What is Telehealth?

According to the World Health Organisation (WHO), “Telehealth involves the use of telecommunications and virtual technology to deliver health care outside of traditional health-care facilities”. This is used to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Some examples of technologies that are used include; videoconferencing, the internet, store and forward imaging, streaming media, plus terrestrial and wireless communication. Telehealth includes preventative, promotive, and curative care delivery.

Telehealth requires a strong, reliable broadband connection. Due to the improvements of broadband infrastructure, we are now seeing telehealth being used more widely as it is now more feasible. Healthcare providers often begin telehealth with a needs assessment which assesses hardships which can be improved by telehealth such as travel time, costs or time off work. The transition can be eased through assistance from technology companies.

There are three key types of Telehealth:

  • Real-time Telehealth: In real-time Telehealth, a telecommunications link allows instantaneous interaction. Videoconferencing is the most utilised of this form of Telehealth.
  • Store & Forward: In store-and-forward Telehealth digital images, video, audio and clinical data are captured and ‘stored’ on a computer; then securely transmitted (‘forwarded’) to a clinic at another location where they are studied by relevant specialists. The opinion of the specialist is then transmitted back.
  • Remote monitoring: This involves the consistent, reliable and accurate remote monitoring of a patient’s vital signs and predetermined health measures (e.g. blood pressure, heart rate, weight etc). This is also called home Telehealth.

A common example of the use of telehealth in day to day life is video conferencing. This is one of three main ways in which telehealth is improving access to healthcare services for patients who live in regional, rural and remote areas. Instead of having to travel to the nearest major city to see a specialist, an increasing number of patients are using video- conferencing. This facility might be offered by their local GP or another local healthcare venue. Another example includes Remote Patient Monitoring (RPM). Remote patient monitoring involves the reporting, collection, transmission and evaluation of patient health data through electronic devices such as wearables, mobile devices, smartphone apps, and internet enabled computers. RPM technologies will remind patients to weigh themselves and transmit the measurements to their physicians. Wearables and other electronic monitoring devices are being used to collect and transfer vital sign data including blood pressures, cardiac stats, oxygen levels and respiratory tests.

Additionally, there are devices that are being utilised to track blood glucose levels and report high or low levels to patient providers. For example, Apple’s ‘Apple Watch’ can be used to detect irregular heart patterns. It enables Apple Watch wearers to perform electrocardiograms in 30 seconds that can easily be transmitted to physicians. Therefore, remote patient monitoring through the use of telehealth can allow for earlier detection of complications and identify patients who need to seek medical attention prior to in – person appointments. Moreover, chronic conditions can be more easily managed resulting in higher quality care and outcomes as well as cheaper and more affordable costs to patients.

Due to the COVID-19 outbreak the Australian Government has made some recent changes to Medicare. 

What telehealth options are available?
Video-conference services are the preferred approach for substituting a face-to-face consultation. However, in response to the COVID-19 pandemic, providers will also be able to offer audio-only services via telephone if video is not available. There are separate items available for the audio-only services.

No specific equipment is required to provide Medicare-compliant telehealth services. Services can be provided through widely available video calling apps and software such as Zoom, Skype, FaceTime, Duo, GoToMeeting and others.Free versions of these applications (i.e. non-commercial versions) may not meet applicable laws for security and privacy. Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws.

Why are the changes being made?
The new temporary MBS telehealth items will allow people to access essential Medicare funded health services in their homes and reduce their risk of exposure to COVID-19 within the community.

What does this mean for providers?
The new temporary MBS telehealth items will allow providers to continue to deliver essential health care services to patients within their care.

Providers do not need to be in their regular practice to provide telehealth services. Providers should use their provider number for their primary location, and must provide safe services in accordance with normal professional standards.

The new temporary telehealth MBS items will substitute current face-to-face consultations that are available under the MBS. The new temporary MBS telehealth items will have similar requirements to normal timed consultation items. The new temporary telehealth items must be bulk billed, meaning MBS rebates are paid to the provider

Telehealth can be seen as having a positive impact on our healthcare systems. This is due to convenience of care, increased access, improved worker productivity and not having to take time off and travel to appointments, decreased costs, and clinician time savings. For these reasons, providers, payers and employers alike are moving forward with more and more telehealth solutions.