Digital health technologies to improve access to comprehensive primary health care in remote Northern Territory, Australia: qualitative findings from thought leader interviews

Abstract Background Existing literature shows the potential of digital health technologies (DHTs) to improve access to Comprehensive Primary Health Care (CPHC) by overcoming various challenges to care provision. However, the usefulness of DHTs in the remote Northern Territory (NT) Australian context to support the delivery of CPHC has rarely been explored. This study aims to explore thought leaders' perspectives about the key challenges to accessing CPHC services and the role of DHTs in overcoming these challenges in the NT. Methods In-depth interviews were conducted with 17 participants who were working or had previously worked in the NT in clinical or non-clinical roles, including in leadership, governance, and management roles with the NT Health Department or Aboriginal Community Controlled Health Services. Thematic analysis was conducted using a deductive approach based on the theory of access. Results The results suggested that the key challenges to accessing CPHC in the remote NT include workforce issues (staff shortages, high staff turnover, poor continuity of care), the large distances and costs of providing care, and how health care services were organised and delivered. Participants highlighted the potential of DHTs for improving challenges relating to provider availability, continuity of care, and cost savings for health services. However, challenges to implementing digital solutions were also raised which were broadly classified as technological and non-technological. Poor digital infrastructure, intermittent connectivity, and the lack of interoperability of systems between healthcare organisations were key technological challenges. Low rates of digital device ownership and low digital literacy; the limited local availability of skilled staff to support digital solutions, and the lack of flexibility in the way appointments were organise were identified as key non-technological challenges. Conclusions There was an optimism that DHTs could substantially improve healthcare access in the NT. Telehealth, used where appropriate and in combination with face-to-face care using a hybrid approach, could improve remote patients’ access to a range of healthcare providers, reduce patients’ and providers’ need to travel and improve continuity of care. This will necessitate increased investment in training local Indigenous people to support communities’ access to DHTs and improve the quality and cultural safety of care.