Green Danielle, Russell Deborah Jane, Zhao Yuejen, Mathew Supriya, Fitts Michelle Susannah, Johnson Richard, Reeve David Mark, Honan Bridget, Niclasen Petra, Liddle Zania, Maguire Graeme, Remond Marc, Wakerman John
Northern Territory Health, Top End Health Service, Darwin, Northern Territory, Australia.
Menzies School of Health Research, Charles Darwin University, Alice Springs, Northern Territory, Australia.
Aust J Rural Health. 2023 Apr;31(2):322-335. doi: 10.1111/ajr.12954. Epub 2022 Dec 9.
In February 2018 the Remote Medical Practitioner (RMP)-led telehealth model for providing both primary care advice and aeromedical retrievals in Central Australia was replaced by the Medical Retrieval and Consultation Centre (MRaCC) and Remote Outreach Consultation Centre (ROCC). In this new model, specialists with advanced critical care skills provide telehealth consultations for emergencies 24/7 and afterhours primary care advice (MRaCC) while RMPs (general practitioners) provide primary care telehealth advice in business hours via the separate ROCC.
To evaluate changes in clinicians' perceptions of efficiency and timeliness of the new (MRaCC) and (ROCC) model in Central Australia.
There were 103 and 72 respondents, respectively, to pre- and post-implementation surveys of remote clinicians and specialist staff.
Both emergency and primary care aspects of telehealth support were perceived as being significantly more timely and efficient under the newly introduced MRaCC/ROCC model. Importantly, health professionals in remote community were more likely to feel that their access to clinical support during emergencies was consistent and immediately available.
Respondents consistently perceived the new MRaCC/ROCC model more favourably than the previous RMP-led model, suggesting that there are benefits to having separate referral streams for telehealth advice for primary health care and emergencies, and staffing the emergency stream with specialists with advanced critical care skills.
Given the paucity of literature about optimal models for providing pre-hospital medical care to remote residents, the findings have substantial local, national and international relevance and implications, particularly in similar geographically large countries, with low population density.
2018年2月，在澳大利亚中部由远程医疗从业者（RMP）主导的提供初级保健建议和空中医疗救援的远程医疗模式被医疗救援与咨询中心（MRaCC）和远程外联咨询中心（ROCC）所取代。在这种新模式下，具备高级重症监护技能的专家全天候提供紧急情况的远程医疗咨询以及非工作时间的初级保健建议（MRaCC），而远程医疗从业者（全科医生）则通过独立的ROCC在工作时间提供初级保健远程医疗建议。
评估澳大利亚中部临床医生对新的（MRaCC）和（ROCC）模式的效率和及时性的看法变化。
分别对远程临床医生和专科工作人员进行了实施前和实施后的调查，受访者分别为103人和72人。
在新引入的MRaCC/ROCC模式下，远程医疗支持的紧急情况和初级保健方面都被认为明显更及时、更高效。重要的是，偏远社区的卫生专业人员更有可能认为他们在紧急情况下能够持续且立即获得临床支持。
受访者始终对新的MRaCC/ROCC模式的评价高于先前由RMP主导的模式，这表明为初级卫生保健和紧急情况提供远程医疗建议设立单独的转诊渠道，并为紧急情况配备具备高级重症监护技能的专家是有好处的。
鉴于关于为偏远居民提供院前医疗护理的最佳模式的文献匮乏，这些研究结果具有重大的地方、国家和国际相关性及影响，特别是在地理面积大、人口密度低的类似国家。
