Academic literature on the topic 'NSW Rural Doctors Network'

EURIPA (European Rural and Isolated Practitioners Association) is a regional rural health network, which was founded by family doctors to address the health and well-being needs of rural communities, on one hand, and the practitioners’ needs across Europe, on the other. EURIPA began its activity in 1995 with a small group of family doctors from across Europe, and in 1997 the structure was formalised into that of EURIPA today. EURIPA was initially recognized by WONCA Europe as a special interest group and subsequently as a representative network for rural family doctors across Europe. Now, it actively participates in WONCA Europe meetings and their annual conferences. The constitution was revised in 1997 when the International Advisory Board was created to support the work of EURIPA and its Executive Committee. EURIPA has worked hard to raise the profile of rural general practice, from its first research project in 1997, to the series of Annual Rural Health Forums, which started in 2010. These forums have focussed on quality, education and research with the 5th Forum taking place in September 2014 focussing on policy engagement. EURIPA uses social media to engage its membership and publishes regular newsletters - “Grapevine”, as well as encourages rural GPs to publish in the European Section of the Journal of Rural and Remote Health.

Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners’ job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners’ job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.

89 Background: In 2006, Tahoe Forest Hospital District—a 25-bed hospital in Truckee, CA, a mountain resort community one hour from regional and two hours from academic cancer services—designed and implemented an oncology program utilizing effective telecommunications with a committed academic partner, the UC Davis Comprehensive Cancer Center in Sacramento. Methods: The UC Davis Cancer Care Network was established with four remote cancer programs, enabling participation in daily virtual tumor boards, clinical trial enrollment, and quality assurance assistance. (Richard J. Bold, et. al., Virtual tumor boards: community-university collaboration to improve quality of care. Community Oncol 10(11):310-315, November 2013.; Laurence J. Heifetz, MD, et. al., A Model for Rural Oncology. J Oncol Pract, 7:168-171, May 2011.). An increasing number of patients were observed to in-migrate to Truckee from even more remote rural areas in the mountains. In 2013, the now Gene Upshaw Memorial Tahoe Forest Cancer Center developed four remote telemedicine clinics to allow even more physically distant patients the capacity to be followed locally. Results: Since we opened the remote telemedicine clinics, our Sullivan-Luallin patient satisfaction scores have averaged 4.82/5.00 for “overall satisfaction with the practice” and 4.90/5.00 for “recommending your provider to others”; our in-migration rate of patients from outside our primary catchment area increased from 43% to 52%: and clinical trial accrual rate averaged 10%. Conclusions: Reducing cancer health disparities is an ASCO mission. (cover, ASCO Connection, July 2014; Laurence J. Heifetz, MD. Country Docs with City Technology Can Address Rural Cancer Care Disparities. Oncol, 29(9):641-644, September 2015.). We believe this synaptic knowledge network effectively addresses that mission for rural communities. This model can be scaled in many configurations to address the inherent degradation of quality care as a function of physical distance to an academic center that rural doctors and patients deal with on a daily basis. The key is to insist on a cultural shift – Do something smart at lunch every day. Attend a virtual tumor board.

With the construction of the network online course platform under the background of “Internet +”, the mixed teaching [1] based on the background of “Internet +” came into being, and has been widely used in the daily teaching of full-time students, and proved its existence advantages. Rural medical majors have limited education degree, age gap, fixed time and other factors, so that students’ teaching methods and full-time undergraduate students cannot be rigid. As one of the most important clinical medical courses for rural doctors, science not only requires students to master theoretical knowledge, but also requires proficiency in basic clinical operation skills. Therefore, for this kind of students, we by building “Internet +” science online open course platform, to provide high quality science teaching resources, at the same time using online learning + offline flip classroom mixed teaching model, the “tailored” for rural medical students, build in line with their learning ability level and receive knowledge ability of new teaching mode[2].

