Interview: Professor Anthony Smith & AProf Liam Caffery
It’s National Telehealth Awareness Month and each week in October, we are asking an industry leaders about their thoughts on telehealth and the benefits of telehealth services.
Today, we speak to Professor Anthony Smith, and Associate Professor Liam Caffery.
Anthony is the Director of The University of Queensland’s Centre for Online Health (COH). He is also an Adjunct Professor of Digital Health and Telehealth at the University of Southern Denmark, in Odense, Denmark.
Liam is an Associate Professor in Telehealth and Director of Telehealth Technology for the Centre for Online Health (COH).
VISIONFLEX: Tell us about the services provided by the Centre for Online Health and how this is increasing the uptake of telehealth in Australia.
Anthony Smith and Liam Caffery: Since COVID-19, there has obviously been much greater awareness and personal experience with telehealth. From an academic research perspective, the Centre for Online Health (COH) shares responsibility for obtaining, interpreting and reporting evidence for telehealth. This ultimately helps with the integration of telehealth into routine practice. The increasing adoption of telehealth is prompting interesting and important questions about new models of care, funding requirements and sustainability. Our research is very clinically focussed, which means there are always practical benefits in the work we do.
In addition to academic research, the COH is a telehealth service provider. The Centre currently manages the Metro South Telehealth Centre at Princess Alexandra Hospital in Brisbane. This is a busy service offering outpatient telehealth services for a broad range of medical, allied health and nursing services. As well, the COH runs a school-based allied service called Health-e-regions, and an ear-screening service for Indigenous children in Murgon.
What are the benefits of telehealth for patients and health-service providers?
Telehealth has been used extensively during the COVID response because it reduces viral exposure for both clinicians and patients.
For the patient, telehealth increases access to care, provides greater convenience, less time away from usual activities and reduces costs such as travel and parking when accessing healthcare. The main beneficiaries are people who have to travel large distances, people who find travel difficult due to age, frailty, immobility or incapacitation, people who have carer responsibilities and people who have difficulty in getting time off work.
‘Frequent flyers’ such as patients with chronic conditions, often enjoy having a proportion of their care delivered by telehealth. In some (but not all services) telehealth can reduce the cost of providing healthcare services.
How has the pandemic transformed the delivery of health services and increased the adoption of telehealth?
Given the widespread attention to telehealth during the pandemic, we are seeing a transformation in the way services are being delivered to patients. Certain appointments with GPs, specialists, nurses, and allied health professionals can be done by phone and video conference.
During COVID, MBS subsidies for telehealth have been increased. Previously, MBS subsidies were largely only available for specialists but now are available to GPs, allied health, and nursing services as well.
COVID has made both clinicians and consumers aware of telehealth, and willing to try telehealth for the first time. This has resulted in new models of care being available. For example, remote patient monitoring services are increasingly being used to keep people away from hospitals.
Online services such as electronic prescriptions, forms, and signatures are now used routinely.
The technologies have improved, for example, virtual waiting rooms, better privacy and security, integration of video conferencing in practice management software.
What needs to be done to ensure that telehealth services remain sustainable, post-pandemic?
The question remains – how do we sustain these telehealth services beyond the pandemic; and how do we redesign models of care so that different modalities (in-person, video, phone, VC, email) can be used, depending on the clinical requirements?
In a recent paper published by the Centre for Online Health (Building on the momentum: Sustaining telehealth beyond COVID-19), five key requirements for the long-term sustainability of telehealth are discussed. These include (a) developing a skilled workforce; (b) empowering consumers; (c) reforming funding; (d) improving the digital ecosystems; and (e) integrating telehealth into routine care.
COVID-19 has resulted in a broad range of ‘telehealth-supported’ service models which may not have existed if it wasn’t for the pandemic. We need to learn from this experience and embrace those service models which have resulted in greater efficiency and better experience for patients. Whilst there is a natural tendency to revert back to usual ways of working, we need to be mindful of new models of care and the next steps of integrating them into routine care.
Telehealth research is important to demonstrate the effectiveness of new models of care, compared to conventional processes; and the reasons why some telehealth service models flourish and others don’t. The key is determining how telehealth can be used as part of an overall health service. Using telehealth as one of the service delivery methods, works well alongside other forms of healthcare – including in-person appointments.
In a perfect world, what would the future of telehealth services in Australia look like?
In a perfect world, all healthcare providers would offer telehealth for certain types of services and the patient would have a choice in how they access care. We need to remember that telehealth is not appropriate for all services and some patients prefer in-person care, but for those that want better access to more convenient and cheaper care, telehealth is available.
All clinicians would be skilled in delivering care by telehealth and to achieve this, telehealth training would routinely be part of undergraduate university courses, and post-graduate healthcare workers would invest in professional development that would give them appropriate skills.
Technology would be user-friendly, reliable and available to all clinicians and patients who wanted to use video conferencing.
Funding for healthcare would not use fee for service, meaning models of care such as remote patient monitoring and store-and-forward services are more likely to be used, and healthcare providers would communicate with each other more readily. The digital health ecosystem such as shared electronic records, patient portals, digital health wallets, electronic communication, and electronic prescribing would make telehealth much easier and simpler.
Next month, you are hosting your 21st Annual Successes and Failures in Telehealth conference. What have you planned for this year’s event?
The Centre for Online Health has been responsible for leading the Successes and Failures in Telehealth (SFT) conference since 2001. SFT-21 is the premier telehealth event being run in partnership with the Australian Telehealth Society.
From 3-5 November, this year, more than 75 presentations will be offered (virtually) by clinicians and researchers from Australia and around the world. A broad range of innovative telehealth services will be described at SFT-21, with a unique focus on what works well (successes) and what hasn’t exactly gone to plan (failures).
