As we have noted in the past, Australia has provided incentives for GPs to implement videoconference telehealth consultations in remote rural areas. Simple though it may be from a conceptual point of view, providing the ability for people in isolated communities to have access to specialists can make an enormous difference to the healthcare they receive.
Dr Ewen McPhee, a GP from rural Queensland, writing in the Australian Family Physician’s December issue (“Telehealth: the general practice perspective”) briefly looks at the state of videoconference telehealth in Australia 3 years after the current incentives were implemented. “Three years later, the implementation of telehealth videoconferencing has been inconsistent and patchy, yet to be normalised as part of primary care practice” says McPhee.
Living in cities like London or New York it can sometimes be hard to imagine what a step improvement in healthcare can be derived from an old-fashioned, or dare I say, some may say out-of-date, videoconference telehealth. McPhee says “The health status of rural and remote people lags behind that of metropolitan citizens; for example, in rural and remote areas, morbidity rates for cancer are higher and outcomes for mental health poorer. The dislocation from family and community in order to seek care delays recovery and has financial, social and emotional impacts that simply cannot be compensated for.” Hence the Australian initiative was a very welcome one indeed.
However, what McPhee reports as the state of the telehealth programme is not exactly a surprise. We reported nine months ago (“Health funding cuts in Australia”, May 31, 2014) that Prime Minister Tony Abbott’s cuts to the health and science funding was likely to see reductions or abandonment of telehealth programmes, though McPhee makes no direct link in his article. He identifies lack of acceptance by clinicians and technical barriers as two key issues.
In the same journal there is a second article on telehealth ( “Telehealth: the specialist perspective” )by Dr James Muir, a dermatologist with Tele-Derm National, a consultation and education service funded by the Australian Government.
Muir raises an interesting question. “Teledermatology provides an accurate diagnostic and management service with turnaround times far shorter than can be achieved with traditional consultations yet with similar patient outcomes. The patients remain under the care of a single doctor while benefiting from specialists’ input to their management. Access to telemedicine reduces professional isolation of doctors. Yet it remains common to see patients referred with skin disorders who could easily have been managed via telemedicine. Why is this so?”
Muir thinks there are two reasons for this. First is the lack of widespread knowledge about the existence of this service by medical practitioners as well as patients. Secondly, he thinks the use of tele-dermatology places a greater burden of responsibility on the referring doctor with no financial compensation (medical rebate).
For a virtual tour of Tele-Derm, see www.youtube.com/watch?v=qtkuQW1PyMA\.