When the Federal Government made telehealth universally available as a safety measure during the COVID-19 pandemic in March 2020, it was life-changing for many people. Patients reported that the ability to have a telehealth consultation decreased their levels of pain, anxiety, and exhaustion, and reduced the impact on their work and income.
40 million telehealth consultations later, in November 2020 Federal Health Minister Greg Hunt pledged to continue to make consultations ‘easier, quicker, and more adaptable to Australian life.’ Before the COVID-19 pandemic, the adoption of telehealth had been slow and represented only 0.1% of MBS professional attendances. However, the broader availability of telehealth and the challenges of the COVID-19 pandemic transformed telehealth into a vital tool for doctors and patients across Australia.
CEO of Health Consumers NSW, Anthony Brown, said, ‘In terms of COVID-19, patients really appreciated telehealth, particularly when they were being told to restrict travel. Telehealth meant that people, particularly those with chronic conditions who needed to maintain regular consultations, could have that continuity of care.’
‘Overall, people felt safer about infection control and less at risk than they would have been if they were sitting in a waiting room or travelling to a consultation. They did find that telehealth was a good way to keep in touch with their doctors,’ he said.
Health Consumers NSW facilitated the COVID-19 Consumer Leaders’ Taskforce and presented the feedback they received from consumers about telehealth in the report Navigating Telehealth: The Patients’ Perspective. The report reveals that there were positive and negative aspects to receiving healthcare via telehealth.
Consumer feedback indicated that the bulk-billed telehealth service cut down a lot of barriers, including cost and travel time, particularly for short consultations. Some patients were pleased to be able to access multidisciplinary consultations involving more than one practitioner on the one call. But Brown is quick to point out that telehealth isn’t always a suitable option and while it can complement face to face consultations, it doesn’t replace them. For some patients and their families, telehealth has introduced new barriers to receiving treatment and support.
The Digital Divide
People in remote and rural areas, those from low socioeconomic backgrounds, and people with low levels of digital literacy are amongst those in greatest need of reliable, affordable healthcare and access to the internet. However, they are less likely to have access to these services than other Australians.
‘If you’re in an area that doesn’t have a good internet connection, or none at all, or you don’t have a phone or the right equipment to access it, telehealth isn’t helpful,’ Brown said. ‘Telehealth doesn’t solve the problems associated with the digital divide. You have to have a certain amount of income to afford the devices and data needed to access telehealth.’
According to Brown, people with physical disabilities also faced barriers. ‘There were some people who had physical disabilities and mobility impairments which made it difficult for them to use existing technology,’ he said. ‘The digital divide is really something we need to talk about and think about more.’
Design for optimal care
Feedback from health consumers reported barriers around privacy, practicality and communications. Many felt that the use of Telehealth should be based on the clinical appropriateness of the consultation, indicating that a mix of telehealth and face-to-face consultation was best for most people.
‘Some consumers felt they weren’t necessarily able to talk about mental health issues, sexual health issues, or domestic violence if there wasn’t space in their home where they could speak without being heard by the people they were living with,’ Brown said.
Others were concerned about the ability to communicate adequately using telehealth. ‘Some people felt that the technology didn’t allow for the sort of communication that you could have face-to-face, they weren’t able to emotionally connect with the practitioner or missed out on things like non-verbal cues.’
And then there were the times when telehealth just wasn’t a practical solution. ‘When blood needs to be taken, or something practical like that, obviously it isn’t going to work,’ Brown said. ‘People said they wanted choice about when they could have a telehealth consultation and when they could see the clinician face-to-face.’
The role of consumers
Brown believes that consumers should play a larger role in making telehealth more suitable and accessible to those who need it most. ‘We’re not collecting the sort of rigorous information and data about patient experience into system improvement, and consumers are not being involved in the design. They could be much more involved in the design of telehealth services. There are existing mechanisms for involving consumers at national, state, and local levels that could be harnessed into being involved.’
However, he does see telehealth playing an important role in the future of healthcare. ‘On the whole, consumers were really happy with telehealth and appreciated that it was a really good adjunct to the way they received their healthcare. But it’s important to them that telehealth isn’t seen as a replacement for other services. People in the country still need good regional hospitals and they still need good patient transport. As good as people found telehealth, it’s no silver bullet.’
Read more about the feedback that consumers provided to the COVID-19 Consumer Leaders’ Taskforce in Navigating Telehealth: The Patients’ Perspective.
Find out more about Health Consumers NSW at hcnsw.org.au