The harmonisation of telehealth models across Australia has been recognised as fundamental to achieving better healthcare results for communities living in rural and remote areas.
The Federal Government’s Australian Digital Health Agency’s Digital Health Strategy, released August 2017, will embed telehealth into clinician workflows to service remote areas. This is flagged as one of six “test beds” to improve healthcare services outside the major cities.
The test beds will enable the government to experiment with technology solutions in real-life trials before taking a national approach, and the roll-out of services.
“It is vital that digital technologies are rigorously tested and their benefits proven in real-world environments (i.e. “test beds”), prior to being scaled up to the whole of the Australian health system.”
Other priority areas slated for the petri dish include chronic disease management, babies’ and children’s health, residential aged care, end of life care, and emergency care.
Already widely accepted as a way of connecting rural and remote communities with health practitioners, the telehealth pilot will potentially deliver consistency to the way videoconferencing and related technology is used to deliver healthcare services.
The test bed will review existing uses of the technology, address regulatory and other barriers that stifle implementation, and offer business cases for adopting the technology.
The initial focus will be primarily on Aboriginal and Torres Strait Islander communities living in rural and remote communities. This is because the standardisation of telehealth services will likely facilitate “timely access” to healthcare, which is critical to ensuring health problems are diagnosed early. Currently, conditions that are detectable at an early stage are disproportionately affecting communities living long distances from healthcare.
Consistent with the new Digital Health Strategy’s overall theme, the key to embedding telehealth into clinician workflows is ensuring telehealth infrastructure is connected and interoperable with other systems.
The Federal Government has already taken steps to standardise telehealth infrastructure. In partnership with Telstra Health, the government has established a National Telehealth Connection Service. This service allows participating jurisdictions to connect disparate video-conferencing platforms used by different health services through a virtual system.
The aims of the National Telehealth Connection Service are to improve access to health services, better manage costs and optimise resources, and establish a telehealth scheduling system.
Currently used sporadically by clinicians around the country, telehealth continues to feature “strongly in the future planning of all state and territory health departments”, according to the strategy. For most governments, the intention is to increase telehealth use to achieve further savings for both patients and clinicians through lower travel and accommodation costs.
In the 2017-18 New South Wales Government budget, $286.3 million was allocated to connect any remaining locations to the secure state-wide network so that clinicians can access data “anywhere, anytime”. Once complete, the system will support mobile healthcare and “next-generation” video conferencing.
In Queensland, the Digital Health Strategic Vision for Queensland 2026 released earlier this year suggests that “further opportunities exist to increase the scope and reach of telehealth services to include aged care and hospital in the home”. In combination with connected devices – essential for the collection of accurate and reliable patient data – telehealth will enable more aspects of healthcare to be administered remotely. In terms of funding, the Queensland Government has allocated $135.4 million towards ICT systems underpinning the state’s healthcare system in the 2017-18 state budget.
The Tasmanian Government has also allocated funds to the ICT infrastructure underpinning health systems, which may lead to improvements to the state’s telehealth capabilities. The Department of Health and Human Services received $18 million for “Health ICT Priority Infrastructure” in the budget handed down in May 2017.
Northern Territory telehealth pulling ahead
The Northern Territory, with its remote population, is leading the charge towards improved telehealth service delivery in Australia.
Between 2014 and 2015, three remote sites in the NT were selected as ideal locations to deliver outpatient appointments using telehealth services.
All telehealth project sites reduced the need to travel, and in one location (Tennant Creek), patients started to prefer telehealth services to avoid a long transit. As a result, the “Did Not Attend” (DNA) rate for appointments lowered significantly. Estimated cost savings for participants alone was in the ballpark of $1.2 million.
The Northern Territory leads other key areas of digital health, including electronic medical records. The NT was the first jurisdiction to implement a shared electronic health record, and in 2015, transitioned their patients to the national My Health Record (formerly the Personally Controlled Electronic Health Record).
InterSystems was recently selected following a lengthy procurement process to implement, support and maintain the Northern Territory’s new clinical management system – a central component of the massive $259 million Core Clinical Systems Renewal Program (CCSRP). The multi-faceted CCSRP intends to enable a mobile workforce, reduce technology ownership expenses, and align 80 NT Health systems with contemporary clinical and business practices.