Sunday, October 26, 2014

What Is Telstra Up To With All These New Activities? The Medgate Partnership Looks To Be A Worry.

In the recent release on their new activities Telstra said the following:

Telstra launches vision for a more connected healthcare system

·         Vision for Telstra Health revealed
·         ReadyCare telemedicine joint venture formed with Swiss company Medgate  
·         Home health care provider Silver Chain selects Telstra Health eHealth platform
·         NT Health partners with Telstra Health to build National Telehealth Connection Service
22 October 2014 – Today Telstra officially launched a new business division, Telstra Health, and outlined its ambition to become Australia’s leading provider of integrated eHealth solutions.
Telstra Group Executive of Retail, Gordon Ballantyne, said Telstra had helped Australians connect for more than a century and looked forward to partnering with industry to help advance healthcare.
“We’ve seen what the digital revolution has meant for other industries and we believe that healthcare in Australia could benefit from eHealth to better serve all Australians.” Mr Ballantyne said.
“Telstra Health wants to be the partner of choice in the health industry to connect patients, healthcare workers, hospitals, pharmacies, government and health funds and build a safer, more convenient way of managing health.”
Mr Ballantyne said eHealth could help solve some of the profound challenges facing the health care industry in Australia.
“Health spend is growing more than twice as fast as our economy to nearly 10% of GDP, from $120 billion in 2010 to an estimated $200 billion by 2020. Aging populations, chronic disease and equal access are just some of the challenges faced in bringing quality healthcare to every Australian across a fragmented system.
“Many Australians have a different experience of the healthcare system because of where they live. Seven million people in rural and regional Australia access GP services at a lower rate than the national average.
“We see our role as integrating eHealth solutions across all care settings to solve these industry challenges. Telstra Health is about connecting you to your doctor, your doctor to your other providers, and having access to care and information where you want, when you want.”
Mr Ballantyne said Telstra Health brought together an experienced team of health experts, and he had appointed Shane Solomon, former CEO of the Hong Kong Hospital Authority who brings 30 years experience in the health sector as Managing Director of Telstra Health.
“Through acquisition and partnerships, the team has assembled 10 of the most innovative eHealth companies from Australia and around the world to create leading integrated eHealth solutions, including the one we’re announcing today,” Mr Ballantyne said.
Telstra Health makes GP consultation more accessible and convenient
Telstra announced a new joint venture with world-leading Swiss based telemedicine company Medgate, ‘Telstra ReadyCare’.
The service will see patients talk directly to GPs over video or phone to receive advice, diagnosis, prescriptions, and referrals. ReadyCare is designed to complement regular GP consultations, with information from a telemedicine GP consultation provided back to the patient’s regular GP to ensure continuity of care. 
Mr Ballantyne said ReadyCare is aimed at overcoming the challenges of distance and availability to provide greater levels of access. It will operate on a 24/7 basis, and address the estimated 2.2 million of emergency department presentations occurring annually that could have been treated by a GP.
Medgate Chief Executive Officer, and President of the International Society for Telemedicine and eHealth, Dr Andy Fischer, was excited to work with Telstra Health to bring the service to Australia.
“There will be a great demand for telemedical consultations in Australia, and I look forward very much to a successful and exciting collaboration with Telstra Health,” Dr Fischer said.
A Clinical Advisory Panel has been established by ReadyCare to oversee clinical guidelines. Dr Chris Mitchell AM, past President of the Royal Australian College of General Practitioners and Associate Professor Dr Bruce Chater, past President of the Australian College of Rural and Remote Medicine have been appointed to the panel.
The full release is here:
A visit to the Medgate web-site was very illuminating:
Essentially what is offered is remote consultation by phone, e-mail or video conference for a fee.
Here is what the Telemedicine Service Offers by phone:

The Medgate Telemedicine Center offers you expert medical advice around the clock. You can even contact our medical team at nights, on the weekend or from abroad.

  • Call Medgate. Reception will take your symptoms and your personal details.
  • Take photos of affected skin sites or eye changes and send them by email or with the Medgate App.
  • The medical team will discuss the ideal treatment with you.
  • If medically required, the Medgate physician will issue you a prescription.
By internet:

You can use the Medgate WebDoctor to ask medical questions online. Our medical team will reply within 24 hours.

