I spotted this last week:
How do telehealth and face-to-face consults differ?
Antony is a medical reporter with a special interest in technology and pharmacy.
8th December 2021
One of the big policy debates for general practice next year will be the long-term plans for telehealth funding — one of the belated technology revolutions facing the specialty.
Aside from the funding, there’s still a heated debate on telehealth’s clinical utility and appropriateness.
As part of a special issue in BJGP Open, Australian researchers have taken a series of looks at the consults and how they differ from GPs’ face-to-face work.
They found that fewer telehealth consultations in NSW and Victoria between April and December 2020 ended with a script being printed (metaphorically speaking — presumably many were e-scripts) than in face-to-face consultations.
The difference was 33% compared with 39% of consults.
Almost every category of drug was prescribed less over telehealth.
The biggest gap was seen in anti-infective drugs (covering antibacterials, antivirals, antifungals and antiparasitics), which were two-thirds less likely to be prescribed over telehealth compared with face-to-face.
This was during the first wave of COVID-19 when both states had imposed various social restrictions.
They found patients were also less likely to receive a script for a new medicine over telehealth.
There was a more pronounced difference in pathology testing.
About 10% of face-to-face consults involved a pathology request, similar to pre-pandemic numbers, but only 5% of telehealth consults.
Among patients who had short-term follow-up consults (two with the same GP within 14 days), those followed-up via telehealth were more likely than those followed-up face-to-face to get a pathology request on the second consult.
The researchers, from Outcome Health, which produces the POLAR QI tool on which the numbers were based, said this suggested that when using telehealth, GPs were waiting to see if the condition was self-limiting before ordering blood tests.
“There may have been a reduction in ‘non-urgent’ or patient-requested tests, for example, driven by suggestions from complementary and alternative medicine providers … this may indicate a reduction in low-value care.”
……
More information:
More here:
https://www.ausdoc.com.au/opinion/how-do-telehealth-and-facetoface-consults-differ
It is also interesting that on-going telehealth funding is still not nailed down:
Telehealth items’ expiry date looming
By Leanne Akiki
9 December 2021
An announcement on the future of telehealth is expected in coming weeks before the current item numbers are set to expire on 31 December.
Medicare-funded telehealth has seen general practice through the pandemic, since its introduction in March 2020. But it’s looking more likely that the federal government’s preference will be to restrict access to patients who are enrolled at a practice.
At the Department of Health’s weekly briefing and Q&A today, First Assistant Secretary, Covid-19 Primary Care Response Dr Lucas de Toca said of the item numbers: “We understand it’s absolutely critical and the government will be making an announcement very, very soon.”
In response to questions, the DoH told TMR that an announcement on telehealth would be made before the expiry date of 31 December.
Asked whether the existing-relationship or 12-month rule would continue – despite the stretching pandemic making it less likely that patients had seen a GP face to face in the past year – the DoH did not answer directly, but cited the draft Primary Health 10 Year Plan.
Under this plan, which closed for community consultation on 9 November, Medicare-funded telehealth would only be available in the context of a voluntary enrolment model.
The DoH told TMR that “continued access to telehealth is being considered in the context of a voluntary patient enrolment model, which maintains the principle of telehealth being provided in the context of an existing clinical relationship between the patient and the general practice where appropriate”.
When approached for comment on the future of telehealth, the RACGP said only that they hoped to hear more in the 2021 Mid-Year Economic and Fiscal Outlook. This is usually announced the week before Christmas, but a date has yet to be set.
More here:
https://medicalrepublic.com.au/telehealth-items-expiry-date-looming/59497
It seems to me that with the evidence from the first article and the fact that use for the last 18 months has gone pretty well overall, with few major issues and reasonable patient and clinician satisfaction, that continuation is inevitable.
Just why the DOH festinates on such issues until the last moment continues to be beyond me!
David.
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