Australia’s telehealth myth busters, part 1

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The use of telehealth has boomed during the pandemic and so too have the misconceptions about this incredibly useful method of delivering healthcare!

With more than 30 years of telehealth experience between them, two of Australia’s top telehealth experts take on the role of myth buster: From The University of Queensland’s Centre for Online Health (COH), COH Director, Professor Anthony Smith; and COH Director of Telehealth Technology, Associate Professor, Liam Caffery.

Professor Anthony Smith

Assoc Prof Liam Caffery

Myth #1 – Telehealth replaces the need for all in-person consultations.

For some reason, when you mention telehealth, people quickly assume it is a complete replacement for in-person visits with their clinician.

Whereas those who are providing telehealth services understand that telehealth is an adjunctive to in-person consultations – not a complete replacement.

Whether a doctor sees a patient virtually or sees them in person, really depends on what the clinical requirements are. For example, a patient undergoing surgery will typically have an in-person pre-surgery consultation, a hospital visit for surgery, and several follow-up visits, which can usually be performed via video consultation.

The point is telehealth is another method of providing care in combination with in-person visits.

Elderly female patient with female nurse smiling

Myth #2 – Telehealth always results in cost savings.

From a patient’s perspective, telehealth almost always results in cost savings: it saves on transport, time off work travelling to appointments, and other expenses such as parking and accommodation.

From the perspective of a health service, telehealth can save money, but our research indicates that savings are realised in around 50 percent of cases. There is the additional cost of purchasing new technology, installing it, and integrating it with the practice system, as well as training for staff.  For a large service, this cost can be considerable.

One of the biggest telehealth costs is employing staff to help with patient-end services. Staff costs can effectively double when you are paying someone at both ends of a video consultation – for example, a clinician in the city, and another assisting patients.

What really needs to be understood is, telehealth enables clinicians to reach more patients. Telehealth is about equity and if we are serious about providing fair access to services – telehealth is one of the ways of achieving this – then yes, it comes at a price.

We have so many patients who do not have local access to health services or they opt not to travel to see a specialist; so, there are a lot of people missing out on the care they require. Telehealth is a way of making sure they have more choice.  We have a responsibility to provide people with good access to healthcare and the Australian Government will have an important role in determining how it continues to fund telehealth services through the Medicare Benefits Schedule.

Myth #3 – Telehealth is easy to implement.

What we have seen during our years in the industry is the providers who have made telehealth a successful and routine part of their practice, have all taken the time to redesigning their service.  Telehealth implementations needs a whole-of-system approach.

Introducing telehealth into a practice is a disruptive process. It represents a new way of working. You need to introduce new processes – such as the use of communication technologies, revise scheduling and billing workflows, and train staff so they can confidently deliver telehealth services.

Most clinical groups find the change process difficult; and unless the whole jigsaw puzzle (of telehealth requirements) is put together properly, telehealth is very difficult to do well.

Small GP practices are typically like cottage services: they might be lacking in IT support, and project and change management; so, they will find it more challenging to introduce telehealth.

Additionally, GP practices and specialist services need to establish processes which respect availability and timing of consultations.  This can be challenging.  Sometimes, even the idea of having to change the way a service is provided can be a daunting process for some clinicians, especially when certain models of care have been in place for some time.

Plus, we now have a new challenge ahead of us: COVID-19 has seen providers introduce telehealth out of necessity. So, how do we ensure that patients will continue to have access to telehealth services post-pandemic? We need to encourage people to develop the necessary processes to help with sustainability of telehealth.

Myth #4 – Training is not required for clinicians to practise telehealth.

Medical Training Books and Stethoscope

Everyone needs training in telehealth – even clinicians who have spent years practising in their field.

Clinicians need to learn how to effectively gather patient information during a telehealth consult; they also need technology training to optimise their system’s audio and video.

It also makes sense to provide our emerging workforce with the opportunity to learn about telehealth. At The University of Queensland, we have written a telehealth curriculum for medical, nursing, and allied health disciplines.

Each curriculum module includes topics such as choice of technology, medical-legal issues, change management, privacy, security, integrating peripheral medical devices, and integration with electronic medical records. We also present relevant case studies and examples of where telehealth works well, and where it does not.

Medicine, nursing, dentistry, pharmacy, psychology, dietetics, speech therapy, occupational therapy, physiotherapy, and exercise physiology are just some of the disciplines embracing our telehealth curriculum.

Continue reading myths 5-8 here.

 

About The University of Queensland’s Centre for Online Health:

For more than 20 years, the Centre for Online Health (COH) has explored how telehealth can address challenges in the healthcare industry.

The COH team develops, implements, and evaluates new telehealth-supported models of care, and gathers evidence to help better understand how to integrate telehealth into clinical practice and policy.

The COH research areas include COVID-19 and telehealth, telehealth service evaluation, tele-dermatology, tele-palliative care, rural and remote health, mobile health, Indigenous health, and mental health.

In Queensland, the COH also supports the Metro South Health telehealth service, based at the Princess Alexandra Hospital – one of largest providers of public health services in Brisbane.

Additionally, the COH provides consultancy, education, and training services for the Australian Government and the telehealth industry.

For more information on the Centre for Online Health, click here.

Continue reading myths 5-8 here.

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