The WebDoctor is best suited for general health care questions. For acute health problems (e.g. sudden or severe symptoms) or to make an appointment, call us directly at 0844 844 911.
Or by video-conference:

Talk with a Medgate physician by video link, as if you were sitting next to each other.

You can make use of the netCare service in over 200 pharmacies throughout Switzerland. Your pharmacist will make the initial healthcare assessment. Then the Medgate physician will join over a secure connection. You will be speaking with the physician over a high-definition video system. Depending on the findings, the Medgate physician may issue you a prescription which you can have filled right there at the pharmacy.
There are also two Health Centers
In the Health Centers General practitioners, gynecologists and pediatricians and other specialists work under one roof. The health centers are equipped with the latest medical technology, such as X-rays, ultrasound, MRI, and laboratory light booths. The collaboration with the Telemedicine Center also allows health care around the clock.
Comprehensive primary care
     General and Internal Medicine
     Obstetrics and Gynecology
     Complementary and Alternative Medicine
Specialist consultations
(depending on the location)
     Ear, Nose and Throat
The video (3 mins or so) on the page makes below makes it all very clear. Interestingly they keep an electronic record of all patient encounters with histories etc.
The AMA has reacted to all this:

Owler slams Telstra eHealth plan

23 October, 2014
A new eHealth service announced by Telstra “cynical and inappropriate” and will undermine primary healthcare, says AMA president Associate Professor Brian Owler.
The ReadyCare service, announced on Wednesday, will connect patients to random GPs via phone and video 24 hours a day, providing advice, diagnosis, referrals and prescriptions.
Telstra says the service will deliver improved healthcare to rural and remote Australians who live a long way from their doctor.
But Dr Owler says it's a recipe for bad medicine.
"This is a really cynical and inappropriate way for Telstra to be engaged in healthcare. It's a commercial solution dressed up as a health solution.
"We want people to maintain a regular contact with their GP, not just ring someone out of the blue.
"They can just ring up a number, and get a doctor on the other end that they have no knowledge of or relationship with, and get scripts and other treatments prescribed.
"This is not the sort of vision we have for general practice and primary care."
Dr Owler says the AMA supports telemedicine, but only where a patient already has a relationship with the doctor on the other end of the line.
ReadyCare would undermine doctor-patient relationships and threaten existing medical workforce initiatives, he says, adding that expressed his concerns when Telstra briefed him on the service two weeks before the launch.
More here:
To me there are a zillion issues with all this around access, fees, quality control etc. Additionally it is hard to see just how different this is to the HealthDirect services and similar other than providing some more direct GP access - albeit there is still a triage front end which streams access to appropriate locations.
Given Telstra is a for profit entity - last time I looked - it is hard to know just where savings etc. will flow in the short and medium term.
Lastly, of course, there are all the clinical safety issues around care offered remotely without a prior established clinical relationship. Even with a proper relationship there are safety risks enough let alone without actually seeing the patient!
I would really wonder just what the legal and responsibility framework in Switzerland is that makes this workable and safe?
What do others think?


Anonymous said...

With NT Health involved I would not worry, their 'we have the solution never mind the question', gameplay, Telstra will be bogged down for years to come with nothing to show except a large drain on resources, just as NT does with the PCEHR mob. Shameful but good luck to them.

Bernard Robertson-Dunn said...

Has anything been said with respect to the Medgate GPs (and other staff?) having access to a patient's PCEHR? Would Medgate be permitted to access a PCEHR under the "emergency" conditions

Anonymous said...

Dare I say it: Shane Solomon "The Emperor" has no clothes on!

Why on earth would Telstra be building an imitation HealthDirect less than a year after it was awarded back to Medibank Health Solutions? Ludicrous.

Anonymous said...

To be fair, HealthDirect is purchaser of services and medibank the current supplier. Someone wanting some of that action would need to have a comparable service up and running to win the tender next time it was let.

Anonymous said...

It will be more money down the toilet.

Anonymous said...

With some of the more recent software developers muscling up against some of the outmoded eHealth vendors acquired by Telstra over the last 12-18 months a very big toilet will be needed to flush away all the money The Emperor has spent.