Telehealth is here to stay, but in what capacity?

Rosemary Korda, MRFF, telehealth, primary health care

When you hear the word ‘telehealth’ what comes to mind?

Do you envisage a doctor and a patient conversing face-to-face through computers?

If so, you might be surprised to learn that from March to December 2020, 97% of general practice telehealth services in Australia were conducted via the telephone, not via video.

“Telehealth has been slowly evolving in Australia for many years, supported by Government, with much discussion about the role of telehealth in primary health care before COVID arrived,” advises Associate Professor Rosemary Korda from the Australian National University (ANU) National Centre for Epidemiology and Population Health.

“The pandemic accelerated the implementation of telehealth for the whole population and particularly within general practice. There’s little doubt telehealth in routine primary health care is now here to stay in one form or another.”

Associate Professor Korda is the lead investigator of a $1.5 million MRFF Grant that seeks to understand the benefits of telehealth in routine general practice consultation and the impact on quality of care.

Prior to COVID19, Medicare-funded access to telehealth in Australia was restricted to specific areas of need, accounting for only 0.1% of MBS-funded attendances (190,000 services in 2018/2019).

After the whole-of-population roll out of telehealth under the Medicare scheme in March 2020, engagement in telehealth services increased dramatically to over 44 million services between March and December 2020, with nearly 36 million of those services being with a general practitioner.

“We now need a clear understanding of what has worked, what hasn’t and what could be done better to ensure patients who engage in telehealth consultation are receiving the best quality care,” explains Associate Professor Korda.

“It may seem counterintuitive for a patient to engage in a telephone consultation instead of a video consultation; however, in some situations, telephone consultations may be a better alternative, and indeed preferred by some patients,” Associate Professor Korda postulates.

“Previous research has shown that at-risk and underserved rural and remote populations benefit from telehealth services. What we don’t know is how a whole-of-population approach has impacted on engagement with primary care in the wider community.  And we have very limited knowledge on whether people most in need are being served well by this model of care.”

“Are people who weren’t accessing a general practitioner engaging with telehealth now that it’s covered by Medicare?”

“Have changes in funding policies impacted engagement in telehealth?”

“How do consumers and clinicians experience and manage safety in telehealth consultations?”

“These are just some of the questions we’re trying to answer.” Associate Professor Korda says.

The research project, involving analysis of large-scale linked data complemented with qualitative data gathered from interviews with patients and general practitioners will run over three years. It will investigate primary care telehealth services pre, during and post-pandemic with a focus on accessibility, safety, continuity, acceptability, appropriateness, and coordination of care.

The multidisciplinary research team also includes Professor Christine Phillips, Professor Kirsty Douglas, Dr Jason Agostino and Dr Sally Hall from the ANU Medical School, and Dr Danielle Butler, Professor Emily Banks, Dr Grace Joshy, Professor Emily Lanscar, Dr Jane Desborough and Dr Anne Parkinson from the Research School of Population Health.