Digital technologies are playing an increasingly key role in all aspects of healthcare. Perhaps one of the most important functions of such technologies is one we typically associate with ‘offline’ life: that of connection.
Patients can connect with healthcare providers and healthcare providers to each other, allowing for better coordination of care for people with chronic and complex conditions, and ultimately, better-informed treatment decisions.
The disruptions of the COVID pandemic and severe flooding in much of Australia highlighted the importance of such technologies and the willingness of Australians to participate.
Between 13 March 2020 and 27 March 2022, 101.8 million telehealth services were delivered to 17.1 million patients.1
As the pandemic fades from the spotlight, reliance on telehealth is changing, but it’s no less valuable.
Telehealth today
According to Queensland pharmacist and Head of eSolutions at GuildLink, Aaron D’Souza, while the ‘heat’ on telehealth services has died down as people have returned to being able to physically access healthcare providers, a shift in mindset has occurred around certain aspects of the medical system.
“People like telehealth,” he said. “They enjoy the convenience of it. And so, while there’s no existential risk driving the use of it as there potentially was during the pandemic, we now see that people are finding it’s a more convenient way to get the not-so-life-and-death stuff sorted out – so, being able to get a script filled or being able to get minor ailments catered for through telehealth.”
The adoption of telehealth services by health practitioners has also significantly altered. Australian Digital Health Agency Chief Clinical Adviser Dr Steve Hambleton says more than 95,000 practitioners have used telehealth services since the start of the pandemic.
“That’s an extraordinary number – the vast majority of providers,” he said, adding participation was occurring in both rural and urban areas. “Only a couple of years ago, very, very few people used telehealth. They were mostly psychiatrists. Telephone calls between doctors and patients occurred but they certainly weren’t funded by the Medicare system.”
Dr Hambleton strongly believes that safe, secure data sharing with the patient and with all those who treat them will result in a better experience of healthcare for the patient and the clinician – leading to better outcomes for the population at a sustainable price.
“Telehealth is going to be part of the future of how we do business in healthcare,” he said. “It’s been pretty much underutilised in Australia and experienced a surge during the pandemic, but it really will form a very important place in how we do business in medicine.”
Telehealth, he adds, is much broader than telephone health, including such elements as non-real-time care, which involves text messaging or secure email, audio images and video.
“Video is a much richer form of communication, where you can get a lot more information about the person, their background, their safety and security,” Dr Hambleton said. “Video calls can probably replace face-to-face calls in many, many situations, unlike telephone care, which can replace it in only a few of those situations.”
Supporting connections
Dr Hambleton says a well-managed and supported service will help connect pharmacies, patients and GPs, streamlining the patient experience. But that’s not to say established systems should be replaced entirely.
“I think it’s very important that we understand how this fits into our clinical activity,” he said. “In many cases, pharmacists find a need to contact GPs to ask questions or get clarification about a prescription. Sometimes that needs an urgent phone call and hopefully, the pharmacist picks up the phone, we take the call and provide that clarification.
“But sometimes a non-real-time confirmation will be fine. We should be able to use broader telehealth for that non-real-time communication. Pharmacists should be able to send a secure message to a GP and get a response about a query about medication. And pharmacists may need clarification on the medical problems that the patient has, including liver or kidney disease, just to make sure the medication is appropriate for that person and [both pharmacist and GP] are using our expertise appropriately.
“Telehealth should be part of the future, it should be easy to do, and it should be built into our clinical information systems, so it’s seamless,” Dr Hambleton said. “There are many ways of communicating with our patients and with each other to make sure the patient gets a better outcome.”
Other benefits
While telehealth is an emergent part of pharmacy practice, anecdotal reports suggest it’s a popular service among both patients and pharmacists, says Mr D’Souza.
“The early reports are that it’s exceptionally popular with those patients using it – the highest satisfaction levels,” he said. “Telehealth helps them to appropriately manage their health, which is being failed by the current access to GPs.
“In terms of the opportunity for pharmacy, our analysis shows that there’s a great opportunity for community pharmacies, not only to make a new revenue stream but, more importantly, to reduce inefficiencies in the pharmacy, which, of course, retains profit within the business.”
Mr D’Souza says community pharmacy is facing employment supply challenges. He emphasises the importance of staff “not doing work that doesn’t matter”.
He points to “waste-of-time conversations which have little value to community pharmacies and drain us of our resources”, giving the examples of ‘I’ll help you get a script’ or ‘these are the local doctors, I’ll see if I can call to get an appointment for you’.
“Enabling patients to self-serve – directing them to telehealth on your website – is a simple call to action that can help significantly with reducing load on staff who are already overburdened and overworked,” Mr D’Souza said.
Supporting telehealth
Dr Hambleton says the government has “done a great job” of supporting telehealth.
“The rapid increase in the number of calls that were made very quickly early in the pandemic was wonderful,” he said. “Combined with things like electronic prescriptions and the ability to request pathology and diagnostic imaging remotely, it was extraordinary.”
Looking ahead, however, “further support is needed from IT providers to actually make it easier to use video health,” he added.
“We need to think about the use of secure messaging for non-real-time care and communication between doctor and patient, between doctor and pharmacist and between pharmacist and patient, where it makes sense.”
On the pharmacy front, Mr D’Souza says GuildDigital is working with partners to build telehealth capabilities in community pharmacies.
“It’s very early days in terms of us offering this,” he said. “We hope that over the next couple of years, we’ll see that grow significantly, as the network adapts, and, I think more importantly, community pharmacies realise that they can play a significant role in helping patients access digital health services.”
Mr D’Souza says the team aims to empower pharmacies with guidance on how to run telehealth services and how to promote this in their area without disrupting their existing relationships with GP clinics.
“That’s an important sensitivity,” he said. “The last thing you want to do is have a medical centre next door becoming upset because the pharmacy is helping patients access simple script services online from telehealth doctors.
“What we’re aiming to do from a GuildDigital perspective is to help pharmacies navigate that, and provide them with the information and the approach to make sure it’s not a competitive problem for their local GPs, who they need.
“Pharmacies do need to be careful as they open these doors to patients. At the same time, they certainly don’t want it to decrease quality of health in a local area because the patient can’t access a GP. It’s about getting that balance right.”
Reference
This feature was originally published in the November issue of Retail Pharmacy magazine.
