Remotely monitoring the Omicron wave

Just as telehealth dominated the last two years of digital health, remote monitoring is likely to dominate the next: that’s pretty much our prediction for the coming year or two under these strange days indeed. Everyone is getting in on the remote monitoring act and it makes sense, clinically, practically and financially.

We reckon the alleged revolution in telehealth in Australia has turned out to be overhyped in a practical sense. While the acute care sector has struggled valiantly over the years to develop funded telehealth models of care using video conferencing, the modality has not been taken up in primary care in the slightest, predominantly due to funding concerns. But when funding does comes through – such as, say, temporary MBS items during a pandemic – phone calls are not really what telehealth is all about. GPs claiming for monitoring known patients by phone should be a given under a properly funded primary care system. Unfortunately, we are stuck with fee for service so even the most minor funding shift is heralded as revolutionary.

For telehealth to work in primary care, the government needs to come to the party and fund both GP and nurse-led telehealth clinics, including the use of remote monitoring technologies. While we suspect GPs will kick up a stink if there is a separate payment for nurses acting somewhat independently, remote clinics and remote health monitoring of chronic conditions is the future. But that will take a revolution in Medicare and so will probably not eventuate.

What will actually prove more useful in the long term – if not as lucrative for GPs – is the automation of remote patient monitoring. Every health service in Australia and New Zealand is now investing in these models, rolling out pretty basic tech for mild to moderate COVID patients rather than the more intensive technology that has so far been deployed for hospital in the home. This sort of model of care has been extensively studied in the past and has proven health and financial benefits, but before COVID, it has largely been ignored.

After COVID, or heaven forbid living with COVID and other pandemics, we fear that the thinking will return to the way it was instead of a situation in which the majority of patients can be monitored very safely at home through some pretty cheap tech and a dedicated nursing workforce. But no: all the talk is of GPs and how they need to be paid as much as hospital doctors.

That being said, health services continue to roll out home monitoring models. Last week it was the WA government through the Medibank/Calvary JV, which is providing similar services in NSW, Victoria and Queensland. Those projects use CareMonitor’s app to cheaply and easily monitor mild symptoms at home. We hear the same technology is going to be used by WA rather than Telstra Health’s virtual care suite, which the Medibank/Calvary JV is using for South Australia’s more intensive HitH service.

Telstra Health is also using its virtual tech for new programs in the same state through a partnership with Southern Adelaide LHN – more on that next week – and New Zealand is also girding its loins for the coming Omicron outbreak, with aged care provider Third Age Health setting up a new collaboration platform using Celo. NZ has successfully surfed each wave through its managed isolation and quarantine (MIQ) systems and the acute care sector – Sysmex NZ and Valentia Technologies in particular have done sterling work there – but it is now bracing itself for a widespread outbreak of Omicron, so is finally turning its head to primary and aged care.

Tech companies themselves are also seizing on this new paradigm. Last week it was Healthengine buying Healthsite, and this week it was Coviu partnering with Propell Health and 1st Group merging with Visionflex. Expect to see a lot more of this happening.

Meanwhile, public health services are getting going in using either cheap or existing technologies. We hear that Healthdirect is running a trial in Melbourne to inform GPs by secure messaging if their patients are COVID positive. This appears to be a way to keep GPs in the loop rather than asking them to action anything in particular, but it seems to be a good move. We’ve asked for a bit more info on this trial, along with what exactly Healthdirect will be rolling out for the Australian Department of Health as part of its new triage and assessment service. We’ll hopefully bring you up to speed next week.

Meanwhile, we here at Pulse+IT are gearing up for AIDH’s Digital Health Institute Summit in Melbourne next month. It will be a cut-down and masked-up version to be sure, but everyone is so keen to see each other in person that it will be welcomed with appropriately distanced open arms. Unfortunately, Health Informatics New Zealand has had to change its plans and will only be hosting its workshops in person this year. The rest will be online.

Let’s hope that later in the year, with the help of technology, we have all ridden the wave successfully and can get together in person.

That brings us to our poll question for the week:

Will remote monitoring technology finally become embedded in routine healthcare?

Vote here or leave your comments below.

Last week we asked: will digital health be important in the COVID-19 response in 2022? Absolutely, our readers said: 94 per cent said yes, just four per cent said no.

We also asked why you thought so and what trends you think will come to the fore. Here’s what you thought.

Comments  

+1 # SA Health staffer 2022-01-31 10:29
The biggest challenge of remote monitoring is resourcing and recipient capability...un til we have more intelligent systems that enable management by exception and alerting this will continue to be a peripheral activity,,,many of the recipients that will fall into this category are from lower socio-economic areas who tend to have higher incidences of complex co-morbidities and present late
0 # Kate McDonald 2022-02-04 15:52
Will remote monitoring technology finally become embedded in routine healthcare? Most said yes: 85 per cent to 15 per cent.

We also asked for your views on what will be the main driver of this: money, or efficiency. Here’s what you said.

- Consumer choice - they will begin to ask or demand it as an option.
- funding and staffing challenges
- Efficiency
- Efficiency
- Efficiency & patient’s will demand this care
- Efficient
- Money
- Patient Centred systems and apps
- Money
- Save on beds
- Reduce travel and increase efficiency.
- both
- (I answered No) It might become a niche practice but it will be far from widespread. It needs far too much detailed attention to make it work properly. It will not be cost effective.
- Money
- Money
- Reliability, costs, complexity particularly with increase in home care.
- Money, sadly. I wanted to write efficiency but have been around medical politics for too long!
- Efficient use of staff will ultimately save money too. Staff can do monitoring from home.
- Patient outcomes
- COVID stretching our capacity, driving need for greater efficiency due to lack of resources.
- Money followed by efficiency
- Lack of GPs in rural and remote areas
- efficiency and push from patients
- Either and both, but common sense should also prevail.
- Continuity of care, reduced hospitalisation
- efficiency
- Efficiency
- Clinical outcomes
- Efficiency and improved patient outcomes hopefully by a more engaged consumer
- Efficiency of service delivery (thereby saving money)
- Money if provided. But efficiency if people have a chance to do the calculations
- patient safety, patient experience (costs, time, convenience)
- Patient/consume r demand and the ability for clinicians to deliver more efficient care.
- Efficiency

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