WA News Letters Telehealth for rural patients
Telehealth for rural patients
Written by Dr Toby Pearn
Wednesday, 07 June 2017

 

Dear Editor,

More specialists are doing Telehealth but it remains a slow uptake. For example, there is still not a single dermatologist that I am aware of in WA who does Telehealth consults, which is crazy given it is a speciality well suited, especially if high quality photos can be emailed.

Neurology is another specialty where Telehealth would be so useful, to aid tinkering with anti-epileptic or Parkinson’s medications.

Rural patients are well known to have significantly higher morbidity and earlier mortality across all diseases. I believe more needs to be done to address this imbalance such as positive discrimination for rural patients to access specialist clinics using Telehealth.

There should be mandatory Telehealth capability for all genres of public clinics for rural patients. The Central Referral Service should instigate this, and not be the barrier to care for rural patients that it has become. Private specialists need to have either carrot, stick, or both to get them to provide the service.

However, there are glimpses of the future. For example, Perth Cardiovascular Institute should be congratulated for making steps towards the “Telehealth Dream”.

Their system works like this: Bob comes to see me in Esperance with a complex medical history and a new cardiac problem. He doesn't need urgent hospital admission and I can organise initial investigation and treatment but I need specialist input. With Bob still with me in the consulting room, I can go online to Perth Cardiovascular Institute’s website, and click on Telehealth Appointments, find the next available, cross check it with my timetable, and book it for Bob there and then.

Bob can then go off and get his investigations done and commence treatment. My practice nurse chases him up and ensures he is in front of our practice computer with all the technology working prior to the appointment time and Perth Cardiovascular Institute admin set it all up at their end.

Then at the appointment time, I walk in and join the Telehealth consult, as does the cardiologist and we set about fine tuning the management plan. Perth Cardiovascular use the Blue Jeans App, which is similar to Skype but allows things like screen share, which means I can open up Bob’s ECG on my computer and the cardiologist can view it instantly during the Telehealth consult. I charge my patient the Medicare fee plus a gap, as does the cardiologist.

Bob gets timely specialist care and avoids an expensive hospital admission, does not have a 1400km round trip to Perth, and the cardiologist and myself are remunerated for our efforts. A great service like this will get lots of referrals from rural GPs.

Dr Toby Pearn, GP, Esperance