Dr Ewen McPhee said that telehealth will continue to play a role in regional health care, but that it does not replace doctors or nurses.
Dr Ewen McPhee said that telehealth will continue to play a role in regional health care, but that it does not replace doctors or nurses.

Where telehealth fits into regional health care

VIDEO and telephone medical consultations, jointly known as telehealth, have been swiftly adopted during the coronavirus pandemic.

The technology is particularly useful for people living regionally, far from clinics.

So where does telehealth fit into regional health care?

Throughout March, the Federal Government acknowledged its importance by authorising health professionals to bulk-bill certain remote consultations, reducing personal costs and increasing accessibility for patients.

This week it became law that those patients could only receive a Medicare subsidy from telehealth appointments if they had an existing relationship with their doctor.

Emerald doctor and Australian College of Rural and Remote Medicine president Ewen McPhee said that in the past few months there had been a "massive uptaking" of the technology, but it had its downside; namely that illnesses may be missed or improperly diagnosed if doctors do not physically examine people.

He said that telehealth would continue to play a role in health care, but would never replace a doctor or a nurse, and that "had to be very clear".

"It's not an excuse to not provide services in rural areas," he said.

Dr McPhee said about 97 per cent of nationwide telehealth appointments were done over the phone, rather than by video, and in any case, regional infrastructure was not quite up to the task.

"Our infrastructure," he said, "such as broadband, just doesn't support video.

"From my point of view the issues are quality, safety, appropriateness, and having the infrastructure to enable it.

"Part of it too is providing educational training."

As for the doctor-patient relationship caveat to telehealth's inclusion on the Medicare Benefits Schedule, Dr McPhee said that there were enough provisions to cover emergency situations, but some rural people might be affected.

"The implication," he said, "is that people who haven't got a regular GP - and as you move further west that's more common - or are unable to see their GP as often, will have to pay.

"Basically it's rationalising taxpayers' money. The Medicare spend in primary care has gone above what it was traditionally.

But, he said, "for most people it doesn't change much".

Regional Health Minister Mark Coulton.
Regional Health Minister Mark Coulton.

Federal Regional Health Minister Mark Coulton said that doctors across Australia had transitioned more than 30 per cent of their offerings to telehealth variants.

The Medicare change, he said, had to do with ensuring better patient care and financial security for established clinics.

"While unrestricted access to general practice services may encourage choice and competition," Mr Coulton said, "the strong feedback from the sector … is that it can fragment patient care and undermine the viability of General Practices.

"Practices that have focused on telehealth in response to the COVID-19 pandemic will continue to be able to do so, but must demonstrate their capability to provide comprehensive care for their patients by providing face-to-face services."

Earlier this week, Shadow Health Minister Chris Bowen said the same: that the intent of the amendment was to "stop lower quality corporate health care companies monopolising the Telehealth market".

Mr Coulton said the National Broadbank Network should offer the speeds needed for isolated patients using telehealth.

"Connectivity has long been a challenge for rural and remote Australians," he said.

"From first-hand experience, I can say the Sky Muster service is very good. I use it constantly when I am home and used it without fault for several months during this COVID period."



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