Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM framework
Abstract Background Rural provider-to-provider telehealth is growing globally. It is used to both facilitate equitable access to specialist healthcare services for those living in rural and remote areas and provide support to place-based providers. There is limited research on the implementation of...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12913-025-12335-2 |
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| author | Kaylie Toll Suzanne Robinson Stephen Andrew Aled Williams Justin Yeung Richard Varhol Joanna C. Moullin |
| author_facet | Kaylie Toll Suzanne Robinson Stephen Andrew Aled Williams Justin Yeung Richard Varhol Joanna C. Moullin |
| author_sort | Kaylie Toll |
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| description | Abstract Background Rural provider-to-provider telehealth is growing globally. It is used to both facilitate equitable access to specialist healthcare services for those living in rural and remote areas and provide support to place-based providers. There is limited research on the implementation of these services, especially in an emergency or inpatient hospital setting. The Western Australia Country Health Service (WACHS) Command Centre is one such example. First implemented in 2012, the Command Centre services a geographical area covering 2.55 million square kilometres, a population of approximately 550,000, and provides five clinical streams including Emergency, Mental Health Emergency, Midwifery and Obstetrics Emergency, Inpatient, and Palliative Care Afterhours Telehealth Services. Objectives This study aimed to evaluate the implementation and access of rural provider-to-provider telehealth in country Western Australia, for the years 2012 to 2023. Methods A retrospective observational analysis was conducted of all patient contacts managed by clinical telehealth streams of the Command Centre, between 31 August 2012 and 31 December 2023. Utilising descriptive statistics, analyses was informed by the expanded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework and Implementation Outcomes Framework (IOF) definitions. Results Over the near 12-year period, a total of 215,965 service contacts were analysed from the five Command Centre clinical streams. There was large variation in the reach and adoption of services across regions, sites, and health facility types, however service scope and activity has increased steadily over time (maintenance). 95 of the 103 WACHS-managed sites had utilised Command Centre clinical telehealth services. The Command Centre has seen an increase in the proportion of clinical telehealth services provided to the most disadvantaged populations, demonstrating improved equity of access (effectiveness) over time. Conclusion There is a steady expansion in the availability of provider-to-provider clinical telehealth services delivered by the WACHS Command Centre across country WA, but with wide variability of usage depending on region, site, and health facility type. The results of this study show there is a need to understand the contextual factors influencing the adoption, implementation, and sustainability of the service. |
| format | Article |
| id | doaj-art-84bcff4eda364a3cbec46afc11127084 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-84bcff4eda364a3cbec46afc111270842025-02-02T12:14:28ZengBMCBMC Health Services Research1472-69632025-01-0125111710.1186/s12913-025-12335-2Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM frameworkKaylie Toll0Suzanne Robinson1Stephen Andrew2Aled Williams3Justin Yeung4Richard Varhol5Joanna C. Moullin6School of Population Health, Curtin UniversitySchool of Population Health, Curtin UniversityWA Country Health ServiceWA Country Health ServiceWA Country Health ServiceSchool of Population Health, Curtin UniversitySchool of Population Health, Curtin UniversityAbstract Background Rural provider-to-provider telehealth is growing globally. It is used to both facilitate equitable access to specialist healthcare services for those living in rural and remote areas and provide support to place-based providers. There is limited research on the implementation of these services, especially in an emergency or inpatient hospital setting. The Western Australia Country Health Service (WACHS) Command Centre is one such example. First implemented in 2012, the Command Centre services a geographical area covering 2.55 million square kilometres, a population of approximately 550,000, and provides five clinical streams including Emergency, Mental Health Emergency, Midwifery and Obstetrics Emergency, Inpatient, and Palliative Care Afterhours Telehealth Services. Objectives This study aimed to evaluate the implementation and access of rural provider-to-provider telehealth in country Western Australia, for the years 2012 to 2023. Methods A retrospective observational analysis was conducted of all patient contacts managed by clinical telehealth streams of the Command Centre, between 31 August 2012 and 31 December 2023. Utilising descriptive statistics, analyses was informed by the expanded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework and Implementation Outcomes Framework (IOF) definitions. Results Over the near 12-year period, a total of 215,965 service contacts were analysed from the five Command Centre clinical streams. There was large variation in the reach and adoption of services across regions, sites, and health facility types, however service scope and activity has increased steadily over time (maintenance). 95 of the 103 WACHS-managed sites had utilised Command Centre clinical telehealth services. The Command Centre has seen an increase in the proportion of clinical telehealth services provided to the most disadvantaged populations, demonstrating improved equity of access (effectiveness) over time. Conclusion There is a steady expansion in the availability of provider-to-provider clinical telehealth services delivered by the WACHS Command Centre across country WA, but with wide variability of usage depending on region, site, and health facility type. The results of this study show there is a need to understand the contextual factors influencing the adoption, implementation, and sustainability of the service.https://doi.org/10.1186/s12913-025-12335-2TelehealthVirtual careEmergency careImplementation scienceObservational analysis |
| spellingShingle | Kaylie Toll Suzanne Robinson Stephen Andrew Aled Williams Justin Yeung Richard Varhol Joanna C. Moullin Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM framework BMC Health Services Research Telehealth Virtual care Emergency care Implementation science Observational analysis |
| title | Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM framework |
| title_full | Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM framework |
| title_fullStr | Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM framework |
| title_full_unstemmed | Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM framework |
| title_short | Implementation of rural provider-to-provider telehealth in country Western Australia: a retrospective observational analysis via the RE-AIM framework |
| title_sort | implementation of rural provider to provider telehealth in country western australia a retrospective observational analysis via the re aim framework |
| topic | Telehealth Virtual care Emergency care Implementation science Observational analysis |
| url | https://doi.org/10.1186/s12913-025-12335-2 |
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