Program Overview

The Commonwealth of Australia, through the Department of Health and Ageing, established a national program called the Strengthening Support for Women with Breast Cancer (SSWBC) Program. The program has an emphasis on women living in rural and remote areas, and on developing sustainable improvements based on evidence of need, evidence of benefit, reducing inequity, and the collaborative development of resources.

Six national objectives were identified for the SSWBC program:

1. All women to receive adequate and appropriate information about their treatment.
2. All women and their families to receive adequate information about supportive care.
3. All women to receive a coordinated approach to supportive care.
4. Women with clinical depression, anxiety or other problems to be identified and referred.
5. All women with lymphoedema to have access to information about treatment options.
6. All women to have information about financial support for travel and accommodation for which they are eligible.

In Victoria, the SSWBC Program was developed and implemented during 2000 to 2004, by the Victorian Department of Human Services through BreastCare Victoria. The Victorian program focused on an e-health model as an approach to improve supportive care and service delivery to women with breast cancer.

E-health can be defined as, the use of electronic communication or information technology for clinical, educational, and administrative purposes (Mitchell J 1999). The technology used in Victoria for the implementation of SSWBC initiatives included: videoconferencing, teleconferencing, internet and email.

Implementation of the e-health initiatives was made possible due to the existing infrastructure and resources available through the Breast Services Enhancement Program (BSEP), a core component of BreastCare Victoria. All five BSEP teams in rural Victoria, including Loddon Mallee, Barwon South Western, Gippsland, Grampians and Hume regions, were responsible for the implementation of SSWBC projects.

The infrastructure and resources available through the BSEP allowed for a range and number of projects to be implemented across rural Victoria. It also enabled and facilitated the implementation of e-health initiatives through the expansion of existing initiatives.

Further information on BreastCare Victoria and the BSEP can be accessed via the BreastCare Victoria website.

E-health as a model to improve supportive care

The issues faced by women with breast cancer living in rural and remote Victoria are largely due to their relative isolation in terms of geography and social supports. These issues include poor accessibility to supportive care through breast care nurses and other support services, and difficulties in accessing information about supportive care and treatment.

E-health has the potential to overcome some of the difficulties experienced by consumers living with breast cancer in rural and remote areas. When developed and implemented appropriately, it has the capacity to greatly improve the delivery of, and access to, services and information for women with breast cancer, their families and for health care professionals.

In Victoria, the SSWBC program provided an opportunity to develop and trial a number of e-health approaches with the aim of addressing some of the obstacles to service provision and access to information in rural areas. The program also provided an avenue to use information technology to link isolated clinicians into treatment planning and professional development opportunities.