Welcome to today's webinar "Delivering quality and culturally responsive telehealth services"

If you have any technical issues please let me know here :)

If you have and questions for our panelist during the webinar please post these in the Q&A box the displays on your screens

Organisations involved in todays webinar as well as DHCRC

Panelists:– Pip Brennan – Executive Director of the Health Consumers’ Council WA (Panel Chair)– Vivienne Pillay – Executive Officer, Ethnic Communities Council of Western Australia– Nihal Iscel – Team Leader Consumer and Stakeholder Engagement, Multicultural Services Centre of Western Australia– Rachel Pearce – Dietitian and Health Services Manager, Ishar Multicultural Women’s Health Services, Western Australia– Ella Davies – Managing Director and Interpreter, WA Interpreters– Dr Amandeep Hansra – practicing General Practitioner in New South Wales and national telehealth expert

very true Nihal - people need the time they need to access quality care

Nihal, I hade few experience with Interpreters that don't have time/patients to interpret.

yes TIS is for allied health too

Great points. We have had the same issues to manage, complicating patient care. TH/videocall can only be used by many with assistance from family. Connecting an interpreter is an added issue. Most CaLD patients opt for phone interpreting which works well but also has limitations. Karella de Jongh, St Vincent's, VIC

A really interesting insight of the barriers people experience and what did work well. Thank you Rachel

Hi all if you have any questions for our panelists please pop them into the Q&A box displayed on your screens thank you

Also how funding influencesSalaried doctors verus fee for service/ATSI etc

Privacy and security of the platform needs to be considered. Zoom isnt approved for clinical care in NSW Health.

I'd be interested in experiences with exploring technology translation services (rather than TIS etc), with the translation services build into the video or voice technology platform? Is anyone using these, how they have been recieved, whether they are accurate enough in a primary care setting?

i have used google translate for oral translation and its has gone very well as far as my concern

Great session. A lot of learnings - Much appreciated. Let's connect - https://www.linkedin.com/in/mazin-gadir-phd-msc-beng-pmp-prosci-lssgb-ebas-agile-b4a4533/

Hi all, How does GP world deal with Patients without Medicare and providing interpreters

TIS is now asking for Medicare

why is it that patients prefer not to have an interpreter and rather have a family member filtering and half interpreting their healthcare appointment?

As an interpreter, How does we make people from CALD communities feel comfortable to talk about private and sensitive issues in front of the interpreters?

Are you referring to machine translation? The accuracy is not there. We have recently put through a simple sentence via automated translation "In the case of Emergency, please hang up and ring 000". The translation from machine translation was "in the case of emergency, please hang (as in kill yourself with a rope and ring 000".

You cant choose a longer mbs item number. The mbs item is related to the length of the clinical consult and claiming a longer consult could be audited with implications.

Good point Donna, but I am pretty sure the consult will end up taking longer, and you bill at the end according to the length

Auto translation can be dangerous. fairly new technology and when we looked in to it the translation was concerning eg hand up and call 000 was tranlated to suggesting to end your life.

From Me to All Panelists: 01:44 PMNSW Health has policy directives that deal with working with interpreters and the issue of machine translation. Short answer is no, we do not use machine translation in the health sector in NSW.

Amandeep - any tips for engaging with GPs?Hi , I am a Telehealth coordinator in Sydney offering a free 12 week PHN funded telehealth program to seniors - I have engaged with and provided information to many GP's throughout Central and Eastern Sydney but have found

Agree with the risk issues connected with using Google Translate

there has been very little interest

google:Appointment Reminder Translation Tooldeveloped in NSW by NSW Refuge Health

it's not my experience in a public hospital, and often Drs prefer to use family members for convenience sake, rather than wait for an interpreter

In NSW it cost up to $100 an hour for an interpreter

Sorry my last message was a bit disjoined - I have found that many GP's have not been very receptive to free telehealth programs for their patients which can also include GP video conferencing functions

Interpreter issues become even more complex when relating to Aboriginal clients / patients where the most accurate interpreter is almost always someone from the community of origin, so intersate / anonymous interpreters aren't always an option.

I have had an instance where the GP service said they were going to charge the patient for the interpreter cost. This patient did not had medicare and was on a visa. How to work with this situation. Are GP clinics allowed to charge clients for interpreters.

Aug 21st that is what TIS annoucened

Family members know the medical history better than the translator. Family members can give more accurate explanations than anonymous interpreters. I’ve experienced this personally on so many levels

But family are also more emotionally connected and can sometimes interpret in their owns word and not translated exactly whats been said by the patient

Re recent changes to TIS (video)https://www.tisnational.gov.au/en/About-TIS-National/News/Telehealth-video-interpreting-for-medical-consultations-is-available-now

In my experience, the anonymous interpreter was not useful in explaining my mother’s complex medical history. My mom even couldn’t hear what was the interpreter saying through tele service

Disease - Sickness - Illness. While these words are often used synonymously, they mean different things.

