Background
The intermittent availability of allied health services in remote Aboriginal and Torres Strait Islander communities was a major barrier to older people accessing these services and telehealth was not available. While telehealth has the potential to improve access to allied health services in remote communities, there is a paucity of place-based evidence on how to implement and sustain these services for older people. This study aimed to (1) describe the existing model of care and identify gaps in allied health service provision in a remote aged care setting; and (2) co-design and evaluate the feasibility of a new model of care to address these service gaps.
Methods
A participatory action research (PAR) study in a very remote Central Australian community, where more than 95% of the population identifies as Aboriginal, used interviews and yarning sessions with 23 participants, including patients, carers, allied health professionals, and aged care staff. Deductive analyses applied the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework and data were also analysed using an inductive approach.
Results
Community-based Aboriginal staff and Allied Health Professionals engaged in a co-design process and proposed a hybrid telehealth model that was tested among service providers and subsequently used for consumer consultations. This hybrid telehealth model was acceptable to Aboriginal Aged Care clients and their families with care provided in partnership with local aged care staff and facilitated by a trusted local Aboriginal staff. While telehealth has the potential to improve access to allied health services in remote communities, challenges for implementation include aged care workforce shortages, gaps in technological skills, and coordination between stakeholder organisations.
Conclusions
A co-designed hybrid telehealth model for older adult allied health services was acceptable and valuable for remote Aboriginal Aged Care clients and Allied Health Professionals. Effective implementation of telehealth as a sustainable mode of service delivery requires strong leadership engagement, dedicated resources, technological capability and capacity, and a stable workforce.