Abstract
In recent times remote medical practice has been developed into a unique discipline in its own right with telehealth one of the eight defining key features. Since 1942, the telemedicine consultation service provided by the Royal Flying Doctor Service in Australia has been supported by a tele-pharmacy program known as the Medical Chest Program. The contents of the chest comprise more than 85 items, including medications and equipment which can be prescribed during a telehealth consultation to cover both emergency care and definitive treatment for less serious conditions. By 2006 there were 3500 medical chests placed throughout Australia. Specifically, the state of Queensland had 21 470 telehealth consultations from 1 July 2005 to 30 June 2006, resulting in the prescription of at least one medical chest item in 2938 (13.7%) consultations. Queensland data regarding medication indicate that antibiotics (26%), analgesics (23%) and gastrointestinal medications (12%) were the most common categories of dispensed medications, and that the most common clinical diagnostic categories for the consultation resulting in dispensed medications were respiratory (17%), skin (15%) and abdominal conditions (13%). In summary, the RFDS medical chest program continues to be a successful large scale provider of medications to those living in remote Australia, enabling early access to medications for both emergencies and definitive care, while minimising the need for mail-order pharmacy or patient travel. This model of care may provide an important template for those designing service delivery models in other remote jurisdictions.
Highlights
Since the late 1990s there has been progressive recognition of rural and remote medicine as a specific field of practice
In Australia this has culminated in the accreditation of specific training pathways for medical practitioners, through both the Australian College of Rural and Remote Medicine[1] and the Royal Australian College of General Practitioners[2]
The definition of telehealth/ telemedicine is usually confined to a consideration of consultations alone[4,5,6] but can extend to include other aspects of health care, including the ordering and delivery of medications, otherwise known as tele-pharmacy[7]
Summary
Since the late 1990s there has been progressive recognition of rural and remote medicine as a specific field of practice. In Australia this has culminated in the accreditation of specific training pathways for medical practitioners, through both the Australian College of Rural and Remote Medicine[1] and the Royal Australian College of General Practitioners[2]. The aim of this article is to describe the tele-pharmacy program of the Royal Flying Doctor Service in Australia that has been in continuous operation for over 65 years. This will help address the distinct paucity of information in the literature about telepharmacy, and provide a detailed description that may benefit other countries that share similar remoteness issues in healthcare provision.
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