Why telehealth care is the need of the hour

By Dr Raj Khillan
Image used for representational purposes only

Across the globe, experts believe post-pandemic the healthcare system will be forever changed due to shift in healthcare models due to COVID-19 enforced social distancing and personal hygiene to stop the spreading of virus.

Telehealth is a simple concept of integrated technology and telecommunications to enable healthcare professionals to consult with patients outside of the traditional facilities, allowing quality healthcare to reach a broader audience.

Recent survey has found over 57% of healthcare professionals are currently using a telehealth platform, 87% of practices are prepared to deal with the changing requirements since COVID-19 and 92% are comfortable with new technology.

The biggest drive to telehealth in Australia came from the nation’s response to COVID-19. On 30 March, the Australian Government announced $669 million to expand Medicare-subsidised telehealth services for all Australians; plus, they are providing extra incentives to general practitioners and other health practitioners. This government response has been further extended for 6 months till March 2021.

Despite the market uncertainty, telehealth innovation will likely persist, and the telehealth industry likely to grow exponentially. The main driving force for this likely future growth is the proposed cost savings. Full acceptance of telehealth can save billions of dollars annually, as per Australian CSIRO. In the last decade increasing Australian health expenditure over 4% per year due to increasing aging population and increasing expenditure on chronic medical conditions further presses the importance of telehealth incorporation in our healthcare delivery system.

During the pandemic in Australia, companies with adequate infrastructure adapted to telehealth quickly and changed the healthcare delivery system—initial consultation and follow ups appointments. Many public and private hospitals in Australia pivoted quickly and embedded telehealth into operations. Royal Children Hospital, Sunshine hospital has moved to telehealth by using WebRTC platform based on Health direct Australia’s video call service. RCH is able to deliver almost 70% of their average 1,200 patients specialist clinic appointments via telehealth, during the pandemic.

The real saving of telehealth is dual-financial saving and time saving—which also convert into financial saving. Telehealth can save significant time and cost of transport and parking. It is likely to save 2-2.5 hours of time to keep a 20-30-minute health care appointment in the middle most cities in Australia. There is no need to mention the additional benefits of telehealth to the rural and remote communities.

Telehealth can also be used for patient and professional education, for expanding the reach of clinical trials so that those in rural areas have same access to new therapies as those living in our major population centres, home monitoring and many other health related activities including patient education.

Telehealth is not new in Australia, but COVID-19 and the new Medicare item numbers have stimulated its rapid adoption across the country. Queensland with its dispersed population over vast distances, has been a leader in telehealth implementation and research for many years. The University of Queensland based Centre for Research Excellence in Telehealth supported cutting edge innovation and evaluation to show what works. This has helped inform a significant cultural change to adopt telemedicine broadly across Queensland Health facilities. Other Australian states such as WA have already adopted a plan to convert 30-40% of outpatient attendances to virtual consultations over the next few years.

The COVID-19 crisis has exposed important weaknesses with our current health care system which we should address and one of those is how we are going to utilize digital solutions including telehealth for the benefit of all in the health system. Think what a difference this will make to Hospitals—they may become smaller, more focused of high technology interventions as in Denmark and other Scandinavian countries. The Topol Review provided for Health Education England delivers an excellent road map of what can be achieved by using this technological revolution not just for health professionals but for patients, carers, and the wider community.

It may well be that social distancing will continue, and many isolated individuals will have difficulty managing their chronic health conditions, getting their medications, obtaining food, exercising, and maintaining their social and family connections. Many people do not have the digital literacy, knowledge of or access to the tools and resources to help them navigate through these complexities to find the required services, resources and supports. Technology is key, so digital health revolution needs lots of awareness campaigns along with attempts to enhance and improve the digital health experience and productivity.

To obtain the full benefits of changing healthcare we need a framework that can ensure appropriate range and connectivity of technologies at both ‘ends’ of the consultation and engagement training of staff and patients to ensure smooth facilitation of the experience.

Importantly these changes will require a significant change in the health workforce. Health workers will be provided with new technology skills, new roles will be developed: Digital health technicians (who will be key part of any clinical practice in the future) to ensure health professionals and patients can connect rapidly with each other at any virtual consultation; and digital health navigators who can guide patients to the information they require to assist them better manage their chronic diseases in a safe environment—their homes and communities.

This is such an exciting time for health care but this changing concept will need changing mindset of our politicians to provide telehealth consultation to Australians particularly remote and rural.

There is a view that post-COVID the Federal Government’s focus will be on getting the economy back in shape and repairing the fiscal deficits racked up during COVID.

In Australia, a roll-back of the Medicare subsidy will re-institute the old barriers to primary care telehealth adoption, which existed pre-COVID-19. Customers will be substantially more out of pocket for e-consults, and doctors will be left without a monetary incentive to join with lagging customer demand. We hope that there will be a permanent and lasting increase in telehealth consults. We believe telehealth will not be a significant threat to in-person healthcare and unlikely to compromise the quality of care with the back up of face to face consult opportunity if needed.

The writer is a paediatrician and director, Western Specialist Centre. Reference and thanks to BDO Australia, Grattan Institute, Digital Pulse

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