eHealth and allied health: the midwives' tale

Allied health is often the forgotten sector in the eHealth industry, so as part of Pulse+IT's new allied health eNewsletter service we are taking a snapshot of the different disciplines, looking at their use of health IT and explaining their role in the eHealth system.

Sarah Stewart, professional development officer for the Australian College of Midwives, explains how midwives use eHealth tools:

Pulse+IT: Is it common for private midwives to use any software products for their case notes and files?

Sarah Stewart: It is my impression that on the whole, private midwives are still using paper case notes and files, and that only a few are using electronic systems. However, there is an awareness that software programs have advantages in terms of moving information around and interacting with external systems, and there are efforts to explore this further. The main challenge is to ensure consistency across the board, not just amongst midwives themselves, but also with how they connect with external systems such as hospital management systems.

Pulse+IT: Is there any widespread interoperability with general practice or acute care clinical management systems?

SS: There isn’t at the moment. One barrier is the concerns about security that hospitals have about connecting external providers into their systems.

Pulse+IT: Do you know of many midwives, either public or private, who are involved in telehealth?

SS: On the whole, there are few midwives involved with telehealth, public midwives even less than private midwives. Having said that, midwives in remote areas are probably the biggest users for obvious reasons. It is my understanding that there is an increase in the use of Skype in these areas. There are also isolated examples of private midwives using Skype in more urban areas. Barriers to telehealth amongst private midwives include a lack of collaborative arrangements – midwives who have collaborative arrangements, or existing relationships with doctors and hospitals are more likely to use telehealth.

Pulse+IT: Do they receive any special compensation for attending a telehealth consultation such as the Medicare rebate available to GPs and specialists?

SS: Medicare provides the opportunity to apply for rebate for eligible midwives. I don’t know of many, if any, midwives who are making use of it, but that might be because they don’t know it exists. The ACM plans to run a campaign to raise awareness around this rebate. A further barrier is that the rebate only applies to a consult with a specialist whereas a midwife would consult with a GP as well.

Pulse+IT: Do you think telehealth is useful mainly for women in remote areas, or is there any value in using it in urban areas where the midwife is involved in shared care with a GP or specialist?

SS: Telehealth is appropriate wherever there is a need, whatever the location. It can take just as long to cross the city to see a midwife as it does in the country. And don’t forget, telehealth isn’t just about the midwife-doctor interaction –.it is also about midwife-woman. If I live an hour across the city and I want some advice about my baby who has spots, think how convenient it would be to call up my midwife with Skype and have a chat, and show her the spots. It gives me peace of mind, and allows the midwife an opportunity to decide if I need a visit or not – this decision can be a lot more difficult to make by phone.

Pulse+IT: Have midwives been involved in any consultation about their potential role in the PCEHR system? For example, will midwives be allowed to upload clinical documents to a woman's PCEHR, if she has one?

SS: Midwives were initially consulted but have since been excluded from initiating a health summary, despite the fact that nurses, doctors and Aboriginal health workers have been given the ability. Needless to say, midwives do need to be included for the PCEHR to be fully useful.

Pulse+IT: What is the official view of the ACM on the usefulness of the PCEHR for maternity care?

SS: The ACM does believe the PCEHR could be useful but its structure does need to reflect the national hand-held antenatal records that are being developed by the Maternity Services Inter-jurisdictional Committee.

Posted in Allied Health

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