Pulse+IT Blog

Back to the new normal

As the saying now goes, the coronavirus has brought the digital health sector 10 years of change in 10 days, but this week also brought us a reminder that some things haven't changed all that much. We refer to a return to the old normal, in which state health departments regularly struggle to procure and implement clinical IT systems large and small, as the repeated tendering for a statewide chemotherapy prescribing system in South Australia has shown us. It did it again this week.

Significant under-investment in IT systems and holding on to legacy platforms for far too long is also a constant refrain. This week, the New Zealand Ministry of Health released a current-state assessment of NZ's health assets, including buildings, infrastructure and IT, and it's not a pretty sight. The ministry is estimating that the DHBs will need $2.3 billion over the next 10 years to fix some of their legacy problems and reap the benefits of digital health systems, although even that seems a bit unambitious.

Signed, sealed, delivered

It was a big week in primary care this week as electronic prescribing ratcheted up, secure messaging got a boost and a private equity firm played a blinder and snapped up a practice management software vendor from under everyone's noses. It ended with an emerging scandal in international health research, as The Lancet was forced to retract an article amid what appears to be a fabricated data set used in a now infamous hydroxychloroquine study for COVID-19.

The week got off to an interesting start with pharmacy software vendor Minfos announcing it was working with fellow EBOS Group company TerryWhite Chemmart to pilot electronic prescription capabilities in the regional NSW town of Armidale. NSW and Victoria are among several jurisdictions that have passed regulations allowing eScripts to be issued and dispensed, and later in the week PMS vendor Zedmed got together with Chemist Warehouse, Simple Retail's Aquarius dispensing system and the prescription exchanges eRx and MediSecure to test out their eScript capabilities in two Melbourne general practices and two pharmacies.

Ease on restrictions as data analysis ramps up

The NZ Ministry of Health had the pleasure to announce today that for the seventh day in a row, no new cases of COVID-19 had been detected in the country. There is no one in New Zealand receiving hospital-level care for COVID-19 and there is just one case still active. So successful has lockdown been for New Zealand in curtailing COVID (and romantic activity) that some are keen to try to stamp out other infections too.

The news comes as restrictions on people's activities are further eased in New Zealand and Australia, with Western Australia announcing today that it would implement a two square metre per person capacity rule for venues, replacing the previous four square metre rule in force elsewhere. It is to the absolute credit of healthcare authorities, healthcare workers and the governments of both countries that we have managed this pandemic so well.

Hunt for the Man from SNOMED River

Australia's Health Minister Greg Hunt had a nice little announcement yesterday, revealing that since March 13, there have been 10.4 million services delivered to 5.71 million patients by telehealth, with $536.5 million benefits paid, and close to 70,000 healthcare providers have used telehealth services.

It's a pretty enormous number and comes as Greg himself is being lobbied pretty hard to continue with MBS-funded telehealth in the future. GPs in particular seem to like it although they are champing at the bit over the requirement that COVID-19 patients and vulnerable groups be bulk billed. The move is on now to keep some form of publicly subsidised telehealth, with the AMA yesterday issuing a strong call for it to be retained.

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.

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.

Pandemic forces change of pace

It has become a cliché in hurry in these unprecedented times but the speed with which the health IT sector has had to adapt to the global pandemic has been stunning to watch. Healthcare usually changes at a snail's pace, for good reason, and health IT is no different. We asked in our poll last week if you thought the health IT industry has successfully risen to the challenge of COVID-19. Not surprisingly, the sector was positive about itself: 79 per cent said yes, 21 per cent said no.

And just as the dealing with a crisis playbook has been thrown out the window, so has years of recalcitrance on the part of the healthcare system and its policy designers in taking up new and not so new technologies. It took a global pandemic to finally get telehealth on the front foot and everyone is doing it now. It has been quite stunning to see how fast the local industry has been in developing solutions for users, with a plethora of video conferencing solutions now available.

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