The incredible telehealth transformation

There are many healthcare needs that can only be successfully addressed in face-to-face visits with health practitioners. It is necessary to see a medical practitioner when we need to discuss private health issues in detail, to canvass different health or treatment options and to assess our health.

Having said this, there are many other situations that only require a telephone call. Results of blood test without complications, simple over the phone advice, follow up checkups and other minor issues can be handled by telehealth in a much more efficient and cost-effective way. This could account for as much as 20-30% of all health care consultations, imagine what such a transformation can do for the health care system.

At an interesting Telehealth Zoom Conference organised by Telsoc, Professor Anthony Smith revealed some very interesting health-related statistics. Here are some to illustrate what happened when telehealth was made available to all Australians.

Before COVID-19, telehealth was provided annually in a few hundred thousand cases. Since March this year, close to 18 million telehealth consultations have been conducted.

In 2009, as part of building a vision for the NBN, several ministerial discussions with industry CEOs were organised. The aim was to build support for the NBN as a tool for social and economic benefit. We discussed with the various ministers and their advisers the benefits the NBN had to offer to sectors such as agriculture, health care and education.

We suggested to them collaboration between departments to reap the horizontal benefits that the NBN could provide to our economy and society.

At the time, former Minister for Finance and Deregulation Lindsay Tanner said something quite memorable. In a meeting, we discussed the social and economic benefits of e-health. Tanner laughed loudly when he said something along the lines of “good luck with e-health trying to convince the 1,500 plus silos in healthcare to use telehealth services as that would mean for all of these silos to work together”.

While progress has been made, it was limited to very small market segments and often is based on expensive technology setups. These frequently proved to be cumbersome to use for both patients and practitioners. Another problem was that there was a lot of resistance from the practitioners as they feared a reduction in their income if people started to use telehealth.

For over a decade very little happened on any large scale. Then COVID-19 hit and within a few months, we have made more progress in telehealth (and teleworking and tele-education) than in the previous decades (the first serious large scale attempts to introduce telehealth date back to the 1990s).

The changes are happening across the medical field.  Within six months, allied health service went from virtually no telehealth whatsoever to 5% of services are now based on telehealth, equalling 54,000 consultations. Psychiatric consultations grew from around 3% to 33% now based on telehealth.

People avoided the complexity of sophisticated services in the previous decade. Close to 90-95% of the 17.5 million telehealth consultations in the first five months took place using the telephone. Both young and old are using it. What this means is enormous time and cost efficiency. Practitioners can provide more services and they can do this from their homes. Patients save costs on travel, parking, taking time off work and sheer convenience.

With now basic telehealth established in Australia, we can start looking at value-added services. During the pandemic, more and more people have also become used to video conferencing, especially services such as Zoom, Skype, WhatsApp. With this experience, health professionals can now more efficiently add this to their toolset.

Medical Practitioners were also reluctant to use telehealth technologies and within the last six months, this has changed. Practitioners including allied service providers, nurses, GP’s and specialists, are now far more confident to use telehealth technologies. They can even add extra services at an extra charge. Many people will be happy to pay a bit extra for the convenience.

It will be interesting to see if the Government will grab this opportunity and use the telehealth momentum to build solid policies around it. Professor Smith and his colleagues have already provided a range of suggestions. This would also assist in building a telehealth knowledge base and industry.

China is already well advanced in offering telehealth services and is rapidly building an industry around it. It would be timely for the Australian Government to embrace telehealth.

So far, it looks like the Australian Government is more interested in looking on how to best rollback telehealth rather than embracing it.

Paul Budde

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