Telehealth a crucial advance requiring more patient engagement and certainty

The continuing outbreaks of coronavirus in Australia have reinforced the need for Medicare support of telehealth and we need a Government’s decision informed by clinician and patient experience to maintain it, the Consumers Health Forum says.

“Telehealth has provided a vital primary health support for patients and doctors during the pandemic and it makes good sense for this measure to continue after the pandemic hopefully passes,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“Telehealth has introduced significant change to the dynamics of health care, encouraging patients to think more carefully about their health and for doctors to be more inquiring to ensure as thorough diagnosis as possible.

“Obviously it is preferable for patients to have a face-to-face consultation when they have a serious condition. But the advent of telehealth, given the impact it has on the efficacy and cost of health care, requires thorough analysis.

“The more active role of the patient makes it important that consumers also have an active role in the long-term assessment of telehealth.

“In general terms we support the decision by Health Minister, Greg Hunt, to limit Medicare payments for telehealth to consultations patients have with their regular doctor or practice. This will ensure that people receive ongoing care from a practice that is aware of their clinical history and knows their circumstances.

“Eligibility for telehealth will be defined as the patient having seen the same practitioner for a face-to-face service in the previous 12 months or having seen a doctor at the same practice for a face-to-face service during the same period.

“We hope this will encourage continuity of care however we are concerned that, for some, this definition may be too rigid. What happens to those people who have a relationship with a GP or practice, have not had contact in the last 12 months, and now find they need to?

We support the premise of the Royal Australian College of General Practitioners that quality primary health care for patients with chronic conditions and people who are ageing and frail comes from continuous, coordinated care provided through the patient’s usual general practice.

“There will be exemptions from the eligibility rules for those patients in areas under stage three restrictions in Victoria. Also exempted will be children under the age of 12 months or people who are experiencing homelessness. They will be able to have access to any provider.

“The exemptions make sense and are welcome and the Government says it will consider further exemptions as necessary.

“CHF research shows that most people – particularly families with children, people with chronic conditions and older Australians – prefer to always see the same doctor. However, this ideal is not always possible due to a range of circumstances such as when a patient wishes to change practices, moves home or town or doesn’t have an established relationship with a practice.

Situations such as these will need to be catered for. Consideration should also be given to exempting younger people who often do not have a regular doctor but may be in need of urgent telehealth assistance in the event of serious conditions such as mental health issues.

“Patient choice, preferences and needs should always guide service development and change. This mode of care delivers better patient satisfaction and health outcomes.

“We would caution against confusing patients too much with too many more changes to eligibility for telehealth.

“We also urge the Government to ensure that these telehealth arrangements are not transitory.

“Subsidised telehealth service must be embedded in our Medicare arrangements and funded through appropriate models that afford practices flexibility and agility to structure services to suit their practice population needs.

Sustainable general practices, innovation in primary care services and assured patient access are not mutually exclusive: we need all to ensure a better health care system that serve the community’s interests.

“We would hope that telehealth forms a permanent part of the Governments primary health care10-Year Plan,” Ms Wells said.

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