November 14 — today — is World Diabetes Day and to mark the occasion, we’re exploring the intrinsic link between diabetes and foot health.
Diabetes-related foot disease is a leading cause of hospitalisation, amputation, and disability burden in Queensland, which have been shown to be significantly reducible with timely access to quality ambulatory care.
Diabetes increases a person’s risk of foot ulcers and amputations because the condition can damage the nerves and blood circulation in the feet. Diabetes-related foot disease is defined as infection, ulceration, or destruction of tissues of the foot associated with neuropathy and/or peripheral artery disease in the lower extremity of a person with (a history of) diabetes mellitus. Timely access to specialist care from a foot care team for persons with foot disease is vital in enabling early assessment and management to limit the severity and risk of hospitalisation. For rural and remote Queenslanders, this specialist advice is not always on hand.
To address this, South West Hospital and Health Services and Statewide Podiatry Telehealth Service are perfecting a system whereby patients can receive timely access to clinical assessments with Telepodiatry. The statewide service was established in 2019 and is jointly delivered by Metro North and Cairns and Hinterland Hospital and Health Services. Sarah Jensen, Director Podiatry at Metro North and Co-chair of our Queensland Diabetes Clinical Network, explained it as an integrated pathway. “Telepodiatry focuses on establishing pathways to connect local services to the statewide podiatry telehealth service so patients can receive timely access to care, which is critical for their foot health,” Sarah said.
“The goal of the service is to provide specialist podiatry and foot disease management for patients who might not have local access. A podiatrist might be available in areas like the South West, but they have a large geographical area to cover. So, a patient might turn up to Roma with a foot ulcer, but the podiatrist can’t see them because they are covering another site,” she explained.
“Telepodiatry provides the opportunity for the service to get same day advice and offer care, which has significant benefits for the patients.”
Essential to the success of Telepodiatry has been the local healthcare team who are with the patient, know the community and provide the hands-on care in an interdisciplinary approach. In the South West, Telepodiatry has worked with a diverse range of clinicians including a nurse practitioner, wound care clinical nurse consultant, diabetes educator, and allied health assistant.
“They are our hands while we review the Doppler Screen and see the wave forms which is what enables us to do the assessments remotely. In those interactions we are able to upskill the local workforce in foot disease management, wound assessment techniques, and neurovascular assessments,” she said. “This all contributes toward building the capability of the health workforce to recognise, respond and refer foot disease.”