RACGP calls for telehealth extension until long-term solution finalised

Anastasia Tsirtsakis

10/02/2021 4:05:32 PM

While practices grapple with the logistical challenges of the upcoming COVID vaccine rollout, questions remain over the future of telehealth.

A GP conducting a telehealth consultation.
While telehealth now plays an important role in healthcare delivery, there are concerns the long-term plan may be burdened with red tape.

It was in November last year that Federal Health Minister Greg Hunt announced that telehealth would become a permanent fixture of Australia’s healthcare system.
The scheme’s temporary extension is due to end in March but GPs have still not received any further detail, even as the deadline draws near.
Given practices are now facing the logistical challenges of the upcoming COVID vaccine program, the RACGP has called for telehealth to be extended until 30 June while the long-term plan is finalised.
Dr Michael Wright, Chair of the RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), told newsGP such an extension would give GPs and their patients some assurance.
‘The pandemic’s put a lot of challenges on general practices, and they responded really well to the challenges and trying to keep our patients safe and also to keep our staff safe,’ he said.
‘Telehealth has been an integral part of that.
‘But GPs needs certainty that telehealth is going to continue and that it’s viable in the long-term. Only then can we fully integrate telephone and video consults into our usual business practices.’
As part of the RACGP’s advocacy, Dr Wright says the college is pushing to ensure that the permanent model is viable for practices – and is not tied up in ‘too much bureaucratic red tape’.
‘We all recognise that telehealth is needed in our health system, but the challenge is making sure it’s funded properly and isn't burdened with red tape,’ he said.
‘It makes it impractical for patients to access and makes it a burden on the viability of general practice.
‘The system needs to be adequately funded for it to be workable long-term, but also flexible for it to be practical for patients to access and financially viable for GPs to provide.
‘Initially you had to bulk bill all telehealth and that regulation has been removed. But still, over 95% of telehealth consults are being bulk billed – so GPs aren’t charging the vast majority of patients for these services.
‘I think keeping that flexible will allow practices to use their usual billing practices.’
Telehealth has been hailed as one of the great success stories of the pandemic response, following successful RACGP advocacy for the introduction of Medicare Benefits Schedule (MBS) rebates.
Since its introduction in March, a total of 26.5 million telehealth consultations have been delivered by general practice up to December.
While Medicare figures show a jump in face-to-face consultations since the easing of social distancing restrictions, there is still significant demand for telehealth.
Recent research led by Macquarie University shows Australians consulted with their GPs more frequently during the pandemic than they did in the same period in 2019, largely attributed to the greater flexibility and access afforded by telehealth.
While not a substitute for face-to-face consultations, the authors concluded that patient uptake is unlikely to change after the pandemic.
‘The evidence shows that telehealth continues to be a valuable addition to GPs and their patients, and that it continues to allow us to provide more flexible care for our patients,’ Dr Wright said.
‘Even as the major threat of COVID has reduced, many of our patients are still seeking advice and are appreciating being able to obtain care without having to sit in front of the GP.
‘I still have a lot of older patients in my practice who are concerned about the virus and concerned about potential dangers from coming into the practice, and I can reassure them by having the flexibility to offer them a telehealth appointment in the meantime, until the vaccine comes.
‘It is a great assistance for them and for me.’
Research has shown the majority of general practice telehealth consultations are conducted via telephone, rather than video, but that many are willing to try.
However, beyond fears over privacy and confidentiality, many practices do not have the infrastructure to conduct this type of consultation.
Dr Wright says this will require further investment.
‘The technology to use video consults will require additional infrastructure for many practices,’ he said.
‘If practices were supported to invest in that infrastructure, I’m sure that the number of video consults would increase.
‘But in the absence of that, we’ve all got telephones on our desk, and so telephones have been the easiest way to provide care for our patients.’
Should the Federal Government adequately fund telehealth, Dr Wright says the investment into preventive care will eventually result in long-term cost savings.
‘We know that patients are using after-hours services less because they’re able to access care at their regular practice through telehealth,’ he said.
‘And there’s some emerging evidence that patients are attending emergency departments less for a similar reason.
‘That’s better for continuity of care and better for the health system and reducing costs.
‘Telehealth has given us the flexibility to access many patients remotely, who might otherwise not have been able to make appointments.
‘Removing access to telehealth or burying it in red tape would be very short-sighted and a bad thing our patients.’
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Dr Duncan   11/02/2021 7:40:25 AM

What reason would could we ever think valid to accept a rebate reduction for telehealth.
Video will rarely add anything, and phones are well known and easy, with know IT headache.

I would attest that telehealth often a great substitute to face to face, and have had some consultations by phone that patients admit they've never been able to have with any doctor face to face. Why else are the crisis phone hotlines for MH do popular and useful.

Erosion of the rebate should be seen as an RACGP failure. The item number should be simplified to the attendance numbers. It is not inferior care.

Dr Primo Phillip Bentivegna   11/02/2021 9:13:49 AM

Wait for the $10.00/Month "all you can eat" telehealth solution from the Feds after 1/3/21. Greg Hunt will issue the statement on a Saturday morning.
It'll be the last straw.

Dr Kodikkakathu Saratchandran   11/02/2021 10:18:43 AM

The Covid 19 time has shown that much of the patient management can be done safely and effectively via: Tele-medicine, it is only logical to continue the availability of the service to patents' convenience. Drs can always determine the need of a face to face consultation on the merit of the problems presented. Unless the Medicare is obsessed about the eye ball to eye ball consultations as a must of reasons of their own, there is no reason that the Tele - health to drop out of the use. Hopefully the College can negotiate it to continue.

Dr Andrew Robert Jackson   11/02/2021 3:54:10 PM

Without "too much" bureaucratic red tape? - we want NO bureaucratic red tape

Like linking TH that we do want, to something that Health bureaucrats and ivory tower academics want, be we don't like compulsory practice registration