Abstract Mankind was living quite an ordinary life when Covid 19 pandemic struck. The whole world was in turmoil and was busy trying to make the situation normal again. But it was impossible to regain the old scenario and people had to accept the new normal. The new normal demands people to follow different guidelines out of which maintaining a social distance of 6 feet was a prominent one. Even in this situation occurrence of any disease does not stop and there are always some patients visiting a doctor. Also, a doctor doesn't always have the luxury to visit every place to see patients, especially in rural areas where there is a transportation problem. So we have come up with a cloud-based system that will use the internet of things to diagnose a patient. This device will contain different sensors like temperature sensor, body oxygen level sensor, blood pressure sensor, heart rate sensor, and height and weight measuring gadgets to measure the body parameters of the patient and then store this information in the secured cloud which can then be accessed by the doctor to diagnose the patient. The sensors will be embedded in an Arduino and it will be connected to the cloud wirelessly with the help of a GSM module and node MCU. Also, a laptop will be present to connect the patient and the doctor in video mode for conversations. This system will also generate a prescription provided by the doctor which can be used anywhere. Thus, this device will not only promote social distancing but also it will prohibit the spread of diseases that are communicable. The doctors can work from the comfort of their home without touching a patient and also without traveling long distances to remote locations.

For optimum Peripheral Health Service and implementation of various Vertical Public Health Programme Services, network of public Rural and Urban Health Centers with trained Specialists in General Practice (GP) is essential. Later such Specialist GPs will thus fulfill both comprehensive training and experience required for Health Management and Planning Service in the centre. About 40%-50% of all Residential Trainings and Specialists are required in GP. There are further up to 100 to 150 possible specialties in which remaining doctors can be trained for Specialty Health Services. Though free Residential Training has numerous advantages, its shortage inside country is the bottleneck to provide above mentioned Health Services. Planning for health service delivery by at least trainee residents under supervision or appropriately trained specialists guides Residential Training’s regulations. Fulfillment of objective training criteria as its core focus is the concept now with the major role of Faculty as supervising residents to provide required service in the specialty and simultaneously updating themselves and their team for Evidence-Based Medicine practice. Similarly the need of Ambulatory Health Service and joint management of in-patients by specialists in hospitals has changed unit and bed divisions and requirements for Residential Training. Residents, already the licensed doctors, are thus providing required hospital service as indispensable part of its functional hierarchy for which they need to be paid. With such changing concepts and trends, there are some essential points in existing situation to facilitate free Residential Training inside country. For Government doctors, relevant amendment in their regulation is accordingly required. Keywords: ambulatory care; general practice; health service; hospitalist; medical council; medical education; public health; regulatory body; research; residential training.

Stroke is the third leading cause of death globally. Pakistan, a low-middle income country (LMIC), reports approximately 350 000 new stroke cases annually, including 20 000 cases each year from Karachi, Pakistan’s largest city populated by 12 million people1. Telerehabilitation is a fairly new branch of telemedicine, defined as the provision of rehabilitation amenities by experts to the patient using telecommunication technology. It reduces hospital stay and expense, thus proving beneficial for both the patient and healthcare provider. Its use is more common in high-income countries (HICs) than LMICs. Popular systems like the Rehab@Home2 framework are examples of telerehabilitation models for patients suffering from stroke3. There is a shortage of literature to comprehensively comment on the impact of telerehabilitation on stroke patients in LMICs. However, telehealth in neurology, termed teleneurology, has the potential for advancement in the treatment of patients with neurological diseases in LMICs, as they have the highest incidence of neurological disorders. A paper proposed that establishing a teleneurology network for Sub-Saharan Africa consisting of transcontinental, inter-regional, intraregional, and national networks will allow neurologists and neurology residents from LMICs to consult with their counterparts in HICs, thus improving the overall quality of the healthcare system4. Pakistan only has 3.2% of the current GDP devoted to the health sector, leading to limited medical facilities nationwide. The outbreak of Covid led to an uplift in the growth of telehealth which encourages evolution in the future. However, this advancement in the use of telehealth has been hindered by several factors since its inception in 2003, including a lack of legal framework and laws for the establishment of new programs, lack of sustainable support from the government, deficiency of funds and resources for the organization of infrastructure, distant rural areas with poverty, low literacy rate, limited cell phone ownership, and internet access. The scarcity of qualified doctors and trained paramedics or nurses and lack of awareness is another significant impediment as depicted by a survey, which informed that 98.2% of doctors employed in the public health sector in Karachi recorded a paucity of training workshops or conferences for telemedicine5. Hence, measures to overcome these barriers like investments from HICs, training workshops from pioneers of the field, and healthcare professionals who can offer services in multiple languages are some of the factors that can aid in effectively introducing telerehabilitation for the masses.

