Breathing easy with telehealth in Western Australia

Four years ago, when Asthma WA launched its telehealth service to help regional patients with asthma and chronic obstructive pulmonary disease (COPD) manage their symptoms, a video consultation with a health practitioner was a revolutionary concept.

Today, according to Asthma WA Learning and Development Manager, Rael Rivers, telehealth has become an embedded practice that is accepted by patients and health professionals alike.

One of the main drivers of acceptance has been COVID-19.

“Since COVID, we’ve really seen a big change with patients willing to video conference from their homes,” said Rael, who has overseen Asthma WA’s Asthma and COPD Telehealth Service since 2017.

“The patients understand that telehealth is not such a big deal and they know that they’re still getting quality healthcare even though it’s not a face-to-face appointment at a hospital … I think that was the big barrier before – the lack of knowledge. People thought it all seemed too difficult even though it is just a couple of clicks to connect. It’s really about letting people know how easy it is to use and health professionals have become more accepting of its use as well.”

The telehealth service has been so successful, the group received additional funding this year from the WA Primary Health Alliance to expand its telehealth service to patients living in metro areas as well.

Funding was also used to establish a COVID-19 Helpline for regional and metro asthma and COPD patients to connect with a respiratory health nurse or educator to discuss any concerns regarding their respiratory condition and COVID-19.

Bringing healthcare to the patient

Every year, Asthma WA provides telehealth support and education to around 360 regional clients either by video conference or telephone.

With its recent expansion into metro areas, Asthma WA has used telehealth technology to connect 823 Asthma and COPD patients with their Respiratory Health Team for regular check-ups, monitoring, education, and coaching.

The group also uses telehealth technology to deliver training and education to more than 750 WA health professionals annually.

Telehealth has become so commonplace, says Rael, that “now, we just look at telehealth or video conferencing as just another medium: our funding allows us to deliver our services face-to-face, through a video conference, or through the phone. We have more options and people are more comfortable with video now.”

Helping patients manage their asthma and COPD

COPD is one of the leading causes of death in Australia.

According to the Australian Institute of Health and Welfare (AIHW), COPD is a preventable and treatable lung disease characterised by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible.

The symptoms of COPD include cough, sputum production, and dyspnoea (difficult or labored breathing). COPD symptoms often don’t appear until significant lung damage has occurred, which usually worsens over time.

It is worth noting that it can be difficult to distinguish COPD from asthma because the symptoms of both conditions can be similar—both have obstruction to the airways; both are chronic inflammatory diseases that involve the small airways.

COPD can interrupt daily activities, sleep patterns and the ability to exercise.

As chronic conditions, COPD and asthma require regular monitoring and medication.

Asthma COPD Medications chart

Asthma WA is a registered charity that has been helping Western Australians breathe for more than 50 years. In 2016, it launched its Asthma and COPD Telehealth Service to bring care to the point of need in rural and remote WA.

“There were gaps in chronic-condition care in the country areas of WA and we wanted a way to centralise it and make a healthcare model where patients would be put on a ‘pathway’ to make sure there was regular follow-up and monitoring,” explains Rael, who is based in Perth with her team.

“…We wanted something that would be community-based which means that we’re monitoring patients and educating patients in their community. It’s not an appointment in a hospital as such, but they can contact us to talk to one of our respiratory health nurses or educators.”

Patients are typically referred to the telehealth service by their physician or as part of the hospital discharge process.

The patient will usually participate in the program for six to 12 months, for around three to four sessions with an assigned respiratory health nurse.

“Asthma and COPD are both chronic conditions which means they are long term and it also means that symptoms can fluctuate so the patients need to manage their condition,” says Rael.

“We get referrals from the GP who has already diagnosed the patient and then we educate the patient along the path to self-management.

“Our nurses provide coaching and monitoring so when the patient is having a flare-up or exacerbation, they will know how to manage it themselves. It’s about the patient reaching optimal health.

“We go through their medications, so they understand how to take them and why they need to take them regularly. We talk about their respiratory condition … and we go over the healthcare plan their GP has drawn up.”

Most consultations are performed via video conference, with telephone consults used for follow-up sessions. If required, the respiratory health nurse will arrange a face-to-face visit for the patient.

In Rael’s opinion, telehealth technology is an important part of the future.

“I think it’s here to stay. Hopefully, it will be embedded in services across the country. Consumers will still have the choice of a face-to-face visit, a video conference, or a phone call. It will give the consumer more choice.”