Telemedicine focus to prevent amputations in Rural/Remote Australia

JCU Associate Professor Usman Malabu, who is also a diabetes specialist at The Townsville Hospital, said people living with diabetes in rural and remote areas have up to three times higher rates of amputations due to complications than other Australians. 

Dr Malabu said many Indigenous people lived in remote areas, far from health centres. “Indigenous people have a higher rate of diabetes than the general population and by the time they are seen by a doctor it’s almost too late,” he said. “In addition, people are often reluctant to be transferred for treatment to major centres far from their home and family.”

He said a late-stage diagnosis of a person in a remote area meant treatment could be extremely expensive, with high-level specialists involved and transfer and accommodation costs for sufferers and their support people.

Dr Malabu and his team have now received more than $460,000 from the Bupa Health Foundation to develop a telemedicine program. The funds will pay for the 3D camera and sophisticated software, which can scan the depth and size of diabetes-related injuries and allow doctors to track changes in the wound over time.

“With that sort of detail, it’s almost better than a face-to-face consultation,” said Dr Malabu.

Local nurses will be trained to use the equipment, and the uploaded information assessed by podiatrists and endocrinologists in the main centres.  

Over time, it is expected the nurses will become more involved in assessing the information themselves.

Dr Malabu said the program will run in underserviced areas in North Queensland and focus on foot ulcers, but if it was a success, it would be ripe for expansion.

“Within five years, 50 per cent of patients with diabetes-related foot ulcers die – usually from other conditions. Once ulcers are identified there is a lot to be done for the patient other than treating the immediate problem,” he said.

Dr Malabu said the scheme had the potential to be introduced nationwide, with Australia second only to the US within the developed world for limb amputations related to diabetes.