Reshaping remote primary care

For remote communities in the Northern Territory, accessing health care can be difficult and delivered in silos.

When Berry Springs’ only medical centre closed, residents had to travel long distances to the nearest clinic. In 2024, local Nurse Practitioner Kylie Straube opened Remote Territory Healthcare, so that people living rurally could access the same quality of care as city residents. The practice is the Northern Territory’s first Nurse Practitioner-led clinic and cares for more than 3,000 patients.

Workforce shortages, financial viability, and vertical integration are some of the challenges of working in rural and remote areas. In response, Remote Territory Healthcare ensures that any AI use has operational benefits and improves the patient experience.

Financial viability is a significant barrier for Remote Territory Healthcare. The clinic relies on block funding and is limited by the MBS item numbers they can use. Clinician time is a precious resource that is limited by administrative tasks. Using AI has helped improve clinical efficiency, with Kylie now able to see more patients daily.

Social interaction is a fundamental aspect of appointments at Remote Territory Healthcare, with some patients travelling up to 200 km to the clinic. For most appointments, Kylie uses an AI scribing software for transcription, note-taking, diagnostic prompts, and care planning support. Using this program means that Kylie can actively listen to the patient, instead of facing her screen to type notes. Patients appreciate this engaged approach, and Kylie has more time for clinical activities.

During busy periods, callers to the clinic will be screened by an AI tool that differentiates between call types. This software supports callers to book appointments, contact emergency services, or take a message for callback – reducing pressure on reception staff.

The fallibility of AI is the main challenge facing its implementation at Remote Territory Healthcare. When using AI scribing software, Kylie has read notes with symptoms that weren’t mentioned in the consultation, incorrect medication names, and diagnostic suggestions that, while statistically likely, are not applicable to the patient. Similarly, the AI phone assist tool can give incorrect information about clinic hours or accessing urgent care.

Patient consent to use AI is obtained with literacy and digital literacy considerations in mind. Information about how AI is used by the clinic is explained in plain language on their website, on the patient registration form, and verbally in the consultation.

While Kylie uses AI as a tool to consolidate knowledge she has gained over a 20-year career, she discourages early career nurses from relying on AI diagnostic prompts as a substitute for clinical reasoning. Accountability for patient care is ultimately the clinician’s responsibility, and critically thinking about diagnoses builds nursing skills.

Remote Territory Healthcare’s goal is to use AI as a complementary tool rather than a replacement for clinician knowledge. To address the shortfalls of using AI in health care, the team:

Review AI-generated notes before they are entered into a patient’s medical record to confirm clinical relevance
Utilise an escalation pathway to a human for calls that are outside the scope of the AI phone tool – particularly in emergencies.

Kylie and her colleagues understand the context of living in a remote community and are determined to maximise the time they spend with their patients. By outsourcing administration tasks to AI, the team can focus on the work that only clinicians can do – providing accessible, quality care to their community. Remote Territory Healthcare’s model of care is underpinned by listening and building trust – qualities that no software can replace.

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