In the article the author characterizes main tendencies of healthcare system development of Northern Bukovyna and Khotyn region in 1918-1940. Investigates the state of sanitary and hospital services, covers the problem of combating epidemic diseases. Lack of qualified and well-timed care for patients with smallpox, typhus, tuberculosis, dysentery and other diseases that became widespread after World War I, led to an increase in mortality among the population. However, over time, the normal work of medical institutions has been restored and the threat of epidemics has been eliminated, and the number of diseases and deaths has decreased significantly.By 1921, the health care system of Northern Bukovyna and Khotyn region was almost completely in line with that in the Old Kingdom. However, the payment for treatment remained. For the most part, in 1918-1940, after receiving new equipment, continued to operate medical institutions established during the period when Bukovyna was a part of Austria-Hungary. According to the needs of time, their structure, number and qualification of medical staff was changing. New branches, laboratories and institutes were being opened on their basis. The pharmacy network was developing, societies of doctors and pharmacists were working, and county councils of hygiene were functioning.While noting some of the undoubted successes in the health care system of the region during this period, it should be noted that a large number of the rural population (especially the inhabitants of mountainous areas) did not have access to medicine.

The consequence of disproportionate distribution and placement of Doctor in Indonesia is affecting people who live in rural area. Patient have to travel to city to receive medical treatment and must encounter another different problem such as: patients often have to wait a long time in the doctor's office even sometimes do not get the service because of holiday or rejected because the queue is full. Medical record in some cases may lost due in Indonesia mostly medical record recorded manually (paper based). Therefore doctor treatment is not optimal because doctor can no longer inspect patient illness history and any treatment that have been conducted before. This research proposes a new concept to help people who live in rural area to get better medical treatment. People could register and monitor doctor service queue via smart phone. System expanded with medical record management facilities to improve service quality of patient. Research object was doctor service in Sulawesi, Indonesia. This research indicates system could increase time efficiency, energy, and cost efficiency for patient and also the doctor. Additionally current system will be optimal if supported with stable internet network.

Whereas the bulk of empirical research has employed nonparametric approaches to estimate efficiency in local government, especially Data Envelopment Analysis (DEA), in this paper we employ a Network DEA (NDEA) model to investigate the impact of the separate divisions of financial management and service provision on overall municipal efficiency. We apply this approach to the New South Wales (NSW) state local government system in Australia using a NDEA model for the four-year period of 2014/15 to 2017/18. We find that the overall efficiency of NSW local councils is statistically significantly associated with financial efficiency more strongly than with service efficiency, indicating that financial activities are relatively more important in terms of municipal performance. Using a fractional regression model in a second-stage NDEA model, we also establish that urban local councils are more efficient than their rural counterparts in terms of both financial efficiency and overall network efficiency.

Understanding factors that enhance or diminish performance levels of individuals is instrumental for achieving individual (low level) and organisational (high level) goals. In this study, the effect of social network structure, position, ties and information and communication technologies (ICT) use on performance attitudes of knowledge intensive workers in dispersed occupational communities is investigated. Based on social network theories of strength of weak ties and structural holes, and the social influence model of technology use, a theoretical framework is developed. In conjunction with qualitative interviews conducted with subject matter experts, the framework is used to further develop and refine a valid and reliable survey instrument. Secondly, network measures of degree centrality, density, structural holes (constraint and efficiency), tie strength and tie diversity are applied for exploring the association with ICT use and performance from a sample of 110 rural general practitioners. Empirical results suggest that network structure, position and ties of knowledge workers play a crucial role in individual performance and ICT use. In particular, degree centrality and task-level ICT use was found to be positively associated with performance while ego-network constraint was found to be negatively correlated with performance. In terms of ICT use, functional diversity and degree centrality were positively associated with task-level ICT use whereas ego-network efficiency was found to be negatively correlated with ICT use at the communication-structure level. Among the variables that showed significance, degree centrality best explained overall variance for performance, and functional diversity best explained overall variance for task-level ICT use, although professional accreditations remains a potent indicator also. The results from this study resonate with findings from past literature and extend traditional theory of social networks and performance within the micro level to include geographically dispersed individuals involved in knowledge intensive work. For individuals in such non-competitive settings, traditional network theories such as structural holes theory still apply. However, a key finding is that network structure is a much more potent predictor of performance although network position is important. The second key finding addresses a major gap in the literature concerning understanding social processes that influence ICT use. As the technology acceptance and the social influence models lack empirical evidence from a social networks perspective, this research shows that rather than the strength of ties which functions as a conduit of novel ideas and information, it is the functional tie diversity within individual professionals networks that increase ICT use at the task-level. Methodologically, the study contributes towards a triangulation approach that utilises both qualitative and quantitative methods for operationalising the study. The quantitative method includes a non-traditional “networks” method of data collection and analysis to serve as a fine complement to traditional research methods in behavioural studies. The outcome is a valid and reliable survey instrument that allows collection of both individual attribute and social network data. The instrument is theoretically driven, practically feasible to implement, time-efficient and easily replicable for other similar studies. At the domain level, key findings from this study contradict previous literature which suggests that professionals in occupational communities such as general practitioners decline in performance as they age. In fact, findings from this study suggest that age and experience do not affect for performance; rather, there is a negative relationship between experience and task-level ICT use, and that task-level ICT use is positively associated with performance in terms of attitudes to interpersonal care. Furthermore, degree centrality is also positively associated with professional accreditations, such as fellowship of the Royal Australian College of General Practitioners, which is conducive to performance in terms of attitudes to interpersonal and technical care. The contextual implication from the quantitative and qualitative evidence of this study is that while contemplating strategies for optimising ICT use or for improving attitudes to quality of care at the technical and interpersonal level, the importance of social structure, position and relations in the practitioner’s professional network needs to be considered carefully as part of the overall individual and organisation-level goals.

