Thinking of taking up telehealth?

This article first appeared in the July 2012 edition of Pulse+IT Magazine.

Technology to enable telehealth has been around for a long time but with the government’s incentive scheme now rolled out, new product solutions have flooded the market. If you are considering jumping into telehealth, there are a number of independent resources available to help you make the right choice.

Telehealth is not particularly complex technology – a computer, a web cam and an internet connection is pretty much all you need – but there are two things that separate it from everyday video conferencing. The first is a linked clinical software package, which while useful is not completely necessary, and the second is a national directory of specialists and GPs who are equipped to offer telehealth services and are willing to do so.

Some of the more successful telehealth vendors have built provider directories of their own, but as these vendors usually sell proprietary products that are not interoperable with competitors, GPs in particular are wary of committing to a product if the specialist they want to consult with uses something else.

An independent directory of general practices and specialists equipped for telehealth video consultations has recently been established by the Australian College of Rural and Remote Medicine (ACRRM). The college has been funded by the federal government to organise the directory, which is free to use by college members and non-members alike.

Jeff Ayton, the chair of the college’s national telehealth advisory committee, says the directory is making an important contribution to health equity for people living in rural and remote areas.

“ACRRM’s telehealth provider directory is the only freely available, non-commercial database of organisations and individuals who provide telehealth services,” Dr Ayton says. “The aim of the directory is to connect doctors who are using telehealth and learn more about the technology used and services offered by a wide range of medical specialist and referring professions, such as GPs, midwives, nurses and allied health workers.”

He says the directory supports key existing rural and remote referral pathways and also overcomes the biggest barrier to the uptake of telehealth: finding telehealth-ready doctors.

The directory is endorsed by ACRRM’s national advisory committee, which includes specialist colleges, medical associations, government bodies, and allied health organisations.

The ACRRM has also compiled a directory of technology products and vendors who provide video conferencing hardware and desktop and mobile software solutions. There is a huge number of vendors out there, so the directory allows users to search by solution type (desktop, mobile, browser-based), hardware, operating system compatibility and cost. It also allows users to search for products that are compatible with the different systems used by state and territory health departments.

The ACRRM also provides a free, personalised service to assist practices to set themselves up for telehealth services, and runs an online discussion forum for users, providers and independent experts.

It is also currently developing a standards framework in association with Professor Anthony Maeder, chair of Standards Australia’s telehealth committee, to provide a guide to understanding a range of issues relating to deployment and use of telehealth products and services.

Guidelines and standards

The Royal Australian College of General Practitioners (RACGP) also provides an advisory service for members thinking of taking up telehealth. It has developed a series of implementation guidelines for video consultations in general practice, and will soon employ three telehealth support office to provide practice support and tools for members interested in video consultations.

It is also developing an education program to offer online and face-to-face workshops on how to select and implement a telehealth solution, including information on MBS item numbers and patient scenarios.

The RACGP is currently revising its implementation guidelines for video consultations in general practice, which provides practical advice on software and hardware choices including more comprehensive information on the use of Skype and other online video conferencing options.

The revised implementation guidelines will be available in August, and clinical guidelines will be published early next year.

The Medical Board of Australia has also developed guidelines to technology-based patient consultations, aimed at informing registered medical practitioners and the community about the board’s expectations of doctors who participate in technology-based patient consultations.

Medicare Australia also provides some very useful advice on its website about the MBS item numbers, recommended hardware specifications, and links to specialist colleges and healthcare organisations that provide more specific advice.

David Allen, who runs the not-for-profit Telehealth Solutions Australia and is a member of both the Australasian Telehealth Society and Standards Australia’s telehealth committee, says the majority of GPs and specialists who are interested in starting in telehealth are approaching their colleges for assistance.

“There are hundreds of solutions that will basically do the job, so what people in reality are doing is speaking to colleagues or the medical colleges or healthcare organisations what to do,” he says. “That’s what I did – we set up Telehealth Solutions Australia to make it easier. What we were finding was that uptake was relatively poor and just to make it easier for them. We have opened up our servers for free, basically.”

Dr Allen says the Standards Australia committee is currently working on a telehealth standard for Australia which will reflect the existing draft international standard, aided by the ACRRM.

“The idea is to keep it as simple as possible,” he says. “I think that doctors are not going to read these documents. Practice managers are probably going to have to.”

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Posted in Australian eHealth

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