When a woman in a remote region of Queensland went to have her eyes tested at a world-first, high-tech facility that had rolled into town in a semi-trailer, she knew it might save her sight but never imagined that within days it would have saved her life.
The iconic IDEAS Van has rumbled across 250,000 kilometres over the past four years, transporting $1 million worth of state-of-the-art technology into areas with little access to specialist services.
A mobile, three-room ophthalmology and optometry specialist treatment centre, it is blazing a gap-closing trail as it heads into rural and remote communities, sparing Aboriginal and Torres Strait Islanders from preventable diabetes-related blindness.
Spearheaded by Lyndall De Marco, Executive Director of the Diamond Jubilee Trust, with the support of Queensland Health, the IDEAS Van’s screening program saw retinal cameras distributed to Aboriginal Medical Services where health workers are trained to screen patients.
The images are uploaded into a secure platform and assessed primarily in Sydney by Professor Paul Mitchell, a world-renowned medical retinal specialist and Director of Ophthalmology for the Sydney West Area Health Service.
With the eyes a window into the body’s endocrine system, the IDEAS Van has also been able to go beyond sight to showcase life-saving benefits.
“One evening Professor Mitchell called me to say that he had been reviewing a patient’s retinal images and found that one lady might have a problem with her carotid artery,” De Marco told Healthcare IT News Australia to mark NAIDOC Week.
“He asked if we could find that patient quickly and get her to the IDEAS Van for an ultrasound which revealed that the lady had carotid artery thrombus. She was sent immediately to Brisbane for two operations and came back to tell us that IDEAS had saved her life.”
The world’s first mobile ophthalmic treatment vehicle journeys throughout the outback with its sensitive equipment on board and has reached more than 5500 people from 47 communities. Of those, over 4600 have been Indigenous and more than 3300 needed further treatment.
Aboriginal and Torres Strait Islanders aged over 40 are six to 10 times more likely to suffer blindness than other Australians, yet 94 per cent of Indigenous vision loss is preventable or treatable.
De Marco said since the success of the IDEAS Van, a Queensland Heart Van and Lions Outback Van in Western Australia had been established, but there is untapped potential for improving Indigenous health in a vast country via cutting-edge clinics on wheels.
“Everything that has been used in the IDEAS model could be replicated and the gap could be closed very quickly.”
With the stakes so high and the potential gains so great, she called on the medical profession to provide more support for remote models of care.
“There are many medical disciplines that could utilise this model and it would save the government billions of dollars and many lives,” she said.
“Telehealth has such potential but has met with a lot of resistance by the medical field. Australia invented the School of the Air – what happened?”
The IDEAS Van, which was developed with a $5 million Close the Gap grant, also allows endocrinologists to conduct consultations through a clinical grade telehealth system, and offers OCT imaging, fluorescein angiography, diagnostic ultrasound and indocyanine green angiography, retinal laser, intravitreal injections, YAG laser capsulotomy and SLT laser.
A bespoke EMR donated by Extensia was created in consultation with the Indigenous community and clinicians.
"Remote communities have fewer health providers and a high turnover, making care coordination a major challenge,” Extensia CEO Emma Hossack said.
“Extensia's platform has a privacy-by-design platform so consumers who wish to share their information can do so in real time with their selected providers. In the case of the IDEAS Van, access to real-time information has not only saved sight but also at least one life."
Diabetes is a significant cause of chronic disease in Indigenous communities with Aboriginal and Torres Strait Islanders almost four times more likely than non-Indigenous Australians to have diabetes or be pre-diabetic.
Retinopathy is an important biomarker of the risk of other complications from the condition, including kidney disease, peripheral neuropathy, stroke and myocardial infarction.
For De Marco, though, despite the lifesaving possibilities of this pioneering rig, there is also real meaning in being able to save the sight of someone who would otherwise have been needlessly blind.
“It is extraordinary and I expect every ophthalmologist feels that way when their patient can see again. I cannot imagine what it would be like to live somewhere where there is no one who can help you from going blind. I am proud of the people who have worked together to put the IDEAS Van on the road and give these people hope.”
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