Telehealth in pharmacies through the cloud

eHealth solutions firm REND Tech Associates has formed a partnership with telehealth company TeleMedicine Australia (TMA) to enable telehealth consultations to be carried out in community pharmacies with secure access to clinical software in the cloud.

TMA offers a suite of telehealth services, including a bank of GPs, specialists, nurses and allied health professionals who provide remote video consultations. It also markets a range of telemedicine devices, including the HiCare device, which allows patients and healthcare professionals to conduct a video conference through the device from anywhere in the world.

HiCare also allows measurements from wireless-enabled medical devices such as glucometers, blood pressure cuffs, oximeters, thermometers, tests for cholesterol and HbA1c levels, ECGs and spirometers to be recorded and graphed over time.

REND Tech last year launched its Cloud for Health service, aimed at allied health professionals as well as solo and mobile GPs or those working from home to use clinical software packages like Best Practice through the cloud.

The two companies have come together to provide a new service called Pharmacy-Link, in which a HiCare device can be installed in a community pharmacy through which patients can both speak to a general practitioner and have their measurements taken by the peripheral devices.

“The idea behind Pharmacy-Link is to bring 24/7 GP, specialist and allied health telehealth services to pharmacies around Australia,” TMA managing director, Ash Collins, said.

“This solution also allows pharmacies to screen for a number of chronic diseases such as diabetes, hypertension, dyslipidemia, atrial fibrillation and asthma. Some of the services, such as specialist medical consultations, are bulk-billed."

While the doctor is conducting the consultation, they can log in to the patient's medical record, check their history and pathology results and, if necessary, write a prescription and send it to the pharmacist. REND Tech's cloud service allows the script to be printed out at the pharmacy while the patient is there.

REND Tech technical consultant Rob Khamas said TMA originally planned to allow its GPs to conduct the video consultations from its offices, using the HiCare device and another screen to bring up the patient's record.

“The HiCare device allows you to do the video conference and to do all of these tests, but the GP also wants the opportunity to see the patient file,” Mr Khamas said. “That's where we've come in.

“We host Best Practice in the cloud, and the doctor just has to log in and they can see the patient's full medical history while they are doing the consultation.

“The patients are remote so why shouldn't your doctors be remote as well, so you are not limited to only offering this service from a particular location. You can bring more doctors on board including those who want to work from home or those who travel.”

Dr Collins said while the HiCare device does have a medical record function, the REND Tech solution is helping TMA's GPs to provide more comprehensive care by sending requests for x-rays, scans and blood tests, as well as receiving those results electronically, regardless of which radiology or pathology centre the patient has attended. It also facilitates the transfer of prescriptions, he said.

”An unfortunate thing is that currently the best technology is available to deliver healthcare to all Australians regardless of where they live, but a lack of quite a number of Medicare items for telehealth has slowed down the service delivery,” he said.

”Currently there are no Medicare items for GPs, nurses and allied health professionals to claim for telehealth services, an area which the Australian government should really look at.”

The idea is for pharmacists to install one of the devices and offer it as an extra service to customers, particularly in rural and remote areas. Community pharmacies can also use the device and the peripherals for screening and risk assessments and disease state management for diabetes and cardiovascular and respiratory diseases, services for which pharmacists are eligible for Primary Health Care incentive payments.

Pharmacy customers can have their measurements taken in-store, and for a $20 fee have the results analysed by an online doctor in real time via the HiCare device. The patient registers to use the service through the device.

“A patient can go into a pharmacy, they sit down in front of the HiCare device and switch it on, they put their ID number in and it makes a connection with a doctor, depending on which doctors are online,” Mr Khamas said.

“The doctor, wherever they may be, can then do the consultation and log in securely to Cloud for Health, they load the relevant clinical software, they can see the pathology results, they can see the patient's history, they can chat to the patient and get their results from HiCare, and depending on how everything goes, if the doctor wants to write a prescription, Cloud for Health allows the script to be printed at the pharmacy.”

Through Cloud for Health, pharmacists can also log in to Best Practice and enter data on medications, he said. “Rural or remote pharmacists can now collaborate with remote GPs and they can look after their frequent users. It will also open up the door to allied health professionals and after-hours services who can now have a unified clinical database that they can access it securely and comfortably.”

Dr Collins said Pharmacy-Link would allow pharmacies to provide after-hours GP services, which could take the pressure off the local emergency departments.

Mr Khamas said the service would be perfect for solo GPs who struggle to compete with corporate practices and who would like to be able to set aside time every day to do telehealth consultations.

“It's the same for aged care centres,” he said. “You have this HiCare device in the aged care centre and you can connect to a GP when you need to.”

REND Tech is also focusing on allied health with its Cloud for Health service. One client is Sydney's Feet First Podiatry, which is able to access the practice management software it uses, Front Desk, through the cloud.

Like many allied health groups, Feet First has a number of locations, so by hosting the software in the cloud, the patient can attend any outlet and the clinicians can access their file.

“All of their podiatrists, whether they work in any location or are visiting an aged care centre, they can see the clinical data in the cloud,” Mr Khamas said. “They just log in to Cloud for Health and access all of their clinical data, and the patient can go to any of those locations and their data will be there. It is easier for the business but also a lot more profitable, because the patient can go to any location and they don't have to commit to one.”

Posted in Allied Health

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