Innovative telehealth program gives cancer patients in regional WA access to metro services

Husband and wife Mick and Helen Denison will tell you they do everything together — even cancer. “He got it first, I got it afterwards,” Mrs Denison said. “I went out in sympathy.” While that might seem morbid, it’s quite the opposite to hear the upbeat Wagin couple talk about their situation. “We’re lucky — we’ve got a home, we’ve got a little dog,” she said. “And we’ve got some beautiful people that look after us when we need looking after. I’m just so happy and grateful for that.” Every couple of weeks one of them makes their way to the hospital for chemotherapy treatment — Mick fighting a rare neuroendocrine cancer, Helen battling oesophageal cancer. But what makes their situation more unique is the innovative healthcare model allowing the Wheatbelt couple to receive that treatment via telehealth from a hospital just up the road. Up until 2019, many regional residents who required chemotherapy in Western Australia were referred to Perth to see specialists for testing and treatments. While not every patient, and not every appointment is eligible for Telechemotherapy (as its called), almost 400 country residents have accessed the service since it began. And WA Country Health Service Haemotology Clinical Director Dr Tony Calogero said it was going a long way to improving health outcomes for regional people. “One of the confronting issues about cancer care in rural and remote WA has been that the cancer outcomes historically — and certainly if we look back some years or some decades of cancer outcomes in rural and remote patients — have been inferior to those patients based in the Perth Metro (area),” he said. “There’s lots of reasons for that, but one of those reasons has been lack of capacity to engage in cancer care. And part of that is the tyranny of distance. “We’re really hoping that this progressive role out of telechemotherapy services and care closer to home will continue to narrow that gap for those patients.” A team of specialist cancer nurses, doctors and pharmacists work across Karratha, Narrogin, and Broome hospitals to offer the Telechemotherapy service. Since its inception, WACHS data shows country patients have accessed more than 2500 sessions of cancer care locally. For the Wagin couple in their 60s, it means a one-hour round trip to Narrogin Hospital, rather than a drive to the city, a gruelling treatment, and an overnight stay with family when they’re not feeling their best, before making the trek home. “It’s 50 kilometres, but it’s country road, so it’s basically about just over half an hour,” Mr Denison said. “It’s an amazing thing that we can have this reasonably close by. And it’s working. It actually works out perfect for us.” WACHS Nursing and Midwifery Executive Director Yvonne Bagwell was the Pilbara Nurse Director at the Karratha Health Campus when the program started and set up the first of the Telechemotherpy services. She said the delivery model was started as a way to deal with the issue of equity of access. “It’s a real focus . . . making sure that (patients) had access when they needed it the most,” Ms Bagwell said. “WA Country Health is probably the global leader in telehealth opportunities. “Not only did we implement the telechemotherapy model, we’ve got a large command centre and we can reach into all of our sites across the whole organisation and provide expert emergency doctors , senior specific-emergency nurses. “We have an inpatient telehealth service so we can support people in the inpatient admission, and we also have specialised midwives that reach in for midwifery, presentations, and support people on the ground. “We also provide palliative care services through that model as well. “It’s just grown and grown, which has been incredible and great to be a part of. Patients from the get-go were just so thankful.” Since telehealth itself was introduced and first utilised in WA country hospitals in 2012, close to 100 sites around the State have been updated to be telehealth-enabled. And at more than half of the sites, local staff can provide continuity of high-quality care for inpatients with the support of telehealth 24/7. In the last financial year WACHS reported regional residents attended 36,000 outpatient appointments via telehealth services, with almost 18,500 outpatient appointments delivered to local community settings or within the patient’s own home. It is estimated the Telechemotherapy program specifically — which won the Excellence in Person Centred Care Award at the 2023 WA Nursing and Midwifery Excellence Award — has saved patients from about five million kilometres in travel.