The Australian Government outlines key issues with telehealth scheme

The success of the initiative is reliant on a number of issues in the delivery process

Establishing a clear deployment model and providing financial incentives for health care providers are some of the key issues to be resolved if telehealth services are to be successfully rolled out across Australia, according to the Department of Health and Ageing.

The issues, detailed in a discussion paper by the department, includes specifics around the implementation of the services, how the service will work, which medical specialties will work best in the online format, and potential technical issues.

The paper is seeking comment on practice models that are best suited to the system, for instance, whether a general practitioner (GP), a specialist or a nurse is required for an online consultation, or whether every GP in a given area will need online consultation facilities, as opposed to a centrally located facility to service all practices. It also looks to examine ways of linking practices with specialists and scheduling joint online consultations.

Medical specialities are also under consideration, as the paper calls for comment on which specialties are particularly suited to the online format. The Government has previously flagged patients of consultant physicians, surgeons, endocrinologists, dermatologists, ophthalmologists and psychiatrists, paediatricians and geriatricians, to benefit from telehealth services.

The paper also details the remuneration models that could be employed, outlining two approaches to the structure of the Medicare Benefits Schedule for online consultations.

“One involves the development of unique items for use solely on these consultations, by GPs and other health professionals attending the patient,” the paper reads. “The other allows the use of existing GP and specialist consultation items in conjunction with ‘add-on’ telehealth items for use with online consultations.”

Financial incentives will be essential to ensure uptake and ongoing participation in the services, according to the Department, and will be achieved through two different payment methods targeted at specific issues.

“These mechanisms will need to reflect a balance between addressing the legitimate needs of participating health professionals and practices, and the responsible management of public funds,” the paper reads.

According to the paper, practices may face capital costs throughout the initial uptake of the services, however many will also have the necessary infrastructure in place. These costs could be resolved with one-off payments, or ongoing funding, which would assist in “maintaining momentum” in the use of telehealth services through the early phases of implementation.

Funding will also be required for the training and support of health professional in using the technology, as well as funding for technical issues.

“One key issue will be the different technical demands of different specialties,” the paper reads. “For example, certain specialties may require a higher level of video resolution than others, while yet others will require higher data transmission capacities.”

“The Department is engaging a consultant to conduct research into the implementation of telehealth services, with a particular focus on technical issues relevant to the provision of video consultations.”

Under the telehealth scheme, the government will provide Medicare rebates for online consultations across a range of medical specialities by 1 July 2011, in an attempt to address access barriers to medical services for rural and regional Australians.

Minister for Health and Ageing, Nicola Roxon, said at least $342 million will support online specialist consultations for Australians in rural, remote and outer metropolitan areas.

“From 1st July 2011, this telehealth initiative will provide around 495,000 services over four years, as well as training and incentives for specialists, GPs and other health professionals to participate in delivering online services,” Roxon said in a statement.

“I look forward to receiving submissions from doctors, health professionals and patient groups,” Roxon said.

The DoHA will also be consulting stakeholders on telehealth issues through a new advisory group which will include professional medical colleges, peak medical and nursing bodies and consumer and aboriginal health representatives.

As reported by Computerworld Australia, the government allocated $466.7 million for the e-health records policy, with the initial three sites in Brisbane, the Hunter Valley and Melbourne’s eastern suburbs to implement the e-health records and unique healthcare identifiers, as well as electronic discharge summary and referrals systems. In addition, the DoHA has issued a further $55 million in grants to introduce further trial sites for the implementation of e-health records.

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