The ADHA Are Certainly Not The Only Ones That Get Carried Away With Digital Health Press Releases.

This excitable and exaggerated release appeared last week.

RMIT Online and Digital Health CRC collaborate to revolutionise healthcare

Published: 22 July 2020

Guest post by Staff Writers

With technological advances disrupting and transforming health systems across the world, RMIT Online and the Digital Health Cooperative Research Centre (CRC) will deliver a suite of groundbreaking courses in digitally-enabled healthcare to enhance industry-led innovation and ensure Australia continues to be a global leader in delivery of best practice care.

As increased demand and the COVID-19 pandemic put health systems worldwide under pressure, the need to adopt technologies that deliver better patient care and curb health costs has become critical.

Wearable sensors to monitor chronic conditions, Artificial Intelligence (AI) assistance in detecting cancer earlier, and algorithms that assess the risk of diabetes are among the advancements that can be enabled by digital health technologies. They also allow patients to be treated closer to home, with a greater range of telehealth services and the capacity to perform treatments like dialysis in-home.

The three courses to be delivered under this project address the in-demand skills required to respond to the fast-moving pace of technology in healthcare and to ensure Australia’s hospitals and its health workforce can continue to deliver high quality care in new and improved ways. 

Trials in digitally-enabled healthcare have found significant scope for digital health practices to both improve patient outcomes and lessen loads on service providers. A CSIRO trial of telehealth monitoring for patients with chronic conditions showed a 53 percent reduction in the number of hospital admissions and a 40 percent reduction in mortality, with the Australian Digital Health Agency identifying the need to embed digital practices in healthcare workforce training as crucial.

Healthcare leaders from across Australia will embrace the opportunity to increase their capacity to shape the future of healthcare delivery.

Each course will be a blend of learning and coaching by industry mentors, delivered online and take just six weeks to complete – allowing participants to make an immediate impact in their own workplace and more broadly. 

Other partners involved in the development of the courses are Queensland Health, Australia’s largest ehealth company Telstra Health, youth cancer organisation Canteen and RMIT’s Health Transformation Lab.

RMIT Online CEO Helen Souness said the courses represent a vital step forward in the delivery of healthcare training that will enhance patient care and unlock transformative capabilities in the growing sector. 

“The healthcare sector employs more than one in 10 working Australians and is going to continue to grow, with another quarter of a million jobs being created between now and 2024. 

“Currently skills gaps in key areas like digital health, change management and remote patient care are holding us back. These skills are critical to enable innovation and transformation in the healthcare sector, so we need to address all three at once. 

“We have designed our courses with the understanding that people, not technology, are at the core of effective healthcare and that new technologies can improve outcomes and equity in access to care.”

Digital Health CRC will be the first CRC to combine forces with one of Australia’s leading technical universities to create industry-relevant micro-credentials.

“The pace of technological change is unrelenting, which means we need learning formats that enable healthcare professionals to adopt and adapt quickly,” Digital Health Education Manager, Dr Melanie Haines explained. “Micro-credentials are the perfect answer and we are pleased to not only be partnering with RMIT Online in the delivery of these courses, but to be sponsoring 70 places.

“These courses will equip Australia’s healthcare professionals and organisations with the capability to integrate technologies such as apps, wearables, internet-enabled devices, virtual/augmented reality, AI and data analytics to improve delivery of patient care. 

“We hope following the success of this trial, we can expand opportunities for healthcare professionals to obtain digital health micro-credentials in the future.”

Queensland Health Acting Deputy Director-General and Chief Clinical Information Officer Professor Keith McNeil said it is imperative for industry to work with education to quickly upskill health workers in critical innovations happening across the sector.

“In this environment, harnessing the capability for innovation to enhance patient care, transform health delivery and preserve healthcare capacity while creating better health and wellbeing outcomes is essential.  Queensland Health is pleased to partner with RMIT Online and DHCRC to be supporting the healthcare workforce of today and into the future.”

The courses will be fully credentialed by RMIT University. Find out more about RMIT Online at online.rmit.edu.au

Here is the link:

https://www.whatech.com/medical-technology/news/660679-rmit-online-and-digital-health-crc-collaborate-to-revolutionise-healthcare

Aren’t we lucky to read such hype! If you believe what is said here 3 six week courses are enough to ‘revolutionise’ health care and benefits of such scale will flow that we will all be amazed!

