This appeared last week. I was amazed by the apparent impact of telehealth.
After-hours GP services 'facing annihilation' as patients turn to telehealth
Industry leader Dr Nathan Pinskier says the future is bleak
26th May 2020
Australia’s after-hours GP services are “doomed” to fail and most will be gone in five years’ time, one of the sector’s top GPs is warning.
Dr Nathan Pinskier says Medicare-funded telehealth is to blame as demand for after-hours home visits slumps as patients turn to phone and video consults.
“The new telehealth items are looking like the straw that broke the camel’s back and our members are very, very despondent,” says Dr Pinskier, president of the GP Deputising Association.
He says some members of the industry body have suffered a 60% slump in revenue since the emergency items, due to remain until 30 September, were first rolled out two months ago.
“I really don’t think some of these services will survive to September. At the very least, they will need to curtail their service delivery.”
He added the industry, which relies on an estimated 1,300 doctors working across 80 services, was already in trouble, mainly as a result of the Federal Government’s moves in 2017 to curtail a multi-million dollar cost blowout in after-hours care.
It included bans on advertising direct to the public and reducing MBS rebates for the sector’s workforce of non-VR doctors.
Dr Pinskier also said a rule requiring deputising services to refuse to provide care for patients who could “reasonably” be seen the following day in regular general practice had a major impact on their revenue.
It means some 30% of patients who now called up deputising services were being referred on to their daytime GP, he claimed.
“Running that call centre and doing the triage isn’t funded by Medicare but it still has a cost. With all the competing telehealth services now emerging, it all becomes unsustainable.”
More here:
https://www.ausdoc.com.au/news/afterhours-gp-services-facing-annihilation-patients-turn-telehealth
It looks like the availability of widespread telehealth has blown up the business model of after hours doctors and that in time we are going to really struggle to have a GP do a home visit after hours in person.
Technology disruption at its best!
The impact is clearly pretty dramatic! Who would have thunk it?
David.
7 comments:
mainly as a result of the Federal Government’s moves in 2017 to curtail a multi-million dollar cost blowout.
They need to rebrand - Digital Afterhours, then the Federal Government of waste and blowouts will bend over backwards to bail me out.
On a serious note I am still out on this, there are something telephones and videos can not deliver. If we avoid the collapse of western civilisation this summer I feel people are going to start pushing back on tech in some aspects of our lives.
Talking about the introduction of new technology, how's electronic prescribing going?
The ADHA forecast that it will be available by late 2019.
Electronic Prescribing - Release Note v1.1
https://developer.digitalhealth.gov.au/specifications/ehealth-foundations/EP-2928-2019/DH-2971-2019
From late 2019, electronic prescribing will provide an option for prescribers and their patients to have a digital prescription as an alternative to a paper-based prescription.
Well that didn't happen, so Greg Hunt threw another 5$million at it and it was forecast to be available by the end of May.
Electronic prescriptions in Australia to be available at end of May
https://www.zdnet.com/article/electronic-prescriptions-in-australia-to-be-available-at-end-of-may/
The Pharmaceutical Society of Australia said:
Pharmacists will be able to better support vulnerable patients following the Federal Government’s announcement to fund home medicines services as part of its $2.4 billion COVID-19 health package.
PSA National President Associate Professor Chris Freeman welcomed the Government’s announcement that $25 million will be allocated to fund home medicines services which will enable patients to have their PBS prescriptions filled online or remotely, and have their medicines delivered to their home.
These measures will support the announced telehealth Medicare items for GPs to help contain the spread of the virus and allow GPs to conduct consultations via phone or video.
“However, the effectiveness of this initiative will depend on the successful roll-out of electronic prescription which the Federal Government has committed an additional $5 million of funding to fast track software capability,” he said.
https://www.miragenews.com/home-medicines-services-and-electronic-prescriptions-to-support-isolated-and-vulnerable-australians-during-covid-19-outbreak/
Promises, promises.
"It means some 30% of patients who now called up deputising services were being referred on to their daytime GP, he claimed." This shift would probably be welcomed by those GPs whose patient loads have decreased since the Covid shutdown. Should deputising services curtail their services until demand picks up again, just like other businesses have had to do? Is this a moral / ethical dilemma or a commercial one?
Is this a moral / ethical dilemma or a commercial one?
The government doesn't do morals or ethics, and it's not a dilemma, they just want to reduce their costs. That's the Federal Government's role in healthcare - they pay for large chunks of it.
That's why MyHR is probably doomed, unless the ADHA can show it's delivered the savings predicted by their tame consultants.
Fat chance of that happening.
@1:01PM You misunderstood the question. The dilemma is for the deputising service executive.
Getting back to electronic prescribing
According to this vendor report
https://www.medianet.com.au/releases/187990/
"...in Beaumaris, Victoria, a patient received his medicine from the Bluff Pharmacy following a telehealth consultation that morning with Dr Kachig Malyan from Bluff Road Medical Centre in Sandringham without ever leaving the safety of his home."
Leaving aside the vendor hype, this is one-off. Known as a proof of concept.
If the government is wise it will go through the well established processes of pilot, limited introduction and final release. This will allow for all the other factors and requirements (e.g. the ability to scale, exception/error handling, education of the users - there are many) to be implmented/conducted)
If initiatives like RoboDebt, myhr, COVIDSafe etc are a guide, the government will go straight from proof of concept to full implementation of the technology.
A dangerous and courageous leap of faith.
.. "leap of faith" !!! You mean, like jumping off a high cliff?
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