Experiences of rural clinicians accessing specialist support via telehealth for trauma and emergency care in Queensland, Australia

Abstract

Abstract Background Trauma and emergency patients presenting to rural facilities require time-critical treatment and management that is sometimes beyond the scope and experience of clinicians in the facility. In Queensland, Australia’s second largest state, telehealth infrastructure facilitates 24/7 communication between rural clinicians and tertiary-based critical care specialists. In this study we sought to understand the current state of Queensland’s emergency telehealth system from the perspective of direct end-users to inform future improvement efforts and resource allocation. Methods Semi-structured interviews were conducted with 11 rural Queensland clinicians who use telehealth to access specialist support during critical presentations. Qualitative data were analysed in three inductive phases: immersion; a combination of process coding and in vivo coding; and focused coding. Results Overall, the findings highlight that emergency telehealth support provides benefits beyond better patient care, as it fosters a sense of collegiality and alleviates professional isolation often experienced by rural clinicians. Four key themes were identified: (1) Challenges of trauma and emergency care in rural Queensland; (2) Strategies for trauma and emergency care in rural Queensland; (3) Factors that affect perceptions of telehealth effectiveness; and (4) How support for rural trauma and emergency care can be improved. Conclusions This study revealed that there are both benefits and frustrations for rural clinicians accessing telehealth specialist support for rural trauma and emergency care. Although telehealth specialist support is seen as a critical service that supports rural clinicians and benefits patient care, the findings suggest that tools, systems, and processes surrounding rural trauma and emergency care could benefit from streamlining, integration, and the introduction of new fit-for-purpose technologies. Addressing limitations of efficiencies would lead to better support for rural clinicians and would likely improve patient outcomes for rural communities.