One of the realities of healthcare is that even when there is a new health problem needing urgent attention, the continuing needs of current and new patients will still need to be met. This can create specific challenges not only in addressing unexpected and novel health problems but in continuing to meet ongoing demand and organise care to protect different patients. It is within this context that telehealth has been seen as part of a national solution to COVID-19. Although introduced as a time-limited response, new telehealth items may have profound implications for care practices with a legacy far beyond the proposed six month period.
The new and temporary MBS (Medicare Benefits Schedule) telehealth items allow health professionals to deliver essential services to patients at risk via telehealth, provided those services are bulk billed. The care needs being addressed means that there are MBS items for a range of health care providers including GPs, nurse practitioners, medical specialists and consultants, psychologists, and midwives. This is not just about those with COVID-19 but about providing care more generally for people aged over 70, Aboriginal and Torres Strait Islander people aged over 50, people with chronic health conditions or who are immunocompromised, and parents with new babies and people who are pregnant. For these groups, telehealth can offer a protective role enabling people awaiting diagnosis and ‘well’ patients with COVID-19 to be self-isolating reducing potential spread while also minimising potential transmission points for “at risk” people. The availability of telehealth as an optional mode of care delivery ensures health care coverage and the capacity to monitor, assess and reassure each of these groups. It may also limit health professional exposure to the virus supporting the health workforce at a critical point.
As well as addressing an immediate need, the widespread nature of the service means that many different groups will potentially be able to access and experience telehealth. They may be a potent group in seeking continuation after the initial period. Health practices that have invested in the equipment and processes to facilitate videoconferencing based care may also argue for telehealth to have a more embedded role in normal care. Much of this will depend on the experience and perceived usefulness of telehealth delivered care during this current crisis. Many IT companies are already adapting their systems to support telehealth practice and enable rapid uptake by health professionals. The Australasian Telehealth Society (ATHS) and the Australian College of Rural and Remote Medicine (ACRRM) have released two guides to getting started with telehealth to help manage the COVID-19 outbreak. There is a quick guide (173kb pdf) to getting started with telehealth, using video conferencing or the telephone. There is also a comprehensive guide (217kb pdf) that offers advice on managing appointments and conducting remote consultations.
The new Telehealth MBS items are likely to be important in the care of palliative care patients in the community setting as many people with palliative care needs will be over 70 and/or have chronic disease. Telehealth again offers an opportunity to reduce their exposure to COVID-19 and maintain ongoing interaction, monitoring and support.
If you need more information about the telehealth items visit MBS Online.
If you need more information about COVID-19, CareSearch has developed pages for Patients and Carers, and for Health Professionals to connect them with available information.
Professor Jennifer Tieman, CareSearch Director, College of Nursing and Health Sciences, Flinders University