Isabelle, cur­rent­ly Nurs­ing Direc­tor Edu­ca­tion and Research for the Tas­man­ian Health Ser­vice North West, served for a num­ber of years on the CRANAplus Board and has been President. 

She was involved in estab­lish­ing the first REC course and vol­un­teered a lot of time to sup­port the devel­op­ment of the remote health suite of cours­es through the Cen­tre for Remote Health. 

As a fledg­ling nurse, Isabelle was inspired to pur­sue a career in remote nurs­ing in Aus­tralia after vis­it­ing Papua New Guinea where she wit­nessed the chal­lenges faced by com­mu­ni­ties in remote areas. 

“I realised then that I want­ed to [be a remote area nurse] in Aus­tralia,” she says, ​“I didn’t need to go over­seas. And that became my dri­ving goal.”

After work­ing in the North­ern Ter­ri­to­ry and north­west West­ern Aus­tralia, where she gained invalu­able expe­ri­ence work­ing with Abo­rig­i­nal health work­ers, Isabelle moved into Abo­rig­i­nal health edu­ca­tion and then high­er edu­ca­tion and set up the nurs­ing pro­gramme at the Notre Dame Uni­ver­si­ty in Broome, pri­or to becom­ing the WA government’s first tele­health coordinator. 

From those ear­ly days she has gone on to have a career as a nurs­ing and mid­wifery aca­d­e­m­ic and senior health leader.

“I didn’t even know what tele­health was back then,” she says, list­ing the numer­ous chal­lenges in those ear­ly days of advo­cat­ing this new type of ser­vice: from band­width lim­i­ta­tions and inad­e­quate sys­tems and pro­to­cols to estab­lish reli­able con­nec­tions with spe­cial­ists, to its reluc­tant uptake by the med­ical profession.

Tame by today’s stan­dards, the steps of progress were inno­v­a­tive and ground­break­ing at the time, she says.

“I had always been inter­est­ed in wound care for peo­ple liv­ing with dia­betes because of the real­ly poor out­comes, abysmal out­comes actu­al­ly, and very com­plex issues,” Isabelle says. ​“We had to come up with solutions.”

An ini­tial solu­tion to telehealth’s tech­ni­cal chal­lenges was the use of dig­i­tal imag­ing soft­ware. In terms of limb ulcers in peo­ple with dia­betes, it was a case of tak­ing a pho­to and using a 1cm sticky label to cal­i­brate wound images and com­mu­ni­cate through tele­health con­sul­ta­tions to deliv­er effec­tive care remotely.

The uptake of tele­health ​“has been a slow burn, but it’s final­ly pay­ing off,” says Isabelle.

“With remote com­mu­ni­ties, the val­ue of tele­health was clear to us who were out there, but when you have five mil­lion peo­ple liv­ing in a city and the view that they can go to a near­by clin­ic, com­pared with 100 peo­ple in a remote com­mu­ni­ty, the small pop­u­la­tion size raised ques­tions about cost-effec­tive­ness and resource allocation.

“It took the COVID-19 pan­dem­ic to move tele­health into the main­stream, because peo­ple in the cities couldn’t leave their homes and [realised] that tele­health was valuable.”