Telehealth has traditionally been used as a mechanism to improve access to healthcare services in rural and remote areas where such services are difficult to access in person.
It can reduce the distance that people need to travel for healthcare services and expand the reach of specialist and allied health services, which are less accessible in rural and remote areas.
Telehealth can benefit people living in major cities too, saving the time it takes to travel for an appointment and avoiding time out of paid employment. These productivity benefits have rarely been realised, however, as government-subsided telehealth services pre-COVID-19 were restricted to people living in regional and remote areas.
But in the wake of the global COVID-19 pandemic and the social distancing and containment measures designed to curb the spread of the virus, the Australian Government has temporarily laxed restrictions on access to telehealth services funded under the Medicare Benefits Scheme.1
This ensures that all Australians, regardless of where they live, can see their GP or other medical practitioners in the comfort of their own home via videoconference or phone.
This avoids unnecessary travel or contact with the community associated with essential medial services. This has led to a rapid uptake in telehealth services, with close to 6 million telehealth consultations conducted in Australia in April and May 2020.2
With these telehealth arrangements due to end on 30 September 2020, questions are being raised around whether this level of uptake could be sustained in a post-pandemic era.
Indeed, telehealth has historically been underutilitsed in Australia by international standards. In 2018-19, prior to COVID-19, Australia averaged 8.8 telehealth consultations per 1,000 people,2 which is well below global leaders, such as Ontario, Canada, who averaged 72.2 consulations per 1,000 people over the same period.3
The recent trends show that Australians clearly are open to using telehealth and COVID-19 presents an opportunity to shift the way we deliver healthcare services in the 21st century.
Access to timely healthcare will likely become increasingly important as we recover from the significant social and economic impacts of the COVID-19 health crisis. Indeed, mental health experts are predicting a ‘second wave’ of the pandemic,4 with poor mental health outcomes likely to emerge as a result of ongoing financial hardship and stress.
With government budgets under growing strain too, telehealth could be more finanically sustainable for the healthcare system too. Some studies have that telehealth can reduce the rate of healthcare expenditure under the Medicare Benefits Scheme by around 46%,5 and the travel and accommodation costs associated with healthcare consultations for rual and remote populations.6
As Australia beings to ease its COVID-19 restrictions, there are opportunities to create a new norm for telehealth, ensuring that all Australians can access quality healthcare services in a timely manner.
Cloud-based video conferencing platforms, like Coviu – a teleheath spinout of CSIRO’s Data61 – could form part of this future vision for healthcare. Coviu reflects a digital copy of traditional medical clinics, providing a secure, easy-to-use system for clinicans to connect with their patients.
CSIRO’s Australian e-Health Research Centre (AEHRC) has also been running a randomised control trial of CSIRO sensor smart home technology to support older people living at home.
With COVID-19 placing restrictions on home visits, in particular with older people, AEHRC and service providers are exploring how this technology could support remote monitoring and management in crises, such as pandemics and natural disasters.
AEHRC, in collaboration with Metro South Hospital and Health Service and the Mater Women’s Hospital, is launching an 12-month implementation trial of mobile health for women diagnosed with gestational diabetes.
The digital platform, M♡THer, was designed and developed to help women better manage and track their condition at home, and help their clinical team monitor key health indicators remotely for early intervention if needed.
CSIRO’s Data61 has also partnered with AEHRC and Queensland Health to explore the future of Queensland’s healthcare system out to 2040, taking into account current and emerging changes.
Using strategic foresight to explore long-term futures, the sector can better position itself to leverage emerging opportunities, including those provided by technology, whilst mitigating potential risks.
References
1 Department of Health. COVID-19: Whole of population telehealth for patients, general practice, primary care and other medical services (cited 2 April 2020). Available from: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/covid-19-whole-of-population-telehealth-for-patients-general-practice-primary-care-and-other-medical-services.
2 Services Australia (2020) Medicare item reports Canberra, Australia: Australian Government.
3 Ontario Telemedicine Network (2019) Connecting people and care: Annual report 2018-19. Toronto, Canada: Ontario Telemedicine Network.
4 Willis O (2020). Mental health toll of coronavirus to create 'second wave' of pandemic, experts warn. 30 April 2020, ABC News.
5 Celler B, Varnfield M, Jayasena R (2018) What Have We Learned from the CSIRO National NBN Telehealth Trial? Studies in health technology and informatics, 246: 1-17.
6 Thaker D A, Monypenny R, Olver I, Sabesan S (2013) Cost savings from a telemedicine model of care in northern Queensland, Australia. Medical Journal of Australia, 199(6): 414-417.