GP Video consultations
Telehealth could considerably enhance access to GP services for specific patient groups and deliver productivity gains in general practice.
The delivery of health services to Indigenous populations in remote Australia is almost exclusively through remote health centres. Medical care is provided by specialised GPs who reside in urban centres such as Darwin or Alice Springs. These practitioners could enhance their face-to-face care of Indigenous populations with video consultations from urban centres to remote health centres.
The AMA has highlighted the problems with ongoing access to medical care for residents of aged care facilities for many years. Medicare rebates for GP video consultations to residents of aged care facilities will improve the efficiency of providing follow-up care by GPs, and ensure full use is made of the video consultation infrastructure in aged care.
Similarly, there are rural, remote and outer metropolitan patients who have difficulty attending general practices because of mobility problems or because of distance. GP video consultations to these patients will improve the efficiency of providing follow-up care by GPs.
The Personally Controlled Electronic Health Record (PECHR)
An e-health system that connects patient information across health care settings, and which can be accessed and contributed to by treating medical practitioners and other health practitioners, will improve the safety and quality of medical care in Australia.
The benefits of e-health in making the best use of existing health care services and avoiding errors, duplication and waste are well known.
To treating doctors, e-health means being able to access all of the clinically relevant medical information about a patient at the time of diagnosis or treatment.
The design of the PCEHR means that its use is limited for doctors in terms of their accessibility, content, accuracy, and the comprehensiveness of information.
Health care of the patient is best served when the doctor has access to the most basic information that is critical to patient care – pathology and diagnostic imaging results, hospital discharge summaries, and information on prescribed medications.
Doctors want to use the PCEHR to enhance clinical care. However, the PCEHR legislation and the participation requirements are complex and introduce new and significant obligations on medical practices.
There are substantial penalties for non compliance with the complex legal requirements.
Medicare rebates that cover GP video consultations for remote Indigenous Australians, aged care residents, people with mobility problems, and rural people who live some distance from GPs would considerably improve access to medical care for these groups.
A clinical advisory group that represents the views of practising clinicians should be established to oversee e-health policy and advise the Federal Government on the clinical functionality required immediately of the PCEHR, to increase its utility to clinicians now, and to improve its use over time.
The clinical advisory group would also advise the Systems Operator on the technical adjustments to be made to the system based on experience with its use in clinical practice.