NEED FOR PROFESSIONAL RESOURCES FOR EFFECTIVE TELEHEALTH CONSULTATION
"Ten thousand miles vanish with a single click."
On July 1, 2011, the long-awaited Telehealth MBS item numbers came into operation across Australia.
Due to its novelty, much interest has been shown by both patients and doctors but as yet, few published guides exist regarding its effective implementation.
Dr. Andrew Hua, consultant physician and geriatrician in Melbourne, Australia with a long-held interest in telemedicine, has conducted geriatric telehealth consultations with general practitioners who had clients with geriatric problems residing in nursing homes. Even with basic equipment such as notebook computers with built-in webcam, microphone and speakers, and wireless internet connection, they were able to conduct effective consultations and could identify movement disorders using a popular free videocall/phone software. However, sound quality was ocassionally choppy and it was important that each participant spoke clearly and in turn. Patients seemed to have no difficulty relating to the voice and image of the specialist and could respond to the specialist's questions as well as ask their own questions. Dr. Hua is currently compiling necessary resources such a consent form, protocol for referral, scheduling, sharing of patient data prior to the consultation, discussion outlines, problem prioritizing, goal setting, management planning and recording. Patient confidentiality is of utmost importance and use of internet resources such as the "cloud" need to meet security criteria.
"A Geriatric Assessment and Management Plan should be comprehensive and patient-focused, " Dr. Hua said; "and a well prepared structured telehealth consultation has a better chance of approximating a geriatrician's visit to the bedside." Infrastructural support, such as a Telehealth Information Exchange, and discussion forum between practitioners would greatly facilitate the introduction of the service to many nursing homes, and rural practices.
"I sincerely hope thatTelehealth will not be a gimmicky "flash in the pan" but develop into a useful mainstream professional tool for better care by bringing specialists closer to the patients and their primary health providers."
At the beginning of September 2011, a telehealth resources page will be added to the Gerimed.com.au website and a discussion forum for health professionals will be commenced.
"If the mountain cannot come to the prophet, he can access it on a webcam."