Ms Sonja Rogasch1, Ms Madeline Primavera1, Dr Neil McMillan2, Dr Kristen Graham3, Ms Cathy Loughry1, Prof Robert Fitridge2
1Central Adelaide Local Health Network, Adelaide, Australia, 2The University of Adelaide, Adelaide, Australia, 3University of South Australia, Adelaide, Australia
Biography:
Sonja Rogasch is a senior Podiatrist and high-risk foot coordinator at the Central Adelaide Local Health network. She coordinates the largest multidisciplinary foot service in Adelaide across two sites, The Royal Adelaide, and Queen Elizabeth Hospitals. Sonja was involved in the development and implementation of the first Telehealth multi-disciplinary foot clinic in South Australia as part of the SAHMRI Diabetes Foot Consortium. She is passionate about improving access to high-risk foot services and improving models of care within health. Sonja has presented at both international and national conferences including The International Symposium of Diabetic Foot in The Hague.
Abstract:
Diabetes-related foot disease (DFD) accounts for 75% of lower-extremity amputations globally with amputation rates 4x higher in remote areas and 38x higher in Indigenous populations. Early identification of wounds and treatment with specialised multidisciplinary management can reduce amputation rates by 39 – 56%. Telehealth has been shown to improve timeliness and equity of access to specialist care in rural and remote communities. We developed a tertiary-based Telehealth Foot Service to provide high risk foot care to patients with DFD in a catchment comprising the majority of South Australia. The service provides video link consultation for patients with a health professional co-located at their site to a metro-based high risk foot service clinic for review by a Podiatrist, Aboriginal Health Practitioner (as appropriate), and Vascular surgeon. An audit of our service between Oct 2022 – June 2024 found 37% of patients were seen at least once via telehealth consult. Of those (not mutually exclusive): 22% were seen as an early referral (within 2 weeks), 25% had a planned hospital admission, 30% were prescribed antibiotics, and 75% were reviewed after discharge from hospital. 75% of regional-remote patients were seen via Telehealth at least once; this cohort had a slightly lower overall rate of hospitalisation (23% vs 26%) than those without, a lower relative rate of amputation (5% vs 8%), and they were less likely to be hospitalised for >10 days (15% vs 23%). Our results indicate that those outside metropolitan areas seen via telehealth had improved management and outcomes of DRFD.