This popped up a few days ago.
EConsults? Show me the time and money
27 October 2023
Broad structural change is necessary if this model is ever to take off in Australia.
EConsults could increase access to specialist care and improve GP-physician relationships, if implemented well – but structural change is needed to allay concerns over remuneration and time allocation, say Australian specialists.
With a 13% rise in referrals from GPs to non-GP specialist over a decade (2006-07 to 2015-16) and 28% of patients waiting more than four weeks for non-GP specialist care, there is a growing need for easy access to timely specialist advice.
EConsults, in which GPs securely share case information with non-GP specialists for advice and support, rather than referring, have been successfully incorporated internationally as a means of asynchronous health provision.
But while the concept of an efficient platform for GP and non-GP specialist communication may appeal, concerns remain over implementation, according to a study recently published by the Australian Journal of Primary Health
The study investigated what 14 RACP fellows, across a range of specialties, genders and ages, thought of implementing eConsults, with a 72-hour turnaround time, in Australia.
According to the study, specialists generally felt this model would improve access to specialist advice and could be of “considerable benefit” for non-urgent consultations.
“RACP fellows agreed this could improve access to timely specialist advice, place downward pressure on outpatient face-to-face clinic waiting times and reduce unnecessary patient travel.”
The fellows interviewed felt that these asynchronous consultations might provide opportunity for ongoing GP education and reduce the need for future referrals or non-GP specialist advice.
But remuneration and time allocation were a recurring concern among study participants.
“It is clear from our work that Australian physicians require reassurance that they will not be pressured to add this work to existing consultation numbers and demand without support,” the researchers said.
“They also did not see the model as workable if it intruded into out-of-work time.”
According to the researchers, for primarily public health physicians the concerns centred around time constraints.
“Without dedicated time, participants were concerned that uptake would be low among their colleagues, and that the 72-h turnaround time would not be feasible, which in turn, would reduce the effectiveness of the model,” they said.
But for private physicians, concerns were around matching existing consulting rates to face-to-face consultation rates.
Ultimately, the RACP fellows felt broad structural change would be necessary to make the model viable across Australia.
“All participants viewed the success of a future eConsult model as contingent on the formal structures that would be required to underpin it.
“They were of the opinion that eConsults would represent a fundamental change to the primary–secondary care interface, and as such, would require a proper administrative and governance structure.”
The change would require incorporating suitable and safe technology, ensuring indemnity was addressed with providers and administrative support.
“All participants viewed a formal administrative structure as essential to the success of the eConsult model of care,” said the researchers.
“An informal or haphazard approach would result in low provider satisfactions and low uptake among both GPs and non-GP specialists.”
Speaking to The Medical Republic, dermatology specialist and associate professor at the University of Queensland Jim Muir discussed an educational and resourcing platform, Tele-Derm, that facilitates advice exchange between dermatology specialists and other doctors and is currently up and running in Australia.
Professor Muir is one of four moderators of the Tele-Derm service that is provided through ACRRM, alongside Dr Dan Kennedy, Dr Rachael Foster and Dr John Bingley.
The Tele-Derm online service offers free advice and education, contributing to CPD point, to all rural doctors, whether they are ACRRM members or not, and now has around 4000 doctors registered on the platform.
Tele-Derm combines hundreds of case studies, videos, how-tos with telemedicine platform to bolster specialist advice with educational support, allowing 80% of the cases received to be managed locally by GPs, said Professor Muir.
More here:
https://www.medicalrepublic.com.au/econsults-show-me-the-time-and-money/101370
Now I understand, what we have here is really just a new name for electronically enabled joint consultation!
It seems to me there are lots of circumstances where such a care model makes perfect sense and equally some where it my not be appropriate.
I reckon it is up to each clinician how they wish to proceed with remote consultation and to go from there. There are certainly a lot of consults where virtual – especially when video-enabled -consults are totally fine – and to have two doctors involved is hardly a stretch!
What do others think?
David.
Former Labor Party leader and Governor-General Bill Hayden has died, aged 90.
Prime Minister Anthony Albanese confirmed the news via social media on Saturday afternoon.
“Bill Hayden was a humble man but there was nothing modest about his ambition for Labor or Australia,” Mr Albanese said.
“He brought a quiet strength to the cause of progress and through his lifetime of service, he changed our party and our country for the better.
“May he rest in peace.”
Mr Hayden served as a minister in both the Gough Whitlam and Bob Hawke governments.
He served as Leader of the Opposition from 1977 to 1983, before being succeeded by Bob Hawke, who led the ALP to victory at the 1983 election.
During the Hawke government, he served as the Minister for Foreign Affairs.
He was also previously Treasurer during the Whitlam government for a brief five-month period in 1975.
He also served as Whitlam’s Minister for Social Security.
He was born in Brisbane in 1933 and joined the Queensland Police Force in 1953, during which time he joined the ALP.
In 1961, he was elected as the Member for Oxley, which he held until 1988.
He served as Leader of the Opposition, following the 1977 election loss and Whitlam’s retirement.
Following the 1987 election, he took up the post of Governor-General and held the role until 1996.
Mr Albanese said a state funeral would be held to honour Mr Hayden.
The Prime Minister describe him as being instrumental in the introduction of Medicare and an important figure in ALP and Australian history.
More here:
https://www.news.com.au/national/breaking-news/former-governor-general-bill-hayden-dies-aged-90/news-story/11c28e421486dad33e92863dff87118e
Wikipedia makes clear his central role:
“Medibank (1975–1976)
The Whitlam government, elected in 1972, sought to put an end to the three-tier system by extending healthcare coverage to the entire population.[22] Before the Labor Party came to office, Bill Hayden, the Minister for Social Security, took the main responsibility for developing the preliminary plans to establish a universal health scheme.
According to a speech to Parliament on 29 November 1973 by Mr Hayden, the purpose of Medibank was to establish the "most equitable and efficient means of providing health insurance coverage for all Australians."[23] “
See https://en.wikipedia.org/wiki/Medicare_(Australia)
I have to say it is not many of us who have made such a fundamental change for our fellow citizens. These sorts of changes are not common, and few have such a huge and lasting impact.
David.