Doctor of Philosophy (PhD)
Understanding factors that enhance or diminish performance levels of individuals is instrumental for achieving individual (low level) and organisational (high level) goals. In this study, the effect of social network structure, position, ties and information and communication technologies (ICT) use on performance attitudes of knowledge intensive workers in dispersed occupational communities is investigated. Based on social network theories of strength of weak ties and structural holes, and the social influence model of technology use, a theoretical framework is developed. In conjunction with qualitative interviews conducted with subject matter experts, the framework is used to further develop and refine a valid and reliable survey instrument. Secondly, network measures of degree centrality, density, structural holes (constraint and efficiency), tie strength and tie diversity are applied for exploring the association with ICT use and performance from a sample of 110 rural general practitioners. Empirical results suggest that network structure, position and ties of knowledge workers play a crucial role in individual performance and ICT use. In particular, degree centrality and task-level ICT use was found to be positively associated with performance while ego-network constraint was found to be negatively correlated with performance. In terms of ICT use, functional diversity and degree centrality were positively associated with task-level ICT use whereas ego-network efficiency was found to be negatively correlated with ICT use at the communication-structure level. Among the variables that showed significance, degree centrality best explained overall variance for performance, and functional diversity best explained overall variance for task-level ICT use, although professional accreditations remains a potent indicator also. The results from this study resonate with findings from past literature and extend traditional theory of social networks and performance within the micro level to include geographically dispersed individuals involved in knowledge intensive work. For individuals in such non-competitive settings, traditional network theories such as structural holes theory still apply. However, a key finding is that network structure is a much more potent predictor of performance although network position is important. The second key finding addresses a major gap in the literature concerning understanding social processes that influence ICT use. As the technology acceptance and the social influence models lack empirical evidence from a social networks perspective, this research shows that rather than the strength of ties which functions as a conduit of novel ideas and information, it is the functional tie diversity within individual professionals networks that increase ICT use at the task-level. Methodologically, the study contributes towards a triangulation approach that utilises both qualitative and quantitative methods for operationalising the study. The quantitative method includes a non-traditional “networks” method of data collection and analysis to serve as a fine complement to traditional research methods in behavioural studies. The outcome is a valid and reliable survey instrument that allows collection of both individual attribute and social network data. The instrument is theoretically driven, practically feasible to implement, time-efficient and easily replicable for other similar studies. At the domain level, key findings from this study contradict previous literature which suggests that professionals in occupational communities such as general practitioners decline in performance as they age. In fact, findings from this study suggest that age and experience do not affect for performance; rather, there is a negative relationship between experience and task-level ICT use, and that task-level ICT use is positively associated with performance in terms of attitudes to interpersonal care. Furthermore, degree centrality is also positively associated with professional accreditations, such as fellowship of the Royal Australian College of General Practitioners, which is conducive to performance in terms of attitudes to interpersonal and technical care. The contextual implication from the quantitative and qualitative evidence of this study is that while contemplating strategies for optimising ICT use or for improving attitudes to quality of care at the technical and interpersonal level, the importance of social structure, position and relations in the practitioner’s professional network needs to be considered carefully as part of the overall individual and organisation-level goals.

