BOOSTING THE UPTAKE OF TELEHEALTH The volume of telehealth services delivered has not met expectations, and just installing technology does not raise uptake on its own. Telehealth can be boosted by developing new models of care, building clinician acceptance, and expanding to include chronic disease management in the home.
DR VICTORIA WADE BSc, DipAppPsych, MPsych, BMBS, FRACGP Vice president, Australasian Telehealth Society email@example.com
For over 20 years, enthusiastic individuals have predicted that telehealth is on the verge of becoming a major new way to deliver healthcare, but the actual uptake around the world has been slow and fallen far short of these predictions. Many telehealth services are still in trial phase with no guarantee of sustainable operations. Roald Merrell, the editor-in-chief of the Telemedicine and e-Health journal, said that failure to adopt has dominated much of our scientific consideration of telemedicine in the last 20 years, and went on to ask why, when doctors have taken up use of the internet and mobile phones with alacrity, telehealth seems to be different.
The situation in Australia
About the author Dr Victoria Wade is a research fellow in the Discipline of General Practice at the University of Adelaide, and the clinical director of the Adelaide UniCare e-Health & Telehealth Unit.
view, some who have broadly advertised their availability to conduct video consultations have found that the time they have set aside for telehealth has not been fully booked. In the state health sector, governments are investing in video communication infrastructure, and clinical use is increasing, but typically these networks are doing around a few thousand consultations a year. This remains very low compared with the total volume of patient contacts. I think there are three ways to tackle this issue: look at the models of healthcare that work for telehealth, build clinician acceptance, and expand the funding to more delivery options.
Let’s consider the actual situation in Australia. In private medical practice, we’ve had Medicare item numbers for video consultations to rural areas and aged care facilities for 2½ years now, and about 87,000 telehealth consultations have been done. The numbers have gradually increased to over 5000 a month and about half of these are dual consultations, with both the GP and the medical specialist being with the patient at the same time.
Models of care that work for telehealth
Yet to put this in perspective, this is less than one video consultation a month per rural GP. From the specialists’ point of
This is the most common situation in private practice at present. This type of telehealth service is hard to grow and is
I studied over 30 telehealth services in Australia, and found that they basically fell into two types. The first is where clinicians fit a low level of telehealth activity into their usual practice; for example by conducting a handful of video consultations a month over infrastructure that is low cost or already paid for.
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