Expanding Access to Addiction Medicine Specialist Care in Regional New South Wales, Australia Through Telehealth

INTRODUCTION: Australians in regional areas face substantial barriers accessing alcohol and other drug specialist medical care. This study observed a newly implemented telehealth model of public addiction medicine specialist care, the TeleHUB model, in two regional New South Wales (NSW), Australia Local Health Districts: Murrumbidgee and Western NSW. A shared-care approach was employed; a metropolitan hospital (St Vincent's Hospital, Sydney) acted as a central coordinating service for providing additional (Murrumbidgee, commencing August 2019) or fly-in-fly-out replacement (Western NSW, commencing February 2021) telehealth consultations by an addiction medicine specialist, while local services provided in-person support. METHODS: Interrupted time series analysis examining changes in monthly scheduled appointments with an addiction medicine specialist were conducted using retrospective administrative data pre- and post-TeleHUB implementation. Data were collected for Murrumbidgee from October 2016 to March 2022 and for Western NSW from July 2016 to March 2022. Qualitative semi-structured interviews examining staff and client acceptability of the model were conducted across participating sites. RESULTS: Monthly scheduled consultations post-TeleHUB implementation increased compared to pre-implementation in Murrumbidgee (16.6 per month, 95% confidence interval 4.0-37.9; p < 0.001) but there was no evidence of such an increase in Western NSW. Qualitatively, clients and staff reported telehealth reduced client anxiety and increased service accessibility. DISCUSSION AND CONCLUSIONS: The TeleHUB model has the potential to improve and maintain service accessibility in addiction medicine specialist healthcare. This model could strengthen local services by providing additional specialist appointments and further support to local services through reduction of travel time and costs associated with fly-in-fly-out models.