Between May 14 and 24, 2020 a representative sample of 2,235 GPs and specialist practitioners completed the MABEL (Medicine in Australia: Balancing Employment and Life) COVID-19 Short Online Survey. This survey gauges a number of work and life factors for medical professionals, including finances, stress, support, how the pandemic has affected practice finances and the usage of telehealth.
The number of telehealth appointments conducted by GPs and non-GP specialists across Australia has risen greatly in 2020, thanks to the introduction of new MBS item numbers as well as incentives. According to the survey, 96% of GPs and 76% of non-GP specialists are utilising telehealth services.
What’s more, during April, 2020, 36% of all appointments across modalities were conducted via telehealth , a massive increase on the 1.3% conducted at a similar time the previous year. The majority of these healthcare services have been bulk billed.
While the usage of telehealth is high across the board, some areas and demographics appear to be less likely to use telehealth. Solo GP practices are less likely to use telehealth (78.5% versus 94.8%) and GPs in poor or rural areas are slightly less likely to utilise telehealth than those in affluent or urban areas.
Surprisingly, the vast majority of telehealth consultations are being carried out via the telephone, with 96.2% of GPs and 81.6% of specialist practitioners choosing to use voice only communication . There does not appear to be any defining factor for phone calls to have been chosen over other video consultations but it may be due to a number of individual factors.
The ease of use and commonality of phones, difficulties in getting older patients to utilise new technology, a reticence to learn new technologies or a lack of technological infrastructure may all be contributing factors to the embrace of phone calls. The fact that non-GP specialist practices appear to be more willing and able to embrace video telehealth may point towards both better technological infrastructure as well as an increased need to visually appraise patients.
Phone vs Video - What Aren’t You Seeing?
While a phone consult can offer an alternative to a face-to-face appointment, voice communication runs a distant second to video conferencing when it comes to utility, practicality and efficacy in diagnosing problems or offering treatment.
According to a study conducted by a team of researchers lead by Dr. Albert Mehrabian showed that when communicating emotion and nuance, the vast majority of communication was performed non-vocally.
The results came to be known as the 7% rule. When communicating emotionally, 7% is verbal, 38% is aural and 55% is visual. This rule may only strictly apply to emotional communication, but the amount of non-verbal communication in everyday interactions definitely plays a part in medical consultation. When you’re talking to a patient over the phone, what are you not seeing?
A patient may be crying but sound normal over a phone, or could be downplaying or misjudging the severity of a wound or illness. In essence, when using a telephone for telehealth, a practitioner is limiting the amount of information they can use to make a diagnosis or offer aid. When it comes to utility and efficacy, video telehealth is a superior option to phone calls .
Given the fact that a number of practices are having their telephone telehealth Medicare claims audited, there are a number of industry insiders who believe that phone calls may be limited in their usage for telehealth consults or potentially taken from the schedule outright. If and when this will happen remains to be seen, but video telehealth is a much more future proof technology when it comes to both usage and security/encryption standards.
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The Future of Telehealth in Australia
More than 80% of GPs and specialists that completed the MABEL survey believe that telehealth should be permanently funded by Medicare , an opinion echoed by the general public. It seems unlikely, given the mandated changes to the MBS items for telehealth, and the incremental changes that are still being made, that telehealth will be discontinued come September 30.
Female GPs and younger practitioners across all modalities were the most likely to agree that telehealth should be continued into the future , but those sentiments were echoed by the vast majority of other practitioners as well.
In addition to the rise of telehealth consultations, the COVID-19 pandemic has also seen a rise in the use of telemedicine solutions for remote patient monitoring. 5.3% of GPs and 5.4% of non-GP healthcare professionals reported the use of remote monitoring for some patients , including those with chronic diseases, due to the pandemic.
With no practical end to the pandemic in sight, it’s likely that the prevalence of telehealth appointments will continue to grow. Ensuring you have the infrastructure required to adapt to any potential changes in telehealth MBS items or restrictions ensures that your practice doesn’t miss out on bookings.
