1. Patient no shows, late cancellations and failed consults Unlike a traditional practice, it is difficult to overbook an online session. No shows, cancellations and consults disrupted by technical issues are not easily filled at short notice, which can result in lost consultation time and/or significantly lower hourly billing. Developing a model to address these issues whilst ensuring lost hours are utilised productively, particularly as you increase in scale, is critical. 2. Billing Creating a solution to bill patients is administratively challenging, as your patient isn’t physically in your rooms during a consultation and may never actually visit your practice. For most providers, introducing a patient co-pay system for telehealth will become a necessity, but this will inevitably further complicate the process and increase the amount of administrative support required. 3. Scheduling and end-point challenges Scheduling patient consult length to match their clinical requirements will affect your ability to maximise consulting time. Having patients conduct video consultations from their GP’s rooms can increase the scope of practice and allow for more reliable end-points. However, this often creates scheduling challenges and increases the percentage of booked consultations that do not eventuate. As patient consultations move into the home, it is likely that technical and clinical challenges will increase. 4. Doctors’ charges A doctor’s time online costs the same as it does face to face. Inefficiency through scheduling gaps can quickly make online consultations more expensive than providing face to face care. 5. Funding streams Existing MBS telehealth funding has limitations, both in terms of item numbers that can be used for online consultations
“Regardless of your view on bulk-billing versus private billing, or for-profit versus not-for-profit, no one can deliver loss‑making services sustainably.” Sam Holt
and the fact that it doesn’t support asynchronous/store and forward and other telehealth modalities that can deliver good clinical outcomes with more efficiency in some circumstances.
the reality is that most providers can utilise free software-based solutions to meet their needs.
6. Practice management support Ensuring that clinicians spend their time consulting and not chasing referrals, reports, scans or conducting technical support requires practice management support. Most doctors prefer to consult rather than perform administrative tasks, so the costs of practice management support should not be overlooked when creating your telehealth model. This becomes increasingly apparent with scale.
Once you start delivering telehealth at scale, it becomes necessary to invest in billing platforms, online booking tools, scheduling tools and other elements to make your online practice secure, scalable and a great customer experience. By factoring the true costs of telehealth you will be able to create a telehealth model that will meet the needs of your practice and your patients. If you can solve the business challenges of delivering telehealth, choosing the right video platform, devices and peripherals (such as web cameras) will become relatively simple in comparison.
7. Opportunity costs For some providers, telehealth can pose a significant opportunity cost. Whether you count costs in terms of possible lost consulting time (patient no shows), potentially lower billable hours or the space required to host a patient’s specialist consultation, there is inevitably an opportunity cost to consider. 8. IT infrastructure Hardware vendors did a great job convincing governments and early adopters to part with significant funds for shiny screens and hardware. Many of these systems are sitting idle across the country as funds were directed at infrastructure rather than ensuring an appropriate supply of specialists to conduct consultations. It’s easy to spend big on IT infrastructure, but
The true costs of telehealth
The future of telehealth is bright, exciting and delivers new opportunities outside of video conferencing. As current government incentives taper off or are refocused, new models of care will start to develop, particularly asynchronous/store and forward services, that are often cheaper, faster and more efficient. Factors such as whether WebRTC is better than Vidyo, Skype, VSee or any other video platform is largely irrelevant in the debate about the future of telehealth in Australia. What will decide telehealth’s fate and role in years to come will be well-thought out funding models and our industry’s ability to devise sustainable and scalable business models.
PULSEITMAGAZINE.COM.AU
015