Heading into the holidays, health sector goes heavy on the hyperbole

Pulse+IT has been running our annual eHealth year in review series this week as we wind down for an extended holiday, but we did take a bit of time out to read up on Australian health minister Greg Hunt’s announcement that telehealth will apparently become a “permanent” feature of the MBS. In amongst a lot of hyperbolic announcements amounting to what seems like eleventy billion dollars in funding for the government’s COVID-19 response, we discovered that the “permanent” telehealth measure merely amounted to just over $100 million over four years.

It appears that the guts of this measure is that a patient can be phoned or consulted by video and the GP can claim for it if they have seen that patient in person in the previous 12 months, as is allowed now under the COVID-19 provisions. The only change is the permanent bit. However, the government’s plans for voluntary patient registration are destined to restrict this further in the future to only those patients registered with one practice. It’s not exactly the free for all the press releases promise but Mr Hunt managed to roll out RACGP president Karen Price for the announcement, which is apparently all that matters.

VPR-restricted phone calls may very well be good for continuity of care as Dr Price says but there is no way in hell it represents “permanent telehealth”. We were reminded of the government’s hyperbole on telehealth at the same time last year when we received a missive from the Medical Software Industry Association this week lauding the measure and repeating the worn-out slogan that the government had a “10-year plan for telehealth that was achieved in 10 days”. A “Herculean effort”, the MSIA says. It was nonsense then and it’s nonsense now.

There is no doubt that telehealth and remote monitoring models of care have been one of the big success stories of the year, driven in large part by the COVID-19 pandemic, but the government  removing its own long-standing limitations on models of care and claiming this as a victory for telehealth is beyond the pale. Telehealth and remote monitoring have been around for a long time, using existing technologies that are now finally being put to good use according to regional needs. But even for that slight advance, we thank them.

Putting together our top 20 stories of the year is always a fun exercise and this one was funner than most. Our top story for the year was Simon James’ article back in July detailing his incredible frustrations trying to book a vaccination through Healthdirect’s site, which then plunged him into the horrors awaiting with NSW Health’s broken systems.

But despite various ad-hoc attempts to provide up to date appointment availability, the roll out of ServiceNow’s new system and Healthdirect releasing an industry offer in September to get booking solutions all using a standard API, it still does not appear to be working.

Simon tried to book a booster vaccine just this week and hit on the same old problems, one of which we’ve highlighted in red in the above screenshot. Searching the vaccine clinic finder on the 16th of December for the next available appointment brings up a suggestion for a spot on the 18th – of November.

As he writes: “Almost two years after COVID-19 started to receive international attention, Australia still does not have a robust booking system for COVID vaccinations. While we have achieved high vaccinations rates in spite of these technology failures, the requirement for Australians to receive at least a third jab means Healthdirect’s botching of its Vaccine Clinic Finder can’t pass without mention.

“As late as this week, the system is still incapable of providing people looking to find a vaccination with a credible list of locations and appointment times. Searching for a third shot in eastern Sydney, the first clinic in the list of "earliest available” appointments displayed the next available appointment one month ago. The second clinic on the list said appointments were available on the day, but navigating into the clinic’s booking system only showed appointments in 2022.

“The third clinic on the list wouldn’t allow a third jab to be booked. The fourth clinic was a hospital operated by NSW Health, and due to changes to their booking system since my second jab in July, the password for the email address used at the time couldn’t be reset and the registration process needed to be restarted from scratch.

“After completing the multi-page form, the system then presented a list of hospitals from across the state, including options to book in on short notice at a nearby hospital. Turns out this option was not meant to be available to the general public but for hospital staff, so more stuffing around ensued.

“A full hour later and with the assistance of NSW Health’s telephone support operator, my third vaccination was booked. Bottom line is that if booking a vaccination takes more time than travelling to and getting a vaccination, something is clearly wrong with the approach.”

It really isn’t optimal, is it? It should not be so hard.

But lest we end the year on a sour note, our year in review throws up tale after tale of good news stories in digital health. Some of our favourites have been about the use of remote monitoring technologies integrated with new hospital virtual health programs. The next big thing is integrating these with primary and community care, which is still a work in progress. Perhaps “permanent” telehealth on the MBS is the start.

That brings us to our final poll for the year:

Are the MBS-funded GP telehealth plans a real game-changer?

Vote here or leave your comments below.

Last week, we asked: Has FHIR lived up to its promise of revolutionising interoperability? 40 per cent of respondents said yes, but 60 per cent said no. Here’s what you thought.

Pulse+IT is heading off for a month's break from December 18 but we'll be back on January 17. Have a very pleasant Christmas and New Year from Abbey, Claude, Cohen, Emily, Hamid, Kate and Simon.

Pulse+IT's top 5 for 2021

1. NSW Health’s vaccination booking system is broken

2. COVID-19 digital certificate can be added to Apple Wallet and Google Pay

3. Confusion reigns over national booking solution for vaccine roll-out

4. Telstra Health rebrands digital hospital platform as Kyra

5. Cerner taps Julie Hoare for APAC top spot

Click here to see the full hot top 20.

Comments  

0 # Kate McDonald 2022-01-21 11:43
Are the MBS-funded GP telehealth plans a real game-changer, or are they just a small step? Here’s what you thought.

Most thought they were just a small step: 64 per cent said no, they weren’t a game-changer. 36 per cent were more positive.

Here's what you thought:

- It’s a small step, there were also major cuts to rural specialist Telehealth funding so all in all, Telehealth funding hasn’t really advanced!

- They provide confidence for the first time ever that there is reimbursement for telehealth. Even the insane restrictions around it can't stop it from being a game-changer.

- It is the initial step to allow remote GP services

- One step forward another step sideways then a step backwards. It's called spin.

- A small step, as the number of consultations that would be covered per year is just not enough.

-Yes

- Small step with threat of PSR looming

-by telephone does not add enough value, they should have mandated by video

-The Dr-Patient Relation as was thought in past will suffer as Face to Face created a strong bond .Telehealth and Televideo will water this relationship especially in Rural Region area.Patient now does not see same doctor and relies on many sources to discuss the medical events.

- GP telehealth at the moment is really just GP phone calls. A game change would be a health system embraced virtual care and remote monitoring.

- NOT JUST GPs! Great especially for OTs (so much mucking around ordering equipment and following up it's supply when clients constantly change their mind) and other allied health as well

- Just a small step

- Telehealth has been around since the nineties. Observation is a key issue in diagnosis and treatment. It is a good tool for followup and certain medical conditions. I wouldn't say it's a game changer but more just another tool of delivery.

- Telephone consults are great.... but they are not telehealth..... and they should have been available 10 years ago...... current MBS funded telehealth is really only MBS funded phone calls... when there are funding incentives, then the GPs will move to offering video options, and not before

- Better than turning it off

- A small positive step to continue some level of service. Not a game changer until evidence based video calls mandated (except in emergency). Pay more for video than phone and that will change the game!

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