The inequity in health services between city and country prompted Peter Tually to develop TeleMed.
IT’S an uncomfortable truth that if you get seriously ill in rural Western Australia you are likely to die earlier and suffer more than a city patient.
Despite WA’s immense mineral wealth, health services in the bush still fail many of the people who are working at the forefront of the current resources boom.
It was this disparity between city and country healthcare that drove nuclear medicine scientist Peter Tually to develop the state’s only rural and remote nuclear medicine service, TeleMed.
“Too often we get overwhelmed by the big issues and fail to look at the small parts of it, the simple things that could make a huge difference.” Mr Tually said.
“I don’t like people being disadvantaged and you shouldn’t have to feel pain or have a poorer outcome just because you live in the bush.”
Founded by Mr Tually in 2005, TeleMed grew out of the WA radiography group Global Diagnostics.
Mr Tually is still a director and shareholder of Global Diagnostics and he takes advantage of its international network of clinics for his research work.
When he is not flying out to a TeleMed clinic in regional WA, Mr Tually devotes his time to two major research projects – one focused on the role of health technology in chronic disease management, and the other looking at the relationship between certain biomarkers and exercise.
The nuclear medicine work Mr Tually undertakes in his TeleMed clinics is predominantly focused on the two biggest killers in Australia today – heart disease and cancer.
The business started with just one clinic in Geraldton, which give Mid West patients a chance to access vital, quantifiable information about their health without the expense and inconvenience of flying to Perth.
“In the country environment what often happens is you have a 50-year-old gentleman who hasn’t had a heart attack but he’s got all the risk factors – he’s got a bit of a tummy, he’s a smoker and he’s complained of chest pain,” Mr Tually said.
“He hasn’t had a heart attack but the emergency department are not happy to say he’s not at risk of it.
“We can do a nuclear scan and a stress test that will show how the blood is pumping through the heart and ... quantify a risk score.”
The information technology that sits behind TeleMed’s nuclear medicine scanners links Mr Tually with top-flight medical experts in other locations, who can assist in drawing a diagnosis from a scan in real time.
“My focus is on trying to get the patient diagnosed before they see the specialist rather than going from the emergency department to their GP then to a specialist then scanning, diagnosis and back to the specialist,” Mr Tually said.
“If we can go from the emergency department to scanning we can determine immediately whether the patient needs to see a specialist and that doctor is already thinking about a diagnosis.”
Traditionally, nuclear medicine has been the domain of the major city hospitals and supported by a team of medical professionals including physicists, pharmacists, doctors and nuclear medicine scientists.
TeleMed was never going to be able to replicate this in a rural setting but Mr Tually saw the opportunity to use technology to virtualise some aspects of it, particularly the data analysis.
“Nothing will beat a doctor sitting in front of a patient but the reality is we are not going to be able to cope with the patient growth tsunami on current flows of clinicians, and that is in the major cities,” Mr Tually said.
“So if you could tap into the top brain electronically, wouldn’t you rather do that?”
In the early days of its operations the data transfer technology barely coped with the information Mr Tually was sending from Geraldton back to physicians in Perth.
“The amount of information we were tyring to push through those antiquated copper wires, it was like trying to push a tennis ball through a garden hose,” Mr Tually said.
And costly technical breakdowns pushed the business to the brink of collapse.
But with grit and a relentless work ethic, Mr Tually worked through the tough times. It’s a steely determination he learned from his father.
Mr Tually’s father David was born with a significant disability in post-war Sydney.
“The world said ‘no David, you can’t do this and you can’t do that’,” Mr Tually said. “He fought against this and built a very successful business, but during the ‘recession we had to have’ my family lost the lot.
“I lived through the indignity of literally being thrown out of the family home by the bank.
“But what is forged in my memory is that dad did not take the easy option and apply for bankruptcy. He maintained his dignity, showed enormous courage, tenacity and battled on with his head held high.”
TeleMed has been a huge investment for Mr Tually, who put his house up as security to purchase the first gamma camera; but it’s his passion for equitable healthcare that has underpinned the operation’s survival and expansion.
From that single clinic in Geraldton, TeleMed now sees patients in Bunbury, Mandurah and Kalgoorlie, and there are plans to expand the network to take in the Great Southern and the Pilbara.
Business is growing strongly and TeleMed’s expansion is only held back by the lack of nuclear medicine scientists keen to work in regional centres.
But big profits are not the ultimate measure of success for Mr Tually.
TeleMed was founded on a no-gap model to ensure there were no out-of-pocket expenses for cancer sufferers, pensioners or patients on social welfare.
“The truth is, if patients in rural areas can’t afford the $150 gap payment (above the Medicare rebate) they just won’t get the test,” Mr Tually said.
Laughing off the label ‘social crusader’, Mr Tually is committed to using the profits he reaps from TeleMed to reinvest in the expansion of the business.
It’s a social capital model he believes avoids the pitfalls of corporatised healthcare.
“I have concerns about healthcare companies being run for the benefit of the shareholders,” Mr Tually said.
“I think we should use capitalist ideas and marketing, because it does make for a more efficient operation but there has to be a release valve, there has to be some profit regulation.”