telemedicine with an efficient diagnosis, follow-up and treatment of the chronic conditions like diabetes. 

Evaluation of the patient and their family response to telehealth model

At the time of video conferencing and consultation process, the patients are often accompanied by their family members so that a culturally competent clinical service can be provided to the Aboriginal patient. As observed by the researchers like McLean et al., (2019), when the Aboriginal patients took their family members in the teleconsultations, they developed a positive perception in terms of the quality of the Care provide as well as the interpersonal communication. Further, the patients were found to develop a positive rapport with the medical specialist during the teleconsultation process (St Clair, Murtagh, Kelly & Cook, 2019).  More number of patients preferred video-consultation instead of a face-to-face consultation with the medical professional. More number of Aboriginal patients believed that with the involvement of the family member during the teleconference with the medical profession helped in the provide culturally appropriate care. This had allowed the patient in gaining confidence on the care facility and service since they were provided with the Care within their local community. 

Conclusion

Hence, from the study, it can be concluded that telehealthcare is an efficient method of distribution of healthcare service, especially in the remote and rural areas. Among the different telehealthcare model, telemedicine has been found to be the most effective in assisting the Aboriginal population suffering from diabetes and diabetes-associated illness. In spite of the lack of adequate internet connectivity and infrastructure that pose a challenge for telemedicine, it can be said, this like of healthcare model is far more effective as it is less expensive and more accessibility for the Aboriginal population residing far from cities.