Telemedicine tech options and the challenges faced

Published on the 02/04/2020 | Written by Jonathan Cotton


Telehealth for medical professionals

We have the technology, but do we have the will – and funding – to bring telehealth into the mainstream?…

As the global health emergency of Covid-19 continues, the race is on to stop the spread of infection, prevent doctors from being inundated and find ways to deal with the sudden demands being placed on the medical sector.

Nothing short of a global crisis, the outbreak is likely to cause long lasting changes to society and the way we manage community health. Is there an opportunity to make this moment the turning point for telehealth technology?

The nation’s primary healthcare providers are already conducting a grand experiment in ad hoc virtual healthcare, says Scott Arrol, CEO New Zealand Health IT.

“The Covid-19 pandemic is an opportunity to demonstrate to health care officials that technology can facilitate sustainable healthcare.”

“The funding model to primary care has come under immediate pressure,” he says. “Doctors have effectively had their cash flow from walk-in patients cut off. If you’re a doctor and you’ve been relying on walk-in customers for your daily cash flow, that business model has come under immense strain.”

“But GPs have to continue working. They can’t just shut the doors and go home.”

While in New Zealand most District Health Boards have some telehealth capability, progress has been measured in baby steps until recent months. Now the Royal New Zealand College of General Practitioners has asked general practitioners to move toward 70 percent of their consults done virtually and to do that, doctors are opening the lines of communication with patients – by any means necessary.

“We’ve defined the problem as more people needing more care,” says Arrol. “Not enough people to deliver it. How do we bridge that gap? Technology. If we fully enable technology we can bridge that gap.”

“Most [GPs] haven’t been doing that because they haven’t needed to. Now we’ve gone from zero to 100 miles an hour, particularly in primary care, and that’s just the beginning.”

So what are the methods GPs are using to interact with infected patients and those in isolation?

“Virtual health care describes a number of ways of interacting with the health system,” says Arrol. “There’s no single standard platform, but there are a lot of tools.”

For most general practitioners, that will mean a greater reliance on phone calls, texting and email in the short term.

“To meet the immediate need, most GPs – broadly speaking – have gone to phone consultations. A lot of information happens by bulk texting, email and some are also offering videoconferencing.”

Beyond that, patient portals are experiencing increased traffic. Medtech’s ManageMyHealth patient portal is used by more than 600,000 patients in New Zealand and Australia, and includes the ability to book appointments online, secure messaging, viewing lab results, ordering repeat prescriptions and requesting email consultations, depending on the functionality that the doctor has enabled.

“Prior to the outbreak of Covid-19, the New Zealand and Australian virtual health sector was very small,” says Ian McCrae, CEO Orion Health.

“However it is clear that health systems need to prepare for a massively increased load, and that patients who can safely be managed at home are managed at home. There is an absolute need to get this technology deployed and operational. We are sure that its value will be enormous, and post-pandemic will remain an essential tool for the long term management of chronic care patients.”

Orion, a New Zealand-based healthcare software company with a global footprint has been working to quickly develop and deploy Covid-19 solutions here and overseas, including a comprehensive outbreak management suite (available with no licensing costs for the duration of the pandemic) that includes, among other things, a patient portal for two-way messaging, remote patient monitoring clinical workflow and case management.

“The Covid-19 pandemic is an opportunity to demonstrate to health care officials and decision-makers that technology can facilitate sustainable healthcare systems,” says McCrae.

“It can support the care of individual patients across the community, while also managing the needs and resources of the wider population. There is plenty more to come from machine learning-based predictive tools as healthcare providers leverage more data and experience from the disease.”

Governments are stepping up to the plate too. The Australian federal government has dedicated AU$1.1 billion to make Medicare telehealth services a reality in Australia, with AU$669 million of that specifically earmarked to provide doctors with incentives to make the switch.

“People will be able to get consultations from their homes via telephone or video conferencing for GP services, mental health treatment, chronic disease management, and a wide range of other services that do not require face-to-face contact,” says Michelle Grattan, Professorial Fellow, University of Canberra.

“The broad telehealth service limits the exposure of patients and health professionals to the coronavirus and will take pressure off hospitals and emergency departments, while supporting self-isolation and quarantine policies.”

The New Zealand government has pledged NZ$50m (of its $500m COVID-19 fund) to support GPs and community health providers using technology to conduct consultations online.

“The NZ Government’s response to Covid-19 has been swift and decisive,” says McCrae, “and there are new funding opportunities available for companies like Orion Health and also for our clients.

“The value of telehealth will be made self-evident by this pandemic and therefore ongoing funding should not be non-issue.”

“Some will enjoy video consultations, some won’t,” says Arrol matter-of-factly. “But there will be a number of us who have interacted with the health system in a virtual manner, exposing us to a new way of interacting with the health system and a number of us who will move to virtual as our first choice for healthcare. “

“Beyond that it’s only constrained by our imagination. Look at the banking sector – how many of us do our banking from a mobile now? You can still visit the branch if you want to, but we’ve moved from being walk-in customers as our first option, to the first option being online.

“For the majority of the public, we’re going to see virtual consultations becoming more and more peoples’ first choice.”

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