Telehealth and its various policy and political ramifications was back in the news this week, with the Royal Australian College of General Practitioners (RACGP) again changing its policy position on MBS funding of primary care telehealth, despite previous lobbying efforts to the contrary.
We’ve been critical of the changing position of the college on Medicare-funded telehealth and its fellow travellers at the AMA in the past, but this week we saw a triple backflip with pike as Omicron swept through the land. We have witnessed the medical fraternity going from dead set against telehealth in primary care to agreeing it is essential in a pandemic, but all of this is conditional it seems on doctors’ income not being affected.
There was welcome news in the primary care sector this week with a new trial being launched in Victoria to use secure messaging technology to inform GPs if patients at medium risk of hospitalisation for COVID-19 have tested positive. The trial is using existing secure messaging technology and vendor directories for patients receiving in-home monitoring from programs like hospital in the home or HARP, and also taps into the Victorian COVID Positive pathways program.
Hopefully, the trial will go some way to solving problems for GPs in actually knowing which of their patients are positive and may need extra support. It doesn’t really solve a problem that former AMA president Mukesh Haikerwal has raised about immediately alerting GPs to ensure at-risk patients receive treatment straight away, but it’s a start at least.
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.