ARIIA acknowledges the Aboriginal and Torres Strait Islander people of this land and recognises their continuous connection to land, sea and community. We pay our respects to them and their cultures and to Elders past and present.
Aboriginal and Torres Strait Islander people should be aware that this website may contain images, voices and names of deceased persons.
This case study describes a telehealth project in three very remote East Arnhem communities - Gan Gan, Yilpara and Wandawuy - selected by Laynhapuy Homelands Health Service. The project tested whether telehealth could be introduced through reliable satellite internet, videoconferencing and a collaborative cross-cultural approach. It is relevant because it shows how telehealth can support access to care, local service delivery and staff support. It also shows how telehealth can support more informed decisions by patients, families and clinicians.
The project responded to a major barrier in very remote areas: limited access to reliable and affordable internet. This was identified as a key constraint on telehealth uptake and broader digital health service delivery. In this setting, telehealth offered a way to improve diagnostic capacity, reduce travel and supported family-based decision making across distances.
The project highlights that some Aboriginal and Torres Strait Islander people, especially older people and people with disability, may choose not to travel for treatment. In that context, local access to telehealth can help services respond more quickly while reducing travel off Country. Introduction of internet and existing Telehealth Video Conferencing (TVS) systems are generally installed in remote clinics by outsiders, but this project took a collaborative and culturally safe approach working through established long-term relationships with community members, known by the Laynhapuy Health Service.
The project installed three Gilat satellite dishes and provided twelve months of internet access reserved for each site, rather than shared across multiple users, alongside the installation of the telehealth videoconferencing system. Which included computer screen, camera, video end point controller, switch, network box, satellite modem and UPS. The project was delivered through collaboration between Charles Darwin University’s Northern Institute, Laynhapuy Homelands Health Service, Aboriginal Medical Service Alliance NT, Broadband for the Bush, eMerge, and Telstra Health, with grant funding, alongside specialist support.
Clinic staff used videoconferencing cameras and software for telehealth. They also adapted less formal tools such as FaceTime and smart phone cameras for triage and diagnostic assessment. The project showed several benefits including more informed decisions by patients, families and clinicians, more accurate assessment for evacuations and retrievals, enhanced staff training and supervision, plus access to a wider range of services. Savings in patient travel were estimated at more than $13,000 per month for specialist visits in the latter part of 2018.
Telehealth also supported more timely clinical decisions. It enabled crucial procedures to be carried out more quickly. These changes were linked to more positive patient outcomes and the potential for improved probability of survival.
Implementation was supported by collaboration, early consultation, repeated site visits, regular communication, alongside relationship building with clinic staff and community members. Project managers worked with Laynhapuy Health Service staff who had existing long-term relationships with local communities. This helped build trust and supported a respectful cross-cultural process.
Practical support included site-specific installation planning, hardware and software modifications, training in videoconferencing and booking systems, plus troubleshooting during commissioning. The source also highlights technical challenges, including routing issues, hardware failures, network management demands and the complexity of maintaining the videoconferencing systems. When formal systems lost connectivity, staff often relied on smart phones to continue care and communication.
Telehealth depends on more than technology alone. It requires staff confidence, clear procedures, fit-for-purpose infrastructure, plus workflow changes that allow telehealth to become part of everyday clinical work. This study also highlights the importance of technical support, because reliability problems placed ongoing demands on staff and systems.
Telehealth also strengthened supervision, staff training and clinical assessment in this very remote setting. It improved access to specialist input and shows that telehealth can help services support older Aboriginal and Torres Strait Islander people who may prefer to stay on Country, while still recognising the importance of family involvement and local ways of knowing, doing and being.
This evidence-based case example has been adapted from the original authors to fit ARIIA’s format. For full detail and context, refer to the original report in the link provided below.