Given this is a talk about responsiveness.. How do you ask/ survey and or get feedback> as cross cultural/age/gender/ATSI and even ATSI to other culture issues

VIC Framework captures this well: ‘Cultural responsiveness describes the capacity to respond and adapt to the healthcare issues of diverse communities … health care services that are respectful of, and relevant to, the health beliefs, health practices, culture and linguistic needs of diverse consumer/patient populations and communities’ (VIC Health, 2009)Source: Cultural Responsiveness Framework, VIC 2009

https://gh.bmj.com/content/2/4/e000486

Hi, a quick reminder the webinar is being recorded, and the link will be shared with all registrants, and posted on the Digital Health CRC website here https://www.digitalhealthcrc.com/webinars/

Please let's stop talking about cultural awareness...when are we going to talk about cultural safety? Cultural safety and cultural humility is what is required and are about providing safe patient care and that's what it comes down to. As a country we're always willing to risk the healthcare of diverse populations whether they're CALD, Aboriginal, LGBTIQ+ etc

It's about EQUITABLE healthcare

Great discussionThanksI have to head to another taskKeep SafeRL:)

Just realized I didn't post this to all

A really good point Pip, just 'ask' :-)

Can the panel focus on telehealth aspects?

Good point re workforce Prie.

Individual preferences and needs are what are important; what matters to the patient; not a homogenous view of the world. Telehealth is an additional layer for vulnerable cohorts.

Health Consumer's Council also does training for health service providers! :-)

Healthdirect have quite a few community language flyers available on their website, which are customisable for each health service

I think the question was more about resources for CaLD people to help them use telehealth?

We will share these links after the session.

https://help.vcc.healthdirect.org.au/templatesandguides/downloads

https://www.racgp.org.au/running-a-practice/technology/clinical-technology/telehealth

How do you know the GP's are competent in the language ? Self-assessed?

https://humanrights.gov.au/our-work/chapter-4-cultural-safety-and-security-tools-address-lateral-violence-social-justice

Cultural safety is making someone feel welcomed and appreciated

Thanks for sharing that link Robyn

Sorry that link didn't copy properly - this is correct https://www.openlearning.com/csu/courses/three-rivers-udrh-telehealth/

I would think that the most important aspect to remember is that every single patient we have has their own wants and needs regarding their treatment. As clinicians we need to ensure we are shaping our care to each persons situation, in relation to previous healthcare experiences, CALD background, technology understanding, and health literacy.

Great panel with excellent facilitation. Got to go... will watch video. :-)

Above link (3 Rivers UDR) great (free) online TH training available for any clinicians who are needing support or training to use TH

mbs for Telehealth and TIS combined. helps build data demonstrating need

THE DREAM!

Yes Belinda we can do that no worries.

From a trauma informed perspective, especially for services where Psychologists are engaged, service delivery choice is imperative

for anyone interested - http://healthtranslations.vic.gov.au

Harmony Alliance is doing a series of webinars that looks at the concept of Intersectionality and various issues affecting refugee and migrant women. It's good to be culturally aware but sometimes competency training can enforce more generalisations.. which can potentially be more backwards

Some local GPs in my area will only book telehealth appointments

Yes and not to forget that allied health practitioners such arts therapists and counsellors could be included alongside psychologists and social workers- adding to the diversity of choice and responsiveness for diverse families including children… arts in health and arts therapy have been working surprisingly well online to bring in a more holistic experience

That's a great point Sheridan

Are there any resources that can be sent re engagement of interpreting services in telehealth please

https://about.healthdirect.gov.au/multi-language-health-resources

Speaking of visual resources, our Flinders Uni Physio students are all getting very used to demonstrating exercises over video!

Hi, a quick reminder the webinar is being recorded, and the link will be shared with all registrants, and posted on the Digital Health CRC website here https://www.digitalhealthcrc.com/webinars/

From an interpreter's perspective, it is also very useful when the doctor shares screen on HealthDirect with the patient, and the interpreter can see the document clearly. It helps heaps for the interpreter to do sight translation with the patient as well as assist with understanding the context for interpreting.

Really interesting conversations and fantastic facilitation Pip. Really enjoyed listening!

Great point Viv! Some clients just get so fatigued even getting physically to a health service and engagement through TH is so much easier & better for them

THANK YOU everyone for your time. Great discussion.

Thank you everyone, fabulous conversations:)

Thank you to all panellists – a very interesting and insightful discussion

Great panel with excellent facilitation thank you all...

excellent session! Thank you for organising!

CESPHN & Feros Care currently provide a free 12 week telehealth program for over seniors, includes remote monitoring, health literacy and coaching, group interaction that supports GPMP and TCA's and other community programmes https://www.feroscare.com.au/home-care/staying-healthy-living-well. with an aim to expand into CALD in the next few years

Thankyou to all the panellists for being so frank and open

Thanks you, a really interesting conversation. Remeber, use interpreters, and gain confidence in having threeway telehealth consults (patient, clinician and interpreter)

Thank you so much for everyone sharing their insights. Has been great and looking forward to the next webinar!

Thanks everyone, this was really insightful.

Thanks to all panellists - great session!