Building a sustainable service
Chair of the National Telehealth Leadership Group Ruth Large says the impact of the Covid-19 pandemic on interest in, and use of, telehealth has been huge. “I can’t open a medical journal or brief without seeing the word telehealth or virtual health in it, whereas previously we would have difficulty getting interest,” she says. A recent ASMS Telehealth Research Brief notes that whereas telehealth had previously been viewed largely as an optional or exceptional means of delivering health care services, one of the lasting consequences of the pandemic may be that telehealth consultations will become mainstream. But moving to virtual consultations involves “numerous and complex changes, for example, to routines for booking appointments, documenting consultations, and for arranging follow-ups,” it says. By giving clinicians and patients the opportunity to try telehealth and see that it can work, the pandemic has broken down a lot of barriers around clinician culture and change management. However, much work needs to be done to build a sustainable quality telehealth service that serves the needs of those who need it most, particularly the vulnerable. This includes the need for education and support for both clinicians and patients and reliable data collection. “First and foremost, we need to make sure that we upskill clinicians,
so they feel safe in order to be able to deliver good care,” Large says. Clinicians also need digital services such as electronic prescribing and ordering as well as modern booking systems that enable seamless booking of telehealth appointments. “Without those things, clinicians end up spending a lot more time on a consultation and then they lose the, ‘what’s in it for me?’ part,” explains Large. “Most clinicians are really happy to do the best thing for the patient, but if it’s taking them an hour to see one patient, then not only is it frustrating for them, it also means that other patients miss out. And that’s where we see their interest really dramatically drop off.” A report on the uptake of telehealth during lockdown at Manukau SuperClinic also identifies that the shift requires “major changes in roles, routines and processes” and “adjusting to these changes risks increasing clinician workloads, disincentivising the ongoing utilisation of telehealth”, the ASMS report says.
“First and foremost, we need to make sure that
we upskill clinicians.”
hinz .org.nz
TELEHEALTH OCTOBER 2020 : : 5
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