Telehealth has more than just video and phone consultation

The COVID-19 pandemic has revolutionized the way Australians access healthcare. We are now using telemedicine more than ever.

Last week’s federal budget confirmed a six-month extension of Medicare subsidies for telemedicine consultations worth A $ 2.4 billion. It also includes A $ 18.6 million for the preparation of permanent telemedicine infrastructure from March 31st next year.

This is some way to recognize that telemedicine is not only an important tool for pandemics, but also highly needed in healthcare systems.

To fully realize the potential of telemedicine, we need to realize that it is more than just a reservation by phone or video conferencing.

COVID-19: Game Changer for Telemedicine in Australia

In March, telemedicine services were funded by all Australians under the Medicare Benefits Schedule (MBS).

The package included telephone and video consultations with GPs, specialists, nurse practitioners, and related medical professionals (physiotherapists, social workers, psychologists, etc.). This complemented the existing MBS funding for medical video counseling for rural people.

There was a rapid spread that more than 35% of MBS-funded consultations were conducted via telemedicine in April 2020.

Telemedicine is more than just a phone call or video conferencing

There are three main forms of telemedicine: “real time,” “store and forward,” and “remote patient monitoring.”

real time This is primarily what we are currently doing — clinical consultation by phone or video conferencing.

During the pandemic, medical professionals have strongly favored the phone over video counseling. Over 91% of MBS-funded telemedicine services are provided by telephone.

While phone calls can be effective in some situations (for example, medical history, triage, referrals, etc.), video consultation greatly increases the chances of a clinician making an accurate diagnosis.

Evidence shows that video counseling can be as effective as direct counseling if telemedicine is appropriate, regardless of the type of clinician.

Store and forward The process of collecting clinical information and sending it online.

A common example is when a patient or his GP takes a skin lesion and sends the image to a dermatologist for feedback and management advice.

The store-and-forward service is located in a small silo in Australia. They do not currently fund MBS, so they often rely on hospital or commercial funding for assistance.

Store-and-forward services are offered worldwide under a variety of conditions. Evidence shows that they make the service more accessible and cost-effective, and clinicians are generally happy with them.

Remote patient monitoring, Also called home monitoring or remote monitoring, it collects disease-specific health information and monitors how it changes over time.

You can monitor conditions such as high blood pressure and diabetes (often asymptomatic) using standard blood pressure monitors and blood glucose monitoring devices that interact with the app and the Internet.

If a patient’s reading exceeds a healthy limit, an alert can be sent to both the patient and the primary care team.

Regular feedback combined with education and support allows people to better manage their condition.

Remote monitoring has been used internationally to manage chronic diseases with good results. A recent review found that 77% of studies gave positive results, indicating that more people were hospitalized and discharged longer.

Telephone and video conferencing only scratch the surface of telemedicine.
The University of Queensland Online Health Center ( template).

While Australia has many trials and small clinician-led programs, lack of infrastructure and funding has hampered the widespread deployment of remote monitoring programs in the community.

Fortunately, the federal budget has promised funding to begin work on the infrastructure to monitor embedded devices. This is expected to lead to interactive remote monitoring of heart disease patients.

Choosing the right type

The choice of real-time store-and-forward or remote patient monitoring must take into account patient needs and specific conditions. You also need to consider the cost of services for patients, healthcare providers, and healthcare systems.

These lesser-used types of telemedicine increase opportunities for interdisciplinary care and allow specific monitoring tasks to be redirected to nursing and related health care professionals as needed.

For example, a nurse or pharmacist can review blood pressure measurements and provide feedback to the patient (and, if desired, refer the GP or specialist’s opinion to the patient).

Telemedicine service compensation must be commensurate with the time, effort, and skills required to provide a consultation. Encouraging video counseling (for example, by subsidizing them at a higher rate than telephone counseling) may be one way to encourage clinicians to use them.

Think broader

Healthcare systems around the world are fighting not only pandemics but also tsunamis of chronic diseases. Therefore, changes in the way we provide healthcare are inevitable.

In Australia, symptoms such as heart disease, stroke and diabetes lead to a high rate of health problems and death.

We need a strategy to inform patients about their health care and involve them. We also need funding to support service and health outcomes, not purely “service charges” encounters.

Store-and-forward and remote patient monitoring has great potential to enhance long-term management of chronic illness and facilitate access to specialized healthcare services through better connected healthcare systems.

We have made the necessary changes to provide access to medical care during a pandemic. Now is the time to take advantage of this change to achieve true reform.

The important thing is to think about how you can make changes to your healthcare system to take advantage of all forms of telemedicine.conversation

This article has been republished by The Conversation under a Creative Commons license. Please read the original article.

Telehealth has more than just video and phone consultation

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