Telemedicine Gets a Shot in the Arm

Photo credit: iStockphoto/Ljupco

It seems that people in almost all industries are converts to remote working. The verb ‘to Zoom’ has entered the global business vocabulary because of the disruptions from the COVID-19 pandemic.

Few industries have felt the impact of this change more than in healthcare. In Australia the lockdowns have driven the rapid acceleration of telemedicine and telehealth practices which have long been on the back burner.

Regulatory beta-blockers

It’s not that the technology to do this did not exist before COVID-19. The ability to deliver health services, at scale and remotely, has been around for several decades and yet, despite lots of talk, very little has been done about it.

As long ago as 2016, Australia’s national science organization, the CSIRO, released a report saying that telemedicine could almost halve mortality rates among the critically ill and save the health budget as much as AUD 3 billion per year.

Since then, progress has been glacial. 

There have been a few reasons for this but the main one, in Australia at least, is regulatory. Previously, general practitioners, nurses, midwives and allied health professionals were limited in the kinds of telemedicine services they could claim for under Australia’s Medical Benefits Schedule Scheme.

This was waived by the Government in March 2020 when Australia faced the dual dilemma of wanting people to have as little physical contact with each other and also wanting to keep hospital beds clear in the event of a major escalation in COVID-19 hospitalizations.

The result was a lifting of restrictions on the kinds of services which could be delivered, and paid for, using telemedicine, and the result has been spectacular. By April 20, over three million Australian patients had used telehealth services so far in 2020.

The Australian Government originally mandated that the lifting of restrictions would be temporary and resumed on Sept. 30, by which time it assumed the pandemic crisis would have passed. Now, with patients and health professionals both enthusiastic about telemedicine, it seems the arrangements will continue.

Digital work mass trials

Belatedly, telemedicine could be a key example of a digital work practice sped up by the COVID-19 disruptions. It is as if the dam has burst and there’s no going back.

An example of this is the ‘virtual hospital’ created at the Royal Prince Alfred Hospital in inner city Sydney.

When plans were developed for this concept last year, it was reported that some health professionals were unconvinced that they could care for people effectively in their homes using digital technology.

The project was scaled up significantly once the pandemic disruptions hit Australia. After opening with only six nurses in Feb., there are now over 30 nurses and other medical staff serving over 600 patients and other departments at RPA are looking at how they might combine telemedicine with outpatient services.

“COVID-19 has forever changed the way we in healthcare interact and engage with our patients,” according to Dr. Vikram Palit, a senior lecturer in health services at UNSW. 

“Vaccine or not, it is unlikely we will completely shift back to our traditional ways of working. With every app and video consulting platform that appears — each one promising to improve patient outcomes from the comfort of their homes, and to do so at minimal cost — there are important considerations yet to be explored.”

These considerations were largely around putting patients first, he said, and the quality of care, and while this is key for urban patients, for those in regional Australia, telemedicine can often be the difference between a medical consultation, or nothing at all.

Infectious success

One third of the Australian population lives outside of the major cities and their health outcomes are significantly worse than for city dwellers.

For that reason, some new initiatives are in regional centers, such as in the Victorian city of Bendigo, which will be one of the first hospitals in Australia to adopt telehealth technology to allow healthcare workers to monitor patient symptoms and vital health signs remotely.

Bendigo is using technology supplied by German company Siemens Healthineers which delivers greater control to doctors and nurses in managing patients remotely, and frees up medical resources while also reducing the spread of infection.

The service adds to other initiatives that were in place prior to Covid-19, such as a Stroke Telemedicine service which gives patients access to a network of Melbourne-based neurologists outside of business hours.

Eye care provider OPSM, which spans Australia and New Zealand, has also been offering tele-optometry during the lockdown period, allowing optometrists a chance to make assessments and referrals through consultations with clients in their own homes.

The unexpected jolt

In terms of telemedicine, COVID-19 was the disruption the uptake of the technology needed.

Australia’s experience has shown how a crisis can be a catalyst for change, but that — foremost — regulation must not be a roadblock.

Now those roadblocks are gone, and Australian telemedicine is out on the freeway and heading  — at speed — for the remotest regions of the continent.

Photo credit: iStockphoto/Ljupco