Telehealth Accounting For 20% Of All Medicare-funded Doctor Consultations

After years of people stating that telehealth would be the future of medical care, the Australian Medical Association (AMA) said the coronavirus pandemic has shown it works in Australia, and that it must become a permanent feature of the health system.

Responding to the Senate Select Committee on COVID-19, the AMA said telehealth was now accounting for 20% of all doctor consultations funded by the Medicare Benefits Schedule.

"The AMA has said for many years that telehealth should become a feature of our health system, complementing face to face care," it said.

"We must now turn to the task of fully integrating telehealth into day-to-day medical practice while ensuring continuity of care for patients and that we follow best practice standards."

The association said most telehealth consultations have occurred where patients and doctors have an existing relationship, but it has noticed "pop up telehealth models" and other models linked to pharmacies as well.

"These arrangements fragment care and blur the important distinction between the prescribing and dispensing of medicines," the AMA said.

"For telehealth in general practice, we need to build on what is key to our very successful primary care system -- the relationship between a usual GP and a patient. This means that GP telehealth consultations need to be restricted to a patient's usual GP or general practice."

For the AMA, telehealth encompasses regular phone calls, as well as video calls.

Earlier this month at a hearing, Grattan Institute director of health program Dr Stephen Duckett said telehealth would need to continue, but the design would need tweaking.

"We strongly recommend that we need to have telehealth continue, but not in its current form," he said.

"The telehealth changes were introduced quickly but the design was probably not something to be desired. We suggest that, for example, in the case of telehealth, we need to make sure it doesn't undermine continuity of care, so you might need to change the design of the telehealth item."

Speaking in a private capacity to the committee last month, Dr Peter Collignon said the current situation in Australia with the pandemic would continue for some time to come.

"People realised: 'Crowds are bad. Keep your distance.' So people, I think, were generally doing that as well. So we're in a good position. The trouble is that we're going to have to keep this up for a couple of years," Collignon said.

"Bars have been particularly bad, I think, because they're indoors with poor ventilation and you can't hear, so you're right next to somebody. That all facilitates spread. Whenever you raise your voice, singing or shouting, it probably increases your droplets."

Collignon added that an underappreciated factor in the pandemic is people going to work while sick.

"If you look at all the outbreaks in Australia and New Zealand, a large percentage are from people with mild illness going to work for four or five days and infecting a lot of others," he said.

"It is mainly affecting their friends and families, who think they're safe. There's a false sense of security."

In a speech delivered on Thursday, Telstra CEO Andy Penn said the pandemic made the economy more digital in three months than it had in the previous five years.

"What this tells me is that previous constraints to our progress were less to do with the technology itself but rather our ability and willingness to adopt it," Penn said.

Speaking to the committee on July 2, former economic advisor to Julia Gillard, Stephen Koukoulas said while many workers are without work or underemployed, the economy has continued to change and Australia will need to ensure those people can retrain.

"Even though the COVID-19 crisis has been very disruptive, technological change, innovative change, automation, and artificial intelligence are still continuing," he said.

"They're still continuing underneath the whole economy. We're getting automation in retail, for example. We need people to have the skill set to be able to work not at the check-out or stacking shelves but in other parts of the economy that require a higher level skill set.

"I'd be looking to make sure that people who are currently out of the labour market have the opportunity to reskill and retrain so that when the economy does recover they can get a job relatively easily in an area that has decent paying jobs."