The doctor will call you now
There was good news for telehealth fans this week with new data about take-up in general practice and acute care emerging, topped off by Australian Health Minister Greg Hunt dangling the potential of a permanent role for publicly funded telehealth in the post-pandemic future.
A spokesperson for the minister told the Sydney Morning Herald this week that he had been lobbying for telehealth to continue after the pandemic. Considering Greg is in the position of actually being able to do something about it, we hope he does more than just lobby.
The new data from Melbourne's Outcome Health POLAR research backs up the anecdotal evidence that most telehealth consultations are being done by the phone, although the numbers the data has revealed are stark. Of the remote consultations conducted since mid-March by 1000 practices in NSW and Victoria, just five per cent are being done video, or just two per cent of overall consultations. People are still turning up to see their doctor in substantial numbers – POLAR's figures show 60 per cent of consults are still being done face-to-face – which might have something to do with people coming in for flu shots. The data is also showing that orders for pathology and radiology tests are way down.
Now that firm numbers are coming through, the anecdotes are about the reasons why GPs prefer the phone over video. The POLAR researchers posit that unfamiliarity with video conferencing, added to a perceived difficulty in using the technology, may be behind it. A couple of practising GPs on the Pulse+IT Chat site say they are using the phone because it's easy, they can type notes or write prescriptions or even take a turn around the room while talking on the phone, and they do not believe that telephone consults are unsafe or offer lower quality care.
The POLAR research is fascinating stuff. It uses the tool developed by Melbourne-based research network Outcome Health, which is also being used by some PHNs for the PIP QI and in two of ADHA's My Health Record testbeds. But it is the freshness of the data and the analysis of it by Outcome Health, led by Associate Professor Chris Pearce, that is most interesting, providing as it does some great insights into how general practice is functioning in these unprecedented times.
New data shows that the acute care sector is taking up telehealth with gusto as well. This week, Royal Children's Hospital reported it is doing 70 per cent of its outpatients clinics by telehealth, which is quite a substantial volume. The hospital provided more than 11,000 remote consults in the month of April alone. RCH has reported in the past that kids love seeing their specialists by video – in person and in hospital, not so much – and we are hearing that patients in primary care do too. Let's hope it continues in the post-pandemic world.
The five per cent figure for video might have alarmed the software industry, however. Every practice management system vendor and their dog now has a telehealth offering using video, as do all of the appointment booking service developers and even the medications app vendors. We had a chat to 1st Group's Klaus Bartosch this week, who had a few interesting things to say about how he sees the post-COVID telehealth world panning out, not just for GPs but for specialists and allied health practitioners as well.
He thinks telehealth will become a mixed modality, with some doctors enjoying it and doing it full-time, while others revert to face-to-face. 1st Group has added a telehealth search functionality to its directory, so this and other appointment booking services might provide some data in future on just how popular telehealth proves for patients, now that they know it's an option.
And in late breaking news, the first electronic prescription under Australia's new national architecture was successfully exchanged this week. A doctor from Anglesea Medical used his Best Practice system to write a script, a token for which was sent to the patient and the full details uploaded to eRx and there to Anglesea Pharmacy, where it was received in medications workflow platform MedView Flow and subsequently dispensed in Fred NXT. Best Practice and Fred have worked hard to fast-track this capability and are to be congratulated for doing so under these trying circumstances.
These trying circumstance were raised by the Pharmacy Guild last week in an utterly baffling press release claiming the new system will cause chaos for pharmacies and prescribers. The guild, which was part of the working group that developed the new architecture in the first place, seems to have taken offence at the use of tokens and instead wants active script lists to be prioritised. (They will eventually work in tandem, and are not an either-or proposition.) Besides which, it's a bit late for the guild to be arcing up now. Perhaps it's not the lobbying force of nature it once was.
That brings us to our poll question for the week: Do you expect to see MBS-funded telehealth continue after the pandemic?
Last week we asked: Have governments been the main drag on technological innovation in healthcare? This question certainly divided our readers, but a majority said no: 58 per cent voted no versus 42 per cent who said yes.