Telehealth to improve remote patient care

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 2 May 2011




(2011), "Telehealth to improve remote patient care", Leadership in Health Services, Vol. 24 No. 2.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

Telehealth to improve remote patient care

Article Type: News and views From: Leadership in Health Services, Volume 24, Issue 2

Keywords: Patient care, Health care, Australia

Australia’s biggest specialist medical college has thrown its support behind innovative health practices designed to promote improved patient care and reduce the burden on patients in rural and remote areas, especially those with chronic and complex illnesses.

The Royal Australasian College of Physicians (RACP) supports efforts to improve the access and availability of health practitioners, particularly medical specialists using Telehealth. The College supports the principal of physicians having greater encouragement to reach out to the patient, especially with an ageing population and the increasing burden of chronic and complex illness.

RACP President-Elect Dr Les Bolitho welcomed the Australian Government commitment to exploring the suite of financial and other arrangements needed to promote better Telehealth uptake.

“It is important to recognise that Telehealth may not be relevant in all circumstances, however if implemented with the appropriate checks and support tools, will help drive our health care system forward to deliver better patient outcomes,” Dr Bolitho said.

“The introduction of Medicare rebates for Telehealth services has the potential to make inroads in combating issues around chronic and Indigenous health, two of the biggest challenges facing our health care system at present.”

The successful implementation of a Telehealth program requires extensive consultation across a diverse range of health specialities, according to Dr Bolitho.

“Differing patient needs must be taken into consideration throughout the diagnosis, treatment and follow-up process, at all times, upholding patient comfort and trust. Key to this initiative is improving the patient journey.

“The suitability of the patient will need to be carefully assessed and not all patients may be able to or wish to have a consult via this method. The option should therefore be given to the patient to commence or cease teleconsulting and give health practitioners the option to revert to a physical consult at any time.”

The College is hopeful that the national health reforms will provide opportunity for greater coordination of patient care across the various health settings and encourage the involvement of physician specialists in the primary and ambulatory setting, working more closely with GPs, nurses, allied health workers and nurse practitioners as part of a multidisciplinary team, especially for chronic and complex illness.

Specific consideration will therefore need to be given to how Telehealth can promote increased patient benefits through group consultations between practitioners and specialist-to-specialist Telehealth consultations, as part of a coordinated care plan or multi-disciplinary team, according to Dr Bolitho.

“Telehealth has obvious applicability in remote communities, especially for Indigenous Australians, suffering disproportionately from chronic diseases.”

Dr Bolitho has urged the government to look closely at the measures to the innovative Indigenous treatment centre established by 2011 Queensland Australian of the Year, Associate Professor Noel Hayman.

“The success of the Inala Community Health Centre is a testament to the flexible treatment options and promotion of patient access, not dissimilar to the intended outcomes of Telehealth initiatives.

“The Inala Community Centre is a place where Indigenous people feel comfortable and understood. If this initiative is linked with appropriate Telehealth services, it would also allow Indigenous patients continuing care from their regular specialist, greatly increasing the rate of continuity and follow-up, promoting positive health outcomes” Dr Bolithio said.

The Australian Government will need to work closely with the state and territory governments to ensure interoperability of Telehealth and availability through hospital networks for physicians consulting out of hospital rooms or other clinical settings within state and territory health services.

To deliver coordinated multidisciplinary care, physicians and other health practitioners must have access to the appropriate MBS items. These include Telehealth item numbers or fee-for-service services in the primary and ambulatory settings, as well as other out-of-hospital and non-acute settings for physician and paediatrician consultation fees and specified items for treatment within coordinated care.

Any incentives must encourage physicians to take up these services where appropriate, while any proposed remuneration models must still maintain the direct accountability of the medical practitioner to the patient, facilitating the provision of care and encouraging quality of care. Any funding arrangements should reflect the level of effort, resources, skill and training of the practitioner and physicians should still be able to set appropriate fees to ensure the appropriate quality and standards and access to health care.

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