If any of it were actually credible the changes would have long since been funded up to kazoo to harvest such glittering benefit. I wonder why it hasn’t? A tiny bit of exaggeration and a less than totally credible research are two possible reasons.

I suspect many who have invested a great deal more into their Digital Health education would be startled to find out how easy and quick it is to make such huge headway.

David.

The Telehealth Arena Is Getting a Little Contentious. Here Are Some Perspectives.

First we have this pretty in-depth article from AMA Insight.

Telehealth: latest changes may exclude some patients in need

Authored by Andrew Baird

Issue 28 / 20 July 2020

CHANGES to eligibility for Medicare benefits for GP telehealth and phone services will solve one problem but potentially disadvantage many patients as a result.

In May 2020, the most recent month for which data are available, 67% of Medicare services at levels B, C and D were provided face-to-face, 32% were by phone, and 1% were by video.

As of today, Monday 20 July, eligibility for Medicare benefits for the temporary Medicare Benefits Schedule (MBS) coronavirus disease 2019 (COVID-19) telehealth (video) services and phone services will be contingent on a patient having an existing and continuing relationship with the GP who provides the service. This relationship is defined as the patient having had at least one face-to-face in-person consultation in the previous 12 months with the GP, or with another GP at the GP’s practice.

There are four exemptions to the requirement for an existing and continuing relationship with the GP providing the service:

1. homeless people;
2. children under the age of 12 months;
3. patients referred to a GP by a non-GP specialist; and
4. people living under Stage 3 restrictions in Victoria (it is implied that this would also apply in the event that Stage 4 restrictions are imposed).

The temporary COVID-19 telehealth service and phone service item numbers will still expire on 30 September.

The Minister for Health stated that the aim of the change is to “support longitudinal, person-centred primary health care, [which is] associated with better health outcomes”.

The change was introduced on the recommendations of the Australian Medical Assocation (AMA) and the Royal Australian College of GPs (RACGP). In their media releases on 10 July, the AMA and the RACGP have welcomed the changes. It is not known if the Australian College of Rural and Remote Medicine (ACRRM) was involved in the recommendations to the government.

I believe that patients will be disadvantaged by these changes because telehealth services and phone services will not be eligible for Medicare benefits in the following situations:

• Very vulnerable patients who require consultation with a GP by telehealth or phone who have not had a face-to-face consultation in the previous 12 months. For example:
• patients who attend headspace;
• students who access general practice through the Doctors in Secondary Schools program in Victoria and through similar youth health programs in other states and territories;
• patients who attend sexual and reproductive health clinics.
• Patients whose consultation with the GP, or at the GP’s practice, in the previous 12 months, was by telehealth or phone service due to the COVID-19 pandemic.
• A GP’s or practice’s regular patients who have not attended a face-to-face consultation in the previous 12 months.
• New patients who have difficulty attending a face-to-face consultation, or who prefer a telehealth consultation to a face-to-face consultation.
• Patients living in regional, rural and remote areas who have not had a face-to-face consultation with the GP, or at the GP’s practice, in the previous 12 months, and who would have to travel a long distance to access GP care.
• Indigenous people who have not attended the same GP or the same practice or health service in the previous 12 months; Indigenous people who have attended different GPs (eg, locum GPs, and fly in-fly out GPs) and different practices or health services, in the previous 12 months.
• Patients who attend new practices that have not yet built up a patient base or practice population.
• Patients who attend GPs who do not do face-to-face consultations during the pandemic for personal health reasons (for example, GPs who are immunocompromised and GPs who have respiratory disorders).
• Patients with mental disorders who have been receiving GP mental health care by video or phone may no longer be able to access this through Medicare – unless they have attended the GP or the GP’s practice for a face-to-face service, in the previous 12 months.
• Patients who develop mental disorders needing initial treatment on or after 20 July will be unable to access Medicare benefits for GP mental health care by video or by phone without a face-to-face service with the GP, or with another GP at the GP’s practice, in the previous 12 months.
• GPs who provide Focused Psychological Strategies will only be able to provide mental health care by video (MBS items 91818 and 91819) or by phone (MBS items 91842 and 91843) for patients whom they have seen face-to-face in the past 12 months, and for patients who have attended other GPs in the GP’s clinic for a face-to-face service in the past 12 months. Medicare benefits will not apply for video or phone consultations for new patients who have been referred to the GP from outside of the GP’s practice.

