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Telehealth: a Core Part of the Aged Care Royal Commission Recommendations

Coviu CEO, Dr Silvia Pfeiffer, provides commentary on the recent release of the Aged Care Commission Report.


The Government has committed almost half a billion dollars in an immediate response to the 148 recommendations in the final aged care commission report, released yesterday.

While a large part of the Final Submissions Report focuses on the quality of care and support delivered by nurses and carers that have daily physical contact with older people, their medical care has also been scrutinised by the report. As a result, there are several recommendations that aim to improve the quality of medical care through telehealth.

The summary of the report states:

“Telehealth is a means of avoiding the potential harm and distress for frail older people caused by travel to receive medical care. The use of telehealth has become widespread as a result of the COVID-19 pandemic in 2020, and on 27 November 2020, the Australian Minister for Health announced that ‘telehealth will become a permanent part of the Medicare system’.”

This recognises that older people, no matter where they live, are finding it difficult to access medical care without travelling and that that simple act of travelling can in and of itself harm them. There are cases of elderly patients dying on their trip to a checkup or to rehabilitation, tripping or falling, being in an accident or having a mental or physical breakdown.

The summary report continues… “Subsidised specialist telehealth services are currently available to people living in residential aged care. They are not available, however, to older people who access aged care from their homes, unless they live in remote Australia or access an Aboriginal Medical Service.”

Recommendation 63 addresses this issue and asks that “By 1 November 2021, the Australian Government should:

  1. expand access to Medicare Benefits Schedule-funded specialist telehealth services to older people receiving personal care at home
  2. require aged care providers delivering residential care or personal care at home to have the necessary equipment and clinically and culturally capable staff to support telehealth services.”

This is a good idea because older people have trouble travelling no matter whether they live in their own home or in a facility. Specialists - such as oncologists, cardiologists, neurologists etc - never make house calls. Requiring aged care providers to make available the necessary equipment and staff to receive telehealth is the right step towards a digital transformation of healthcare that is required to future proof the sector.

What is surprising, however, is that the request for telehealth services is limited to medical specialists. Throughout the pandemic, we have seen numerous cases where GPs and Allied Health practitioners have been able to successfully deliver their services via video telehealth. Many millions of telehealth sessions have helped keep our elders safe from potential infection through in-person visits where the likelihood of coming in contact with an infected patient was high.

Why then does the report only mention specialist telehealth services as a recommendation for expanded reimbursements? Surely, the delivery of GP and Allied Health services via telehealth is just as important to reduce exposure to harm. In fact, video telehealth for these primary care services may even lead to more timely access to care as is necessary with older people that may find it difficult to find a carer to take them to the GP, the physiotherapist, the dietitian, the dentist or the psychologist.

Recommendation 56 refers to such telehealth as part of a new primary care model that the government is suggested to trial out for 6 to 10 years. Why do we need to trial this? The pandemic has given us enough data to confirm that it works for providing timely, clinically adequate and outcome oriented care. We can’t wait another 10 years to make video telehealth part of the standard way of delivering healthcare to our elders.

Video telehealth addresses existing issues around a lack of timely access to GPs and allied health practitioners when/where needed, reduced mobility, and good further to address language barriers, geographic limitations and plays a key role in supporting the mental health of patients.

In a bid to expand access to subsidised telehealth services and ensure providers have the necessary equipment and capable staff to support it, telehealth needs to be holistically integrated into the aged care system. If it’s integrated holistically, we’ll have the ability to enhance healthcare delivery for older Australians, up-skill and reduce time/work pressures on residential aged care workers, enable more clinicians to service more ageing citizens, as well as implement funding arrangements to offset costs for patients.

 


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