The heart of it: Successful cardiology services prove valuable to remote communities

Tuesday, March 8, 2016

Many rural and remote locations in Western Australia do not have adequate access to comprehensive medical care. Patients are often required to travel long distances to attend specialist consultations in regional centres, resulting in a high level of reluctance to attend appointments. However, a multidisciplinary team has been successfully delivering their cardiology services on a regular basis to support the Aboriginal population living in the isolated Ngaanyatjarra Lands.

Rural Health West is the leading health workforce agency in Western Australia, focused on the attraction and retention of health professionals to rural and remote Western Australian communities. The organisation also provides outreach services, through our Outreach in the Outback Team, who support planning to determine community needs for health services and identify gaps in specialist services available.

Funded by the Australian Government Department of Health, the Medical Outreach Indigenous Chronic Disease Program (MOICDP) is administered by Rural Health West and aims to increase access to multidisciplinary primary health care teams for Aboriginal and Torres Strait Islander people, to prevent, detect and manage chronic disease.

Within the range of services supported to improve access for Aboriginal and Torres Strait Islander people to chronic disease management and follow-up care, the five health priorities specifically addressed include cardiovascular disease, diabetes, chronic respiratory disease, chronic renal disease and cancer.

As a result of the MOICDP, the Ngaanyatjarra Health Service has been receiving regular visits from a team of cardiology health professionals who work together to address cardiovascular disease and related conditions. The visiting cardiology team are able to give patients in this extremely remote area a level of service which is equivalent to that offered in a regional centre, but without patients having to suffer the stress of leaving the Lands.

The team travel by charter plane three times per financial year to three communities within the Lands. The team is led by cardiologist Dr Jamie Rankin and includes a cardiology registrar, echocardiographer, a cardiac rehabilitation nurse educator (all of whom are based in metropolitan hospitals), a private practice dietitian and a chronic disease coordinator and specialist visits coordinator from the Ngaanyatjarra Health Service. Patients are referred by the Ngaanyatjarra Health Service general practitioner for specific cardiology services, depending on the needs of the patient. The visiting team also provides support, education and upskilling to the remote area nurses and medical officers.

A portable echo-cardiography machine is taken on visits so that patients who require a cardiac echo can receive this during their consultation with the specialists. The visiting dietitian assesses and recommends various dietary needs of patients with heart disease. Patients who have recently undergone cardiac surgery, or are in need of surgery, can meet with the cardiac rehabilitation nurse educator to discuss any pre and post-operative issues.

“The Ngaanyatjarra Lands are extremely isolated and one of the hardest areas to service logistically. However, Jamie Rankin’s team is a model example of how a continuous, comprehensive service greatly benefits a rural community and how successful and sustainable it can be,” said Ms Vivienne Duggin, General Manager of Business Development and Strategy for Rural Health West.

Since the commencement of these team visits, patients are now showing greater awareness of their own chronic disease selfmanagement and are more willing to attend specialist clinics. The team is scheduled to visit the Ngaanyatjarra Lands again in March and June of 2016.

As the leading rural health workforce agency for Western Australia, Rural Health West is a not-for-profit organisation funded by the State and Commonwealth Governments responsible for the recruitment and retention of a highly skilled sustainable health workforce to meet the needs to rural and remote Western Australians communities.

This article was originally published in the February 2016 edition of The Health Advocate. To access current and previous editions, click here.