In the AMA media release, AMA President, Dr Tony Bartone, stated:

“The great majority of GP telehealth consultations to date have been in circumstances where a patient has an existing relationship with a GP, but we have seen the increasing and disturbing emergence of ‘pop-up’ telehealth models and models that are linked to pharmacies.

“Both the pop-up and pharmacy telehealth models are also unable to facilitate access to a face-to-face consultation when a patient needs one. [These] changes will put an end to these inappropriate models of care.

“[The changes preserve] the foundation of quality primary care – the very real benefit of patients having a regular ongoing relationship with their GP … This is the patient-centred approach that we know works so well in Australia.

Lots more here:

“The AMA wants to see telehealth for GPs and non-GP specialists continue beyond [the expiry of the Medicare telehealth items at the end of September].

“Telehealth is key to continuity of care and quality of care.”

https://insightplus.mja.com.au/2020/28/telehealth-latest-changes-may-exclude-some-patients-in-need/

Also we have:

MBS telehealth reform extended to medical deputising services

Patients will be able to access bulk-billed telehealth consultations through approved medical deputising services, but under tight restrictions.

Medical deputising services will now have access to the MBS telehealth items, as an extension of a patient’s regular practice.

Anastasia Tsirtsakis

20 Jul 2020

Approved medical deputising services (AMDSs) will only have access to the COVID-19 telehealth items under the Medicare Benefits Schedule (MBS) if they have a formal agreement in place with a general practice to provide services to its patients.
 
And patients will only be eligible to obtain a service through an AMDS if the practice has provided, or arranged, at least one service for the patient in the past 12 months.
 
The AMDS will be providing services for and on behalf of the patient’s usual general practice.
 
The new requirements are part of the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone GP Attendances) Amendment, in effect from today, 20 July, with the intention of ensuring greater continuity of care during the COVID-19 pandemic.
 
Dr Nathan Pinskier, member of the RACGP Expert Committee – Practice Technology and Management (REC–PTM) and President of the General Practice Deputising Association (GPDA), welcomed the reform as a great move for patients and the profession.
 
‘The inclusion of medical deputising as the extension of the practice for and on behalf of the regular practitioner is an appropriate move,’ he told newsGP.
 
‘Otherwise doctors and practices will be having to provide their own after-hours.
 
‘It would also be creating a risk for deputising doctors whereby they couldn’t do telehealth services. We [would] then have to go and see the patient face-to-face where it may not always be necessary, and that creates a potential infection control risk as well.
 
‘I want to actually thank the RACGP for its strong advocacy in ensuring that medical deputising was included in the ongoing MBS telehealth item numbers. It’s a great outcome for the industry.’
More here:

https://www1.racgp.org.au/newsgp/professional/mbs-telehealth-reform-extended-to-medical-deputisi

There are also some views here:

Telehealth roll-backs are short-sighted and dangerous

By Dr Catriona Melville

July 21, 2020 — 4.34pm

COVID-19 has tested the world’s healthcare systems. Movement restrictions and second wave infections have forced healthcare providers to innovate to deliver medical services to patients. Telehealth is one innovation that healthcare providers globally have expanded to provide timely services to patients during the pandemic.

At the start of the pandemic the Australian government acted swiftly to broaden the Medicare Benefits Schedule, or MBS, to support expanded telehealth services. This included broadening the criteria for access to the MBS item numbers for telehealth consultations by GPs and other health professionals to new patients. This has meant that patients have had more choice in the doctors they can consult via telehealth for services that are not provided by their regular GP. This includes the medical termination of pregnancy, STI testing and treatment including HIV prevention services.

On Monday, the criteria for MBS support of telehealth during this pandemic was wound back so that patients can only access telehealth services under the scheme if they are a regular patient of a GP or practice and have been an active patient within the last 12 months.

