Dr. Jill Benson AM grew up in the southern suburbs of Sydney and has lived in Adelaide for the last 35 years. She has done volunteer work throughout the world including Vanuatu (WHO mental health consultant), remote eastern Nepal during the Maoist insurgency, and most recently in Fukushima, Japan.
Jill now has 45 letters after her name and, as being a GP means, has changed her focus many times. She has worked mostly in Aboriginal health and refugee health for the last 20 years and also in mainstream general practice as a practice owner, university health, corporate health, travel medicine, doctors’ health, public health (with a PhD in public health), research, mental health, medical education and a few other areas. She has just become a FACRRM through ACRRM’s Rural Experienced Entry to Fellowship (REEF) Program.
I’ve done a lot of remote work in the last 20 years, a small amount of rural work, and some fly-in/fly-out work in underprivileged areas in other countries. I know that rural and remote work requires a different skill-set as well as a different mindset. I wanted to have the credibility with my younger colleagues to support them in undertaking similar work to what I have done over the years, and thought that a FACRRM would give me that recognition.
Technology brings better health care to one of the most remote communities in the world. In one of the most remote communities in the world, the Aboriginal community of Tjuntjuntjara in Western Australia, telehealth and the use of My Health Record have transformed health care delivery.
Tjuntjuntjara is 650km north east of Kalgoorlie in the Great Victoria Desert in Western Australia. There are about 160 people living at Tjuntjuntjara - they speak a southern variety of the Pitjantjatjara language and identify as belonging to a group of people known as Pilanguṟu, meaning ‘from the spinifex plains’. For the last 10 years, the Aboriginal community-controlled Spinifex Health Service in Tjuntjuntjara has had a fly-in/fly-out (FIFO) GP and other health professionals through the Adelaide-based Kakarrara Wilurrara Health Alliance (KWHA).
With the advent of COVID-19 and the closure of the Western Australian border to the KWHA planes and health professionals from South Australia, there were no doctors or allied health outreach professionals able to go to Tjuntjuntjara for more than ten months from March 2020 to January 2021. This is when digital health provided the answer. With telehealth the clinic was able to continue to have a high level of health care for chronic conditions, preventive activities and mental health issues. Medical Director at Spinifex Health Service and GP, Dr Jill Benson AM, has been going to Tjuntjuntjara for more than a decade and is familiar with many of the patients there. “In many cases, and despite the reduced face-to-face encounters with visiting medical specialists, the increased use of telehealth sessions improved care,” she said. “This meant better continuity of care, the ability to have timely review and follow-up, the ability to deal with issues as they occurred and not just once a month and specialist referrals as needed and not just when they were scheduled to come out.
The use of technology has been a real benefit in telehealth.” Dr Benson said the majority of the patients in Tjuntjuntjara have all of their medications, investigations, discharge summaries and health summaries from Spinifex Health Service in My Health Record. “This means that when they travel to other communities, all of this is instantly accessible. It also means that if a patient has a recall set up in another community then the health professionals there can alert the Spinifex staff if they can see the person has recently been in Tjuntjuntjara. This has been an invaluable resource to maintain continuity of care.”
Australian Digital Health Agency CEO Amanda Cattermole said: “For National Reconciliation Week 2021 we celebrate the success of Aboriginal community-controlled health care delivery in Australia.” In line with this year’s theme More than a word. Reconciliation takes action, the Agency is promoting the benefits of digital technology to connect even the most isolated Aboriginal communities with first class health care.
Jill states that the Case-Based Discussion exam was probably the most nerve-wracking part of the process. I’m usually on the other side of exams, but with the prospect of having to justify why I’d done certain things I needed to self-reflect in a different way and then be able to articulate my clinical reasoning clearly. I found the Multi-Source Feedback exam quite heart-warming as we don’t usually hear from our patients and colleagues what they think about us.
I would recommend REEF for those who would like recognition of their rural and remote experience. It is always useful to review how we practice and this was certainly a good chance to reflect on many aspects of my work.
I thoroughly enjoyed the ACRRM graduation ceremony as it renewed my faith in a strong, enthusiastic and sustainable rural general practice workforce. I could have sat for another hour listening to the heart-warming stories about why the young graduating doctors had trained as Rural Generalists. It is a challenging and extremely satisfying path at many levels. I think for me, the main drivers are the difference you can make to people’s lives, that you use so many more skills than straightforward city-based general practice, and that you work with some amazing teams.
“The Agency works with the National Aboriginal Community Controlled Health Organisation and its State and Territory affiliates to promote and embed digital health in Aboriginal Community Controlled Health Services (ACCHS). ACCHS’ deliver a holistic and culturally appropriate health services to their communities, and the work that they undertake is fundamental to Closing the Gap in health outcomes. Digital health is a key enabler for improving access to services and delivering improved health outcomes for Aboriginal and Torres Strait Islander peoples, particularly those living in remote communities,” Ms Cattermole said. Head of Regional and Remote Health and Education at NBN Co, Dr Jen Beer, who is a proud Darlot woman from the Western Desert region of Western Australia, shared that connectivity and the role it plays in enabling digital health has never been more important in particular for Indigenous Australians.
“We are hearing the many benefits that health practitioners, clinics as well as patients are experiencing in regional and remote communities across Australia where connectivity has improved their timely access to quality healthcare services. Examples of this include in East Arnhem Land where Wi-Fi calling access, through nbn Sky Muster™ Plus, enables medical staff to co-ordinate emergency retrievals at any time of the day or week through to telehealth services allowing greater continuity of care with staff who are familiar with their patients.” “NBN Co is committed to continuing its work with the Australian Digital Health Agency and the National Aboriginal Community Controlled Health Organisation to enable access to digital health across regional and remote Australia,” Dr Beer said.
Agency Consumer Advocate, Aboriginal and Torres Strait Islander Champion and Co-Chair, Reconciliation Working Group and National Medicines Safety Program, Steve Renouf, said Aboriginal people and communities across the country were embracing technology to take control of their health. “It’s fantastic to see yet another example of an Aboriginal health service leading the way in providing digital health benefits to their patients,” he said.
Over 2020, the Aboriginal community-controlled Wirraka Maya Health Service uploaded the ninth highest number of Shared Health Summaries in Western Australia, to My Health Record. Shared Health Summaries provide a summary of a patient’s key health information. The Wirraka Maya Health Service also viewed more uploaded documents than any other primary care provider in Western Australia. “Aboriginal health services are at the forefront of a revolution in health care that uses technology to transform and improve people’s lives,” Mr Renouf said. Ms Cattermole said the Agency was six months into implementing its first Reconciliation Action Plan (RAP) which has a strong focus on strengthening community partnerships, cultural safety, community empowerment, and opportunity. “As we look back on our history as a young organisation, and celebrate the Agency’s impressive track record in building digital health capabilities right across Australia in partnership with Aboriginal and Torres Strait Islander communities, we also acknowledge that we have much more to do as Australia seeks to close the unacceptable gap in life expectancy and other health indicators between Indigenous and non-Indigenous Australians,” she said. “Our organisation is committed to working in deep partnership with the Aboriginal community-controlled health sector to foster and earn their trust and respect in our joint pursuit to improve health outcomes for Aboriginal and Torres Strait Islander communities.” Over the last six months, the Agency has established eight delivery partnerships with Aboriginal and Torres Strait Islander health organisations to support the co-design and uptake of digital health, implemented a cultural competency training program for agency staff, implemented procurement protocols Indigenous businesses, and commenced implementation of a My Health Record and digital health eLearning module with CPD accreditation for Aboriginal Health Practitioners. National Reconciliation Week runs from 27 May to 3 June each year.