However attractive the idea of telehealth may appear to them, clinicians in regional hospitals will be preoccupied with clinical matters and are unlikely to have either the time or the expertise necessary to address the infrastructure and organizational aspects of establishing a telehealth service. Our experience of telepaediatrics in Queensland has shown that the support of the central service and coordinator has been essential in overcoming initial difficulties and has freed us as clinicians to concentrate on appropriate clinical referrals and consultation via telehealth. The central service is also able to assist in data collection, and in the analysis and interpretation of telehealth activity, for example in measuring cost-effectiveness. We have found that consolidating most consultations into planned clinics creates efficiency. The central coordinator can teach and support those new to telehealth in the regional and primary care setting, thus relieving the local clinician of this responsibility. As telehealth services expand in a regional centre, having a dedicated local telehealth coordinator may become appropriate. A central telehealth support service, which is clinically focused and responsive to clinicians' needs, is an essential foundation for successful telehealth.
Effectiveness and cost-effectiveness of a stepped care intervention for alcohol use disorders in primary care: pilot study