The premise of this rollback is that the MBS changes under COVID-19 have led to a proliferation of what the college of general practitioners classifies as "low-value" pop-up telehealth services, mostly aligned to pharmacies. Unfortunately, the change will significantly impact the provision of established, reputable telehealth services to patients who are unable to access specialised healthcare through their regular GPs, ultimately disadvantaging patients, limiting the provision of timely services and placing additional strain on health providers.

Take for instance medical abortion via telehealth. Abortion is classified as an Essential Category 1 service across the country. It is a service that many people may not be able to access through their regular GP, may not want to access through their regular GP for fear of rejection or conscientious objection, or may not feel comfortable accessing through their regular GP. During COVID-19, the demand via telehealth for medical abortion, which is the use of medication to end a pregnancy, has grown as restrictions limit people accessing clinics, particularly in regional areas. In the past three months Marie Stopes alone has seen a 140 per cent increase in the use of medical abortion through telehealth.

More here:

https://www.smh.com.au/national/telehealth-roll-backs-are-short-sighted-and-dangerous-20200721-p55e21.html

What seems to be going on here is that availability of a benefit for telehealth was made available in a rush by the Government and a few smarties decided to play fast and loose with harvesting payments.

This led to a clamp down on the rules which may have gone too far and now we are gradually homing in on a sensible policy which works to address the need and the new found adoption of the “technology’ while not setting up a free for all!

In less difficult times this may have all happened in advance rather than reactively!

David.

Interesting To See What Research Into Medical Technology Is Being Funded By Commonwealth Government Grant

This release appeared last week:

$18.8 million to supercharge digital health technologies

The Australian Government is investing $18.8 million to supercharge the discovery of better treatments for cancer, epilepsy, stroke, paralysis, Irritable Bowel Syndrome, brain injuries, back pain and chronic middle ear disease.

The Hon Greg Hunt MP
Minister for Health

Date published: 20 July 2020

The Morrison Government is investing $18.8 million to supercharge the discovery of better treatments for cancer, epilepsy, stroke, paralysis, Irritable Bowel Syndrome, brain injuries, back pain and chronic middle ear disease.

Under round three of our Government’s $45 million BioMedTech Horizons (BMTH) program, 21 very promising projects will receive funding to help unlock some of the key health challenges of our times.

Successful applicants will use the funding to develop medical devices–including wearable devices–telehealth and telemedicine, and digitally-enabled personalised medicine.

Our Government is supporting Australia’s world-class biomedical and medical technology sector for the benefit of all Australians, while creating new jobs, growing expertise and building sustainable export markets.

Victoria-based Seer will receive $1 million to develop a real-time seizure forecasting system, through mobile and wearable monitoring, to empower people with epilepsy to regain control of their condition.

This project has great potential to save lives and improve lives of people with epilepsy and their families.

Other projects include a 3D bioprinting system for regenerating skin and developing a smart brain biopsy needle for faster, safer neurosurgery.

The Morrison Government provides funding for the BioMedTech Horizons program through its $20 billion Medical Research Future Fund (MRFF), while industry is backing these projects by matching contributions to the tune of $21.3 million.

The MRFF is a key pillar of Australia’s long term national health plan to build the world’s best health system.

MTPConnect, a not-for-profit organisation driving innovation, productivity and competitiveness in the medical technologies, biotechnologies and pharmaceuticals sector, delivers BioMedTech Horizons on behalf of the Australian Government. 

Further information is available on the MRFF website.

