Pandemic forces change of pace

It has become a cliché in hurry in these unprecedented times but the speed with which the health IT sector has had to adapt to the global pandemic has been stunning to watch. Healthcare usually changes at a snail's pace, for good reason, and health IT is no different. We asked in our poll last week if you thought the health IT industry has successfully risen to the challenge of COVID-19. Not surprisingly, the sector was positive about itself: 79 per cent said yes, 21 per cent said no.

And just as the dealing with a crisis playbook has been thrown out the window, so has years of recalcitrance on the part of the healthcare system and its policy designers in taking up new and not so new technologies. It took a global pandemic to finally get telehealth on the front foot and everyone is doing it now. It has been quite stunning to see how fast the local industry has been in developing solutions for users, with a plethora of video conferencing solutions now available.

That said, we are hearing a lot of anecdotal evidence that most telehealth being done in general practice is over the phone, and that once the pandemic is over, quite a few GPs will revert to pre-pandemic days, for financial if no other reason. We'll be most interested to find out how many consults have been billed using the telehealth (video) items as opposed to telephone, as we are hearing that upwards of 65 per cent and even as high as 80 per cent of consults are audio only.

The Department of Health won't be pleased about this as it has specified that video be used if at all possible, but then again the department has been a drag on telehealth uptake for years, mainly concerned as it was that doctors would rort the system if they were allowed to practice this way. We think those fears are mainly unfounded, barring the odd opportunist, so it's a shame telehealth has been held back so much by antiquated and restrictive government policy.

And just as all of the fears surrounding telehealth seem to have been swamped by the pandemic, so has the stricture against using what has always been a no-no in healthcare: email as a means of communicating health data. Not only are GPs emailing and faxing images of prescriptions to pharmacies, but even referral letters no longer have to be printed out and handed to the patient. These too can be emailed or faxed directly to the local radiology practice complete with name, date of birth and clinical details. All of those security fears have also been chucked out the window, and you wonder if they were overblown in the first place.

It will be fascinating to see just what remains when the pandemic is over, but as old and new technologies come to the forefront, we have to ask the question: why has it taken so long? Is it a case of technology being stymied by reluctance to change workflows or by government red tape or a combination of both? Should so much effort have been put into the My Health Record when getting secure messaging, electronic prescribing and telehealth in general use might have made more sense?

Even the acute care sector has joined the party: our top stories this week included the roll-out of remote monitoring at Bendigo Health using technology from Siemens Healthineers. Western Sydney is also doing this, using a locally developed system, and so is West Moreton Hospital and Health Service in Queensland, using Philips gear. This sort of technology is not new and not even that sophisticated, but its use is still in its infancy. However, as a presentation at AIDH's From the Frontlines conference showed last week, even massive health systems like Metro North HHS can move in a hurry if they want to.

Perhaps the pandemic is showing that when it comes to technology take-up and innovation, governments should just get out of the way. This government and its bureaucrats, obsessed as they are with lifters and leaners, rorters and robodebt, have shown themselves to be remarkably flexible when the crunch came and able move fast when put on the spot. We'd hope that long may it continue, but we fear not.

That brings us to our poll question for the week: have governments been the main drag on technological innovation in healthcare?

Sign up to our weekend edition or Pulse+IT Chat to vote, or leave your thoughts below.


+1 # Oliver Frank 2020-05-02 09:03
You said: "...years of recalcitrance on the part of the healthcare system (...) in taking up new and not so new technologies". This is an unfair claim. Speaking for GPs, we have been at the forefront of computerisation . What has held back GPs and other health professionals with whom they communicate from using secure messaging universally has been the still mostly unresolved problem that users of any one secure messaging system can't write to users of all other secure messaging systems. Once that problem is solved, we will see universal use. What has held GPs back from conducting email, telephone and video consultations has not been recalcitrance but the lack of Medicare benefits or other payments until now for GPs to do so.
0 # Paul Venables 2020-05-02 09:08
There is no doubt the COVID-19 pandemic has become a huge driver of rapid change in multiple aspects of our lives, not just in Healthcare. Some are for self preservation, such as the transition to on-line food shopping by those of us in the “high risk category” as a result of age and/or health history. Others are primarily designed to reduce the risk to service providers and allow essential services to continue to be provided; Healthcare is in this category. Some of those short-term changes will stick for the long-term such as the transition to on-line shopping, others will go back to how they were. In the case of Healthcare I hope any change that improves the care process for patient and provider sticks around; it should because the pandemic is going to be with us for long enough for everyone to adjust and see the benefits of change.
0 # George Margelis 2020-05-02 13:22
Whilst it is exciting that innovations that we have been promoting for many years are now being implemented, I have to admit to a degree of anxiety of the rushed process. Many of the technologies will demonstrate their value, but we need to capture the evidence and subject it to the normal clinical diligence we subject other clinical interventions to. Anecdotal evidence is a start, but systematic evaluation which will allow us to iteratively improve on the current situation will enable us to develop a better, more robust healthcare system.
I worry that some of the low-value uses of telehealth will slip in with the high-value ones.

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