Hospitals dial up remote monitoring

Much has been written in these pages and others about the way telehealth has fundamentally changed primary care during COVID-19, although whether that change will continue into the future is still a matter of debate. We are hearing more positive things about the Australian government's plans to continue with Medicare-funded telehealth after the pandemic, although our readers are hedging their bets on whether they think this will come to fruition.

We asked in our poll last week whether you expected to see MBS-funded telehealth continue after the pandemic. Lots of people doubt it, but a small majority is more positive, with 58 per cent saying yes and 42 per cent saying no. We are hearing that Health Minister Greg Hunt is keen, but the big sticking point for general practices in particular will be whether the items are required to be bulk-billed or not. If they are, we believe widespread provision of telehealth will prove financially unsustainable for general practices, and things will revert to business as usual.

In the acute care sector, meanwhile, a number of health services have ramped up their telehealth capabilities, and we very much hope that this becomes sustainable in the future. As we reported last week, hospitals such as the Royal Children's in Melbourne have been doing outpatients clinics for patients in rural and regional areas for some years and have now expanded that capability to patients in metropolitan areas. RCH is doing 70 per cent of outpatients clinics by telehealth and adult services like Metro North in Brisbane are hoping to do 30 per cent. New Zealand DHBs are hoping for the same.

Health services are also using remote monitoring technology as part of their telehealth expansion, using devices that can monitoring patients who are currently stable but may deteriorate quickly. Bendigo Health, which runs the successful Geri-Connect program providing gerontology services by telehealth to over 50 residential aged care facilities in regional Victoria, has since rolled out a cloud platform called teamplay myCare Companion Pandemic to monitor COVID-19 patients at home. Western Sydney is running an innovative service involving GPs as well as hospital-based clinicians to monitor COVID-19 patients at home.

Vendors are coming to the party too: this week we spoke to Baxter Healthcare, which is offering its remote peritoneal dialysis platform for free for six months, and Medtasker, which is allowing clinicians at Northern Health in Victoria and Whanganui DHB in New Zealand to use the communications and task management tool in the community.

Aged care services are doing it too, not just for COVID-19 patients but for the elderly in general, who are at the highest risk. In a welcome move, the Australian Department of Health has said home care providers can use any unspent Commonwealth Home Support Package funds for monitoring solutions and other home-based technology during the pandemic, to the tune of $1000.

Sydney's Royal Prince Alfred Hospital, one of the largest and busiest in the country, has also been monitoring COVID-19 patients at home, having cared for 446 positive patients so far, along with 156 COVID-negative patients who were in quarantine. This has seen the Sydney Local Health District rapidly scale its rpavirtual service, which started out as a proof-of-concept trial for palliative care and cystic fibrosis patients in February, when it had two full-time equivalent nurses on staff. It has over 30 now as well as a team of doctors, all of whom had to be trained for virtual workflows, eMR documentation and scheduling remote appointments.

This service is also using some nifty tech at the patient end, such as the TempTraq temperature sensors, which nurses at RPA's Care Centre can monitor in real time, as well as iHealth's pulse oximeters and the Pexip app for video. We had a chat to one of rpavirtual's health information managers about her experience of the service, and extremely interesting it was too.

Just as there is the potential for telehealth to become embedded in primary care if funded properly, it would be good to see remote monitoring become established as a routine part of acute care provision as well. The CSIRO has produced compelling figures in the past on the cost effectiveness of remote monitoring, so it is hoped that one of the good things to come out of the pandemic is a change of mindset about where care is delivered. The technology is there and is working, so it is now the policy levers that need to be pressed.

That brings us to our poll question for the week: Do you expect to see hospital services continue with remote monitoring after the pandemic?

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

For our poll last week we asked: Do you expect to see MBS-funded telehealth continue after the pandemic? 58 per cent said yes, 42 per cent said no.

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