Round three — BioMedTech Horizons program

Project	Recipient	Funding
Digitally enabled skullcaps to monitor brain swelling in craniectomy patients to optimise timing of skull reconstruction surgery.	Anatomics Pty Ltd, Victoria	$997,920
A nano-optimised surface to prevent orthopaedic implant and dental infections.	Anisop Holdings Pty Ltd, New South Wales	$1,000,000
Artificial intelligence-based clinical decision support software for guiding acute stroke therapy.	Apollo Medical Imaging Technology Pty Ltd, Victoria	$346,500
Automated methods for evaluating cardiac CT angiography and high-risk imaging biomarkers	Artrya Pty Ltd, Western Australia	$987,428
Application of Atmo ingestible gas sensing capsule to diagnose Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO).	Atmo Biosciences Pty Ltd, Victoria	$620,000
Development of an implantable vision system in the Bionic Eye Generation 3 device to restore functional vision for blind patients.	Bionic Vision Technologies Pty Ltd, Victoria	$1,000,000
High resolution cortical recording for the prediction and prevention of epileptic seizures.	Carbon Cybernetics, Victoria	$1,000,000
ClearDrum® which is an acoustically-optimised silk fibroin membrane for the treatment of chronic middle ear disease.	Ear Science Institute Australia, Western Australia	$993,500
Improving colorectal cancer outcomes with hybrid cancer tracers.	Ferronova Pty Ltd, South Australia	$826,000
Development of miniature, low-energy wireless power and data transmission systems for implantable medical devices.	Hemideina, Victoria	$660,520
Developing a 3D bioprinting system for intraoperative skin regeneration.	Inventia Life Science Pty Ltd, New South Wales	$1,000,000
Augmented digital re-construction and re-visualisation of spine MRI for the personalised diagnosis of back pain.	Merunova Pty Ltd, New South Wales	$977,000
A smart brain biopsy needle for faster, safer neurosurgery.	Miniprobes Pty Ltd, South Australia	$1,000,000
Commercialisation of hand and arm wearable for use with Neuromersiv Virtual Reality rehabilitation system.	Neuromersiv Pty Ltd, New South Wales	$994,000
Advancing commercialisation of its PulseVAD pulsatile rotary blood pump designed to treat patients suffering from a form of Congestive Heart Failure (CHF) for which there is no effective treatment.	Northern Research Pty Ltd, New South Wales	$1,000,000
Compact wireless technology for improved accuracy during breast conserving surgery.	OncoRes Medical Pty Ltd, Western Australia	$1,000,000
Use of non-invasive confocal endomicroscopy system to enhance oral cancer screening and surgical margin assessment.	Optiscan Pty Ltd, Victoria	$971,000
Personalised epilepsy treatment via mobile and wearable monitoring.	Seer, Victoria	$1,000,000
Stentrode; enabling people with paralysis to restore functional independence (email communication, text messaging and online shopping) by controlling apps and external devices through thought alone, and without requiring open brain surgery.	Synchron Australia Pty Ltd, Victoria	$990,000
Development of a transcatheter blood pump system for Cardiogenic Shock and Hemodynamically Compromised patients.	VenstraMedical Pty Ltd, New South Wales	$850,000
Establishing domestic capabilities for combined R&D and manufacture of point-of-care diagnostics.	Zip Diagnostics, Victoria	$600,000

*Funding amounts are subject to contract negotiation.

Here is the link to the release:

https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/188-million-to-supercharge-digital-health-technologies

ZDNet covered the announcement as well.

Australian government fronts up $19 million for digital health tech development

Elsewhere, RMIT Online and the Digital Health Cooperative Research Centre have announced a suite of digital health short courses.

By Aimee Chanthadavong | July 20, 2020 -- 02:44 GMT (12:44 AEST) | Topic: Innovation

The federal government has announced it will be handing over a total of AU$18.8 million to fund the development of 21 new biomedical and medical technology projects.

The funding is part of round three of the government's AU$45 million BioMedTech Horizons program, an initiative designed to support the development of health technologies.

"Successful applicants will use the funding to develop medical devices -- including wearable devices -- telehealth and telemedicine, and digitally-enabled personalised medicine," Minister for Health Greg Hunt said.

"Our government is supporting Australia's world-class biomedical and medical technology sector for the benefit of all Australians, while creating new jobs, growing expertise and building sustainable export markets."

Projects that will receive the funding include Victoria-based Seer to develop a personalised epilepsy mobile and wearable monitoring device, New South Wales-based Inventia Life Science, which is developing a 3D bioprinting system for skin regeneration, and South Australia's Miniprobes for developing a smart biopsy needle for faster, safer neurosurgery. Each of these projects will receive AU$1 million from the handout.

Other technology projects are focused on treatments for cancer, stroke, paralysis, irritable bowel syndrome, brain injuries, back pain, and chronic middle ear disease.  

More here:

https://www.zdnet.com/article/australian-government-fronts-up-19-million-for-digital-health-tech-development/

Seems to me it is worthwhile to be seeding these projects with a little funding to see if they really can make a difference! It is but a very tiny part of the overall Health Budget.

David.