Telehealth item numbers will help redress deficits in rural health services

04 July 2011

Specialist health services are in very short supply in more remote areas and telehealth has the
capacity to assist with healthcare delivery to people in such areas. Therefore, people in rural
and remote areas will welcome the fact that, starting last week, video conference consultations
with medical specialists will be reimbursed through Medicare.

In general, health risks are substantially worse for rural people than their city counterparts.
For cancer, for example, rural patients are up to three times more likely to die within five
years than other Australians. Rural people seeking specialist care can miss out altogether or
face significant travel and accommodation costs, and long periods of time away from home
and work.

“The people of rural and remote areas stand to gain substantially from the extension of
telehealth services,” said Dr Jenny May, Chairperson of the 32-member strong Alliance.
“That’s why we believe priority should be given to rural people who currently have worse
health outcomes and poorer access to health services.”

“However videoconferences should not be seen as an acceptable substitute for face-to-face
contact between patient and health professional.”

“Rural and remote primary care providers will need support to establish fit-for-purpose videoconferencing
facilities and to maintain the facilities, as well as ongoing training and support in
telehealth applications as they expand,” Dr May said.

To achieve best practice in using videoconferencing technology, specialists will also need
encouragement, guidance and support from the professional Colleges and other sources,
according to Dr May.

“We envisage that such guidance may include advice on the situations in which videoconferencing
is clinically appropriate, on technical requirements and limitations, and on
information and support for patients who agree to this approach. It is good to hear that
progress is being made on these fronts.”

The capacity of telehealth to work well in more isolated areas depends in part on the
availability of high-speed broadband – both its technical presence and its affordability.
A target of 495,000 telehealth consultations by July 2015 has been set by the Federal
Government and it is to be hoped that the bulk of these will be for patients in rural and remote areas. While quick runs on the board and early adoption after 1 July will provide immediate benefits, including in the outer suburbs, the goal must be the systematic adoption of telehealth
across all rural, regional and remote areas and all areas of need.

Rural and remote health consumers and health care providers need to be involved in
systematic development of clinical protocols and practice standards by relevant professional
bodies, including the specialist Colleges. Online consultations must be provided within a
safety, quality and technology framework that balances the risks of this approach to service
delivery against the risks of having no service at all.

The new items should complement and add to existing services, such as those provided under
the Medical Specialist Outreach Assistance Program (MSOAP). Primary care providers and
specialists must ensure that referral and coordination processes for online consultations with
specialists are fully integrated with ongoing primary and acute care for health consumers.
The $620 million telehealth initiative was flagged during the 2009 election campaign and
launched last week by the Prime Minister and Health Minister Nicola Roxon.