Written by Professor of Healthcare Innovations Sharon Mickan.
For more than 30 years now, the evidence has been building in favour of telehealth, but it was most often talked about as an innovation for the future. The barriers for patients and providers – from technological skills to equipment to training required, meant it hadn’t been widely adopted.
Australia's road to embracing telehealth
Australia has been slow to adopt telehealth, particularly when we compare the populations’ engagement in online banking, travel and shopping over the same time period. Unlike other industries, where innovations are trialled before any research or evaluation takes place – maximising commercial opportunities – but with government, policy change requires a much more cautious approach. The potential risks of any change need to be identified and managed in terms of uptake, costs and affordability. There also needs to be a political will to lead a change, and a clear benefit to the population, which is often communicated in terms of existing research evidence and evaluation data.
The real charge towards telehealth started almost 10 years ago, when the ‘Connecting Health Services with the Future’ initiative was developed and a taskforce was established to explore opportunities in telehealth. The taskforce sought advice from over 70 Clinical Committees and over the past four years, more than 700 clinicians, consumers and health systems experts have participated in these committees, with 66 reports generated. But still, we were behind.
How COVID-19 changed everything
The current COVID-19 pandemic provided an urgent opportunity for real change, underpinned by research evidence and perceived patient and provider benefits. There was a very real concern that patients were avoiding primary care consultations because of the threat of COVID-19, coupled with the fear that that primary healthcare providers did not have sufficient personal protective equipment.
The circumstances drove a positive policy change for expanded telehealth access to general practitioners and other medical specialists. This landmark policy change also includes rebates for allied health professionals, which is another innovative opportunity to extend publicly funded healthcare.
This is an exciting time for Australians to embrace a long-awaited change to the delivery of healthcare services. It’s also a critical time. As healthcare service providers, we can quickly integrate telehealth into consultations where there is evidence of effectiveness, such as for monitoring chronic conditions, requesting repeat prescriptions, access to mental health services and for services in rural and remote Australia.
We must also use this opportunity to evaluate the implementation of telehealth services, from the perspectives of patients, their families and providers. We need to be innovative in the way we evaluate as traditional forms of research will likely take too long. We also need to collect data for complex productivity and cost analyses to support the integration of best practice in the new normal that will follow this crisis.
The way forward
Telehealth is a very broad umbrella and we have a time-limited opportunity to be creative while using the best available digital health devices to fully embed telehealth within both private and public healthcare services.
The possibilities are limitless. We have an opportunity to investigate the benefits of tele-monitoring for patients who have their own blood pressure machines and good technological connectivity. Healthcare staff, using automated data systems, may be able to remotely monitor patients, and respond more quickly to those who are experiencing unexpected variations.. Allied health professionals may also be able to provide tele-therapy and tele-rehabilitation.
To make the most of this opportunity, it will be important to allow for some flexibility and creativity to meet the diverse needs of different patients. Clinicians and researchers will need to be responsive to managers and policy makers.
Innovation is more than just generating and solving problems. It requires us to embed the best solutions in future practice, so that patients and providers realise the clinical and cost benefits. One size will not fit all.
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