Telemedicine and health apps can be convenient for patients but one researcher in Victoria is using the ehealth tools to help disadvantaged patients get the care they need.
Professor Vicki Anderson is the Head of Psychology at Melbourne’s Royal Children’s Hospital that treats children from all over Victoria, South Australia, Western Australia and South East Asia.
Anderson’s work saw recent success when they saw family participation rates in therapy jump from 15 to 85 per cent, with 100 per cent completion.
“The old model of getting families to come back into the hospital for treatment really is not viable,” Anderson said.
“The kids we see have had quite traumatic events – head injuries, strokes, cancer. They’ve been in hospital for a long time and they’re not all that keen to come back in. It has bad memories for them.”
When children suffer a traumatic, serious injury their families can struggle to cope at the best of times. When families are from remote or rural locations, or both parents are forced to work, the increased demands can leave parents burnt out, and see a child’s care and health suffer.
To try and address the disadvantage, Anderson has been working with other researchers, postdoctoral fellows and a digital design team at the Murdoch Children’s Research Institute to develop apps and use platforms like Google Hangouts to help families and children get care wherever they are.
One recent program, Take A Breath, provides online therapy sessions for parents of kids with serious illness or injury.
“We want to treat the parents’ trauma, because if the parents are functioning better, the better the kid’s recovery will be,” Anderson said.
According to Anderson, participation and completion rates were poor for the face-to-face program because many families couldn’t afford to travel to Melbourne for the sessions or they simply didn’t have the time in their schedules.
“So we sent iPads to the families and communicated with them in groups using Google Hangouts,” she said.
“One guy was in building construction in Perth but his child had come to Melbourne for treatment. So he took his iPad to work and during lunch he was able to go off and do his therapy online.”
Anderson’s work has also seen a number of other apps developed that are helping parents protect their child’s health.
In partnership with the AFL, they developed the Head Check app, which helps parents check for symptoms after a suspected concussion and then prompt them to call emergency.
“On the sidelines of your child’s sports game you can go through a set of symptoms and depending on your answers the app will tell you want to do,” Anderson said.
Similar health monitoring apps, specifically around mental health and depression, are appearing each day. Some have expressed concerns about their efficacy but Anderson emphasises that MCRI’s work is based on evidence and research.
“We're a research institute that prides ourselves on evidence-based apps. There's billions of apps out there, but what we do has to have that evidence base,” she said.
Other research has shown that ehealth and app-based approaches to patients can increase uptake and overcome access barriers to mental health care.
At MCRI they have found that a combination of ehealth and face-to-face is required.
“Online methods are not optimally helpful unless you access to a clinician at some stage – maybe a psychologist, a social worker. They have use on their own but they’re not optimally useful,” she said.
Beyond increased access for those at a disadvantage, Anderson said there have been other unexpected benefits.
“Typically for kids whose families come back into the hospital, it’s usually mums that come,” she said.
It meant that fathers weren’t as involved in their child’s health and they missed out on support and counselling. Anderson said online methods now meant fathers were more involved and couples were able to participate in trauma therapy sessions together at home.
“Many parents told us afterwards that they’d turn off the iPad after a session, and then sit and chat with each other about with it meant and how they could use what they’d learned to parent better,” she said.
“I think it’s fantastic – parents getting the same information at the same time, and then using it and working together.”