This thesis has been supported by an ARC Industry Linkage grant and sought to explain the process of adoption of information technologies by comparing two main theories that have been developed to explain adoption of innovations, that of innovation diffusion and that of actor network theory. In the process of analysis for this thesis I decided very early on that the better way of explaining the pattern of adoption was by using the framework of actor network theory supported by qualitative methodology. A major contribution of this thesis could be seen as an ANT analysis of IT/IM in general practice. It appears that the multi partner, multi discipline research approach was a success for it created the opportunity to draw on diverse backgrounds. More importantly this research indicates that the qualitative research methodology of Actor Network Analysis has delivered an insight that is richer in data than the quantitative research that is usually undertaken in this field. This process assisted with enlightening the barriers and enablers to the adoption of information technology/information management (IT/IM) in general practice in a particular study area and to explain why, in the study area the pattern is fragmented and unclear. This study found it is important to note the difference between the adoption of IT/IM by general practice and adoption and use by general practitioners. The adoption process has been complex and many stakeholders have grappled with issues such as the cost of computerization, the rapid changes in technology, the lack of agreed standards and the problems of introducing technology information solutions in to the daily work place of general practice. Through comparison via case studies, extended interviews and implementing several study phases to develop a longitudinal aspect for the research, the teasing out of such issues as decision making in general practice and general practice as small business was undertaken. Through review of models that seek to explain adoption I will finalise by formalizing which theory of adoption better suits explanation of adoption of innovation within this study area. This thesis reports that while there are generally pockets of high uptake and use of IT/IM, this is not the complete picture across the study area and this reflects the situation in Australia. There are differences in adoption from one practice to another and even within practices; there are differences in adoption in terms of acceptance of an idea versus doing; in the study area there is only one practice which can reasonably claim to be paperless. Throughout this thesis a series of vignettes will be developed which set out to provide a whole play. Each vignette presents an aspect in the total picture of computerization. This thesis does not set out to provide the whole picture as that is still a work in progress, as such this thesis has no definite border, and the vignettes will sometimes show only the head and shoulders of the story with the background fading off. Other vignettes are very clear but as with all vignettes there are questions about the shaded areas. It is in these areas that questions arise to demonstrate there is greater depth in the story of the adoption of IT/IM in general practice in the study area, and, that adoption of IT/IM in general practice is complex and a continuing developmental story.

Abstract In rural or remote countryside areas (e.g. in the northern part of the French Alpes), far from large hospitals and specialized medical departments, patients suffering from disabling episodic or chronic head/facial pains may benefit from local care and long-term follow-up involving general practitioners, specialists from various medical and paramedical disciplines, as well as experts in the headache field. The challenge stands on daily collaborative practice between experts, family doctors, and paramedical interveners, specifically dedicated to proximity care and parallel follow-up. Such a horizontal organization of care allows fast specialized diagnostic or therapeutic help and adequate multimodal therapeutic choices for patients who would otherwise stay away from or enter belatedly into the appropriate medical channels.

The ideal of “culturally appropriate care” that medical anthropologists had advocated was limited by broader shifts in the corporatization of medicine that affirmed the status of health as a commodity and sharpened global health disparities. Faced with various constraints, some charted new paths to reform and humanize medicine, from efforts to train “culturally competent” doctors in the US to advocating for the equitable distribution of medicine across the globe. Before he became a leader in the contemporary field of global health and medical anthropology, Paul Farmer found in Hazel Weidman a mentor and friend, whom he visited in between frequent field visits to rural Haiti as a budding physician-anthropologist. Chapter 5 locates such interpersonal networks in the context of internecine academic debates, a global AIDS crisis, and the emergence of modern global health. Although Farmer distanced himself from the “culture broker” approach to medical anthropology, an examination of his rise to nonprofit stardom shows how he acted in his own right as a broker—not as much between physicians and patients, but between the cause of health equity and an emerging landscape of philanthropies, universities, and national security regimes that would financially support the transnational allocation of medical resources.