Telehealth valued by NDIS participants

Morgan Liotta

11/05/2021 4:44:34 PM

The service, which will soon become a permanent part of Australian primary care, has been welcomed by vulnerable patients.

Man in wheelchair talking on phone
A recent survey found the majority of NDIS participants rate telehealth positively.

The expansion of telehealth during COVID-19 has been embraced by GPs and patients alike.
And while the positive impacts are widespread across specific patient groups, it has been particularly beneficial for vulnerable populations, such as those accessing the National Disability Insurance Scheme (NDIS).
Despite earlier challenges faced by both participants and healthcare professionals in accessing the scheme, a recent survey of 2391 NDIS participants found 63% have been able to successfully receive supports and move their NDIS-funded allied healthcare services to videoconference or telephone.
The research, stemming from a collaboration between the National Disability Insurance Agency (NDIA) and the University of Melbourne, analysed participants’ and family/carers’ experiences accessing and receiving supports via telehealth video and phone consultations, as well as dealing with the NDIS during the pandemic.
The findings suggest that telehealth is not a replacement or substitute for traditional face-to-face care, but rather an additional option to increase the accessibility of services that patients will continue to use into the future, according to Professor Kim Bennell, who led the survey.
‘Around one-third of respondents said they would be likely to choose telehealth after the pandemic, which is equivalent to approximately 130,000 NDIS participants,’ she told newsGP.
‘Offering mixed models of service delivery may be beneficial, including both in-person and remotely delivered consultations. This would allow participants to choose which would suit them at the time depending on their preferences, needs, or requirements of treatment/therapy.
‘As such, it appears likely that there will be demand for such services in the future.’
According to Professor Bennell, the contributing factors to participants’ overall positive experiences of telehealth include convenience, maintenance of continuity of care and routines, and better access to services, especially for those in regional, rural and remote areas. 
Reduced waiting times, reduced physical and cost burden of travelling to an in-person appointment, and reduced risk of potential exposure to COVID-19 were also cited as positive factors.
These findings are similar to those taken from a small study out of Flinders University, which recently looked at patients across nine general practices in metropolitan Adelaide who had been identified as being at high risk of poor health outcomes during COVID-19, due to having two or more chronic diseases.
Of these 30 patients, 25 accessed telehealth consultations at least once during a one-month period in 2020, as they helped them more easily access general practice care. The study participants especially valued the combination of telehealth and face-to-face services with their regular GPs, with the flexibility to choose between the modes.
Participants also indicated that for telehealth services to be effective, an existing doctor–patient relationship was important.
With the Federal Government extending Medicare-funded telehealth until at least the end of 2021, and reportedly in the process of developing a permanent framework, telehealth looks likely here to stay.
Figures from late 2020 also confirmed that the popularity of telehealth has grown by around 70% since before the pandemic, with mostly young people embracing its use, while for people living in rural or remote areas, or who are housebound, telehealth has been a ‘lifeline’.
As such, Professor Bennell says it is vital to ensure healthcare professionals are best prepared for its ongoing use.
‘It is important that they have appropriate technologies and systems in place and … the requisite knowledge and skills required to competently deliver quality care via telehealth,’ she said.
‘Therefore upskilling clinicians and students in telehealth is important moving forward.’
Professor Bennell said these areas include:

  • regulatory compliance
  • patient privacy and confidentiality
  • patient safety
  • technology skills
  • telehealth delivery
  • assessment and diagnosis, including appropriate patient selection
  • care planning and management.  
Continuation of provision and funding of telehealth services will allow greater access to services – including the NDIS – and streamline GP referral pathways to allied health services, according to Professor Bennell.
‘This is particularly important for those patients in regional, rural and remote areas who previously had limited or no access to some services,’ she said.
‘It will also increase access for those who found it difficult to attend care for reasons such as difficulty accessing transport, work commitments, or benefitting from or preferring to stay at home, such as those with fatigue, mobility issues, social anxiety issues, and [those who are] immunocompromised. 
‘This will mean that we need an adequate number of clinicians offering telehealth services moving forward to meet the needs of this increased demand.
‘Mechanisms for maintaining privacy and confidentiality within remote models of service delivery also need to be made clear and supported by Government in order to give providers, and users, confidence in telehealth services.’
As well as ensuring that the workforce is skilled and able to provide quality telehealth care, Professor Bennell said it is vital that barriers from a patient perspective are addressed.
‘These include improving patient access to appropriate technology, as well as increasing their confidence and competency for using the required technology, including through clear patient information and instruction resources,’ she said.
‘Patients should also be aware of the different models of care delivery available to them.’

NDIS-and-telehealth-article.jpgAccording to Associate Professor Robert Davis, convenience and accessibility have helped to enhance NDIS participants’​ experience with telehealth.
Associate Professor Robert Davis, Chair of RACGP Specific Interests Disability, told newsGP there are many benefits to increasing telehealth flexibility and uptake for NDIS participants, but agrees it’s not a complete replacement for face-to-face care.
‘Access to telehealth has expanded within the NDIS. This is particularly useful when multiple people are involved, and GPs can provide input on health issues as they relate to the person’s disability using case conferencing,’ he said.
‘Most patients and their carers find [telehealth] has improved their ability to gain access to services without affecting the quality. So there is the convenience and accessibility factor.
‘There is definitely a place for the convenience of telehealth but at times face-to-face assessments, training and support are needed.’
Findings from the University of Melbourne survey confirmed that two in three participants felt their recent NDIS experience was better or the same as their previous face-to-face meetings. Nearly half (45%) of participants also said they would likely choose a plan review by phone or video in the future.
As part of its Management and Operational Plan for COVID-19 for People with Disability, the Government announced further support for people on the NDIS. The plan includes a more flexible health service delivery and healthcare models, including telehealth, to accommodate a range of communication needs to assess patients and/or to access GPs and specialist services who are in isolation.
Associate Professor Davis believes telehealth in the NDIS space is moving in the right direction.
‘People are much more attuned to using telehealth now and this should result in better interdisciplinary communication and more direct involvement of patients and their carers,’ he said.
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