Diabetes WA has partnered with Panaceum Karratha to provide weekly virtual clinics and community outreach programs for remote Aboriginal communities. KATIE WOOTTON, Integrated Chronic Disease Care program manager at Panaceum, says the partnership allows for the relationship building that is key to improving health outcomes.
I think the best thing about working with Diabetes WA over the past year is that nothing has changed since last year. We’ve had the same diabetes educators attending the virtual clinics we run. That consistency is our biggest selling point.
In the Pilbara, we have a lot of issues around a transient health workforce. When we’re dealing with Aboriginal clients who have lived with diabetes for such a long time, the big complaint we hear is they’re sick of talking to white girls who come and go. Having Kasi and Linda every week has been awesome. People really appreciate it.
At Karratha, we run the virtual clinics as if they were face-to-face appointments with clinicians. It’s a little different when we’re on an outreach in Tom Price or Onslow, because that’s when we have a budget to fly the girls up. On those occasions, we travel as a multi-disciplinary team, so I’ve got myself a dietitian, a podiatrist, and an exercise physiologist, as well as our diabetes educator. Those clinics are a little less structured. We don’t necessarily have booked appointments; some people just show up. We might do a cooking class or some education in the community somewhere. We’ve done some group education sessions there as well.
Delivering diabetes education in a community setting is obviously very different, but we’re aware that medical centres are not as friendly to the Aboriginal population. When we’re in Tom Price, we work from a community centre. We used to work from the hospital, but we understood that there was a bit of a barrier there for some of the community members at the hospital.
Getting outside that traditional clinical session is important, because with Aboriginal health, best practices involve going slowly to build a rapport. It’s a very white man model to think that you can just meet with an Aboriginal person and deliver healthcare straight to them, and away you go on your merry way. That’s just not how it works, especially with people who live out in community. We see those community sessions as an entry point – step one in a long journey of building a relationship with that client.
Partnerships like the one we have with Diabetes WA are great, because in the past allied health professionals sometimes felt second best. Now we’re seeing a wider recognition that a whole team approach is really important. Travelling with a team works well, because people might not come in to see a diabetes educator, but they’ll come to see a podiatrist. That’s the carrot. Everyone wants to have their toenails cut and their feet looked at, so that’s how we bring people in. Then we say, while you’re here, why not have a quick yarn with a diabetes educator? We’ll just take your blood glucose levels. With the educator in that role, as part of a team, you can start teasing out a bit of information and build it into a consultation.
We’re seeing the benefits of strong care coordination. It’s helping to break down the resistance we’ve seen to telehealth. I was working with an Aboriginal gentleman in a community called Youngaleena, which is way out into the bush, and we were able to link up with Kasi while she was here in Onslow. He sat in the car and had a consult there. It was great to see an older Aboriginal gentleman who wasn’t too familiar with technology happy to link up like that.
Engagement is always the hardest part, as is knowing how to provide education to a patient in a culturally appropriate way without scaring them off. We have to keep people interested and coming back to build relationships. Our did-not-attend rate has decreased. Even when people don’t show up to their appointment, now they might text or call ahead and say they’re not coming. That might seem like a small win in the Western medical system, but in the Aboriginal health world, that’s huge.
One of the most rewarding things about working with Diabetes WA is having a link with a broader team of educators. It’s not just working with a solo subcontractor; you’re working with the backing of an entire organisation, which means they’re ready to help if you’ve got additional questions. This year, we’ve had a couple of clients who have pumps or are interested in getting one. We’ve been able to link with Cate and the Diabetes WA pump start clinic, so she’s been there to help on those patient journeys.
Another thing I appreciate is how flexible Diabetes WA has been. IT support, Geoff and clinic coordinator, Bianca and the whole telehealth team are just amazing – so helpful and organised. I feel very, very lucky to have set up this partnership.
