Mappa – improving the patient journey
Mappa has the capacity to address the need to influence positive change in the following areas of the wider health system for Aboriginal people, and non-Aboriginal people in regional and remote WA:
- Improved access to healthcare;
- Better-utilisation of, and access to services;
- Improved patient journey;
- Greater awareness and consideration of cultural obligations, and
- Reducing the high statistics for DNA*, DAMA* and DNW*.
*Did Not Attend (DNA) rates are high amongst Aboriginal clients due to travel from rural and remote areas for outpatient and specialist appoints. Some of these clients have no experience or understanding of metro areas. English is their second or third language. Sometimes it can be due to the need to meet cultural beliefs or obligations. There is the potential to reduce DNAs if healthcare options were visible across of whole of WA (including rural and remote).
*Discharge against Medical Advice (DAMA) is also high within the Aboriginal patients. Using Mappa, health professionals will be able to be more culturally and geographically aware of their clients location and cultural beliefs and obligations;
*Did Not Wait (DNW) a high rate amongst the Aboriginal clients / patients when they presented to hospital, either for emergency reasons, or for scheduled appointments. Mappa has the functionality to help streamline hospital waiting rooms by showing people other options for services, or assistance pathways for example, if there is an Aboriginal Health Liaison Officer (AHLO) within the system that they can access.
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Mappa is a custom made platform for the WA health industry that captures not only contact details but lots of useful information to help (i) Aboriginal people; (ii) the health industry professionals; (iii) the public that lives, works or travels within WA.
Health Services accessibility
For Aboriginal people and their communities, there is an extremely strong connection to family and country. When people are put into situations where they must take part in the ‘patient journey’ a lot of the time, positive health outcomes are delayed due to increased anxiety and distress of travelling to foreign places for health services.
Using Mappa, people will be able to utilise services that are closer to home, with family and on country, where people are comfortable and stress-free, and where people can also fulfill family and cultural obligations.
The use of the Mappa platform will promote more culturally appropriate health care access, and enable Aboriginal people and their communities to receive the right care, at the right time and in the right place. Mappa will help health care professionals, allied health workers and visiting specialists to have a better understanding of community locations, distance from major hospitals, travel times and culturally appropriate information when travelling to a community or region.
Mappa is an unparalleled, immensely collaborative project that has bought together a vast range of Health and Community services, including Aboriginal Community Controlled Health Services and Public health services, in one of the remotest parts of the world, to work together in achieving better outcomes for Aboriginal and nonAboriginal people living in remote and regional areas.
Long Patient Journey
An ACCHS Aboriginal Liaison officer presented the following case study during a Mappa demonstration.
A two-year old child needed to see a specialist in Perth, the mother was told she will be travelling on the bus from Carnarvon to Perth for the child’s appointment, the journey from door to door totals 17 hours. The child was very unwell and this long journey was strenuous for both mother and child. The mother was subjected to judgement from other passengers unaware the child was crying for the whole journey due to being unwell. The mother was unable to express herself, stressed and worried. Arriving in Perth, the mother being unfamiliar with local bus routes, almost missed the child’s appointment.
Missed appointments are common due to long patient journeys that don’t take into account the high likelihood of delays, disruptions and missed connections. Patients travelling from long distances, especially remote areas may not have any knowledge of the city, transport routes or hospital locations making it a highly stressful and complex journey. Using Mappa, the Patient and Transport Scheme (PATS) clerk would have been able to gain a better understanding of the patient’s journey and take this, as well as the child’s presenting wellbeing, into account and be able to make a better judgement about the patient’s capacity and make changes accordingly. For example, the journey time could be significantly reduced by a 2.5 hour plane trip.
Long Journey interrupting medical care
The following scenario was provided as an example from the Aboriginal Health Liaison Officer (AHLO) at Royal Perth Hospital.
The patient was transported to RPH due to an emergency medical incident. As part of the treatment plan the patient required intravenous antibiotics (IAVBS) daily for 4 weeks as an outpatient at their local hospital. The patients journey home takes over 15 hours and therefore required a stopover. This means the patient would not arrive to their local hospital in time for the next dose, affecting their ongoing medical requirements, as it was imperative they had IVAB’s daily.
RPH, as a test site, used Mappa to show the medical team the distance to travel home in order for them to understand that IVAB’s were required at the overnight town.
The AHLO was able to contact the Hospital in the connecting town to make the necessary arrangements enabling the patient to be discharged and to return home to recover as an outpatient. Without Mappa, the patient may have been discharged without the medical team fully understanding the risk involved due to the long journey. Mappa enables everyone to appreciate patient journeys, and how they can adversely interact with a patient’s treatment plan.
Connecting patients with culturally-appropriate care
The following scenario was provided as an example from the Aboriginal Health Liaison Officer (AHLO) at Royal Perth Hospital (RPH).
The patient presented to RPH on several occasions due to an ongoing health issue. The AHLO identified the patient was not familiar with support services in Perth and had been presenting at the hospital’s emergency department whenever they felt sick. The patient had no GP details.
Using Mappa, the RPH AHLO was able to locate the nearest Aboriginal Community Controlled Health Service (ACCHS) to arrange a GP appointment and GP management plan reducing the burden placed on the emergency department and ensuring the patient was able to access appropriate, ongoing care.