Telemedicine clinics and mobile health screening services for Indigenous children

Health-e-Screen 4 Kids

In Queensland, the incidence of ear disease such as otitis media in children from Aboriginal and Torres Strait communities can be as high as 70%. If chronic ear diseases are not detected early and consequently left untreated, there is a high risk of perforation of the tympanic membrane and hearing defects, affecting language development and education.

Mobile screening van

This new method of health screening being trialled by the COH includes a custom designed vehicle which has been converted into a mobile clinic. The mobile screening van has all of the facilities required for the onboard assessment of children in the South Burnett region of Queensland –approximately 300 km northwest of Brisbane. The vehicle has wireless telecommunication (Telstra NextG) links which will enable specialists in Brisbane to assess children from a distance using information collected by specially trained health workers in the community. 

The screening van has undergone a major transformation with professional signage including Aboriginal and Torres Strait Islander murals done by local Cherbourg artist Peter Carlo, making the van culturally appropriate.

Service delivery

This innovative application will give dedicated health workers the opportunity to travel to surrounding communities for the routine screening of children. Senior health workers will collect patient information and digital images, together with a clinical history of the patient, hearing assessment and health risk questionnaire. This information will be stored on a computer and transmitted via a website to a secure database which will be routinely monitored by a team of specialists based at the Royal Children’s Hospital in Brisbane. 

Practical benefits

HealtheScreen4KIDS is unique because it is operated by a dedicated Aboriginal and Torres Strait Island health worker (based in Cherbourg) on a daily basis rather than an ‘intermittent’ service which visits communities once or twice during the year. This project is important because it may help ensure the early detection and monitoring of children at higher risk of developing a chronic disease. By taking the screening service to the selected communities on a more regular basis, we are hoping that we can increase the overall screening rate to above 90% of all Aboriginal and Torres Strait Islander children in the selected region.

Success in the South Burnett

Since the screening program formally commenced in February 2009, the community support and reaction to the new service has been extremely positive. Within the first few months, we received a consent rate of over 75% (759 children), indicating strong support of the community based service. By the end of the first year, 665 children had been screened at least once by the HealtheScreen4KIDS service – revealing a group of about 230 children (35%) with potential hearing problems and 80 children (12%) with potential vision impairment. All of these children were referred to local and specialist outreach clinics for further assessment and treatment.

Acknowledgments

The HealtheScreen4KIDS research project is being funded through the Royal Children’s Hospital Foundation with the generous support from Virgin Blue, the Zig Zag Foundation, the Rio Tinto Aboriginal Fund, the Telstra Foundation, the Ian Potter Foundation, Grosvenor Foundation, the Sidney Myer Fund, Perpetual Trustees and The Australian Children’s Trust. This project is an initiative of The University of Queensland Centre for Online Health in collaboration with the Royal Children's Hospital and Cherbourg Community Health Services (Queensland Health).

Update

The official launch of the HealtheScreen4Kidsproject in February 2009 marked a successful first phase of the three year project. The South Burnett became the first region in Queensland to trial a custom designed mobile health screening clinic with telemedicine links to Brisbane – and their gratitude was unmistakeable in a spectacular ceremony led by respected elders in Cherbourg. The response to the service this year has been outstanding. The Cherbourg community deserve full credit for their enthusiasm and commitment to the project, which has already resulted in a significant improvement in screening rates of school-aged children at risk of chronic ear disease.
 

Media Highlights

• University of Queensland News Online:  New mobile clinic puts the health of Indigenous children in the front seat
• The Courier Mail:  Children get fair hearing [ JPG, 615KB ]
• The Courier Mail:  Mobile ear checks to screen Cherbourg youth
• ABC Brisbane:  Mobile service to treat Indigenous ear disease 'epidemic'
• ABC National:  Mobile health clinic to tour Indigenous communities
• Brisbane Times: Roving clinic to fight Indigenous 'glue ear'
• The South Burnett Times: Boarding the bus for healthier, deadlier and stronger children [ PDF, 152KB ]

References

• Elliott G, Smith AC, Bensink ME, Brown CA, Perry C, Stewart C and Scuffham P. The Feasibility of a Community-Based Mobile Telehealth Screening Service for Aboriginal and Torres Strait Islander Children in Australia. Telemedicine and eHealth Journal, 2010, 16 (9):

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