Recently, a young man in his forties living in regional Queensland was diagnosed with not one, but two different types of cancer. This is quite rare. He travelled between his home town and the closest regional hospital for hours on each visit. Eventually, he had to relocate and stay with family close to the hospital. The diagnostic and treatment process went on for over three months. His specialists have been spread out throughout the state. There has been very little psychological support and co-ordination and tests have taken weeks and weeks. Weeks that are now very precious. He has had to drive hundreds of kilometres for care and hospitalisation. There have been trips down to Brisbane and many specialist visits. At the end of this three month diagnostic period they also found multiple brain tumours. We don’t know if the diagnostic process would have been quicker, his case managed more efficiently or his treatment would have been different had his medical support team and specialists been using telemedicine. But, we can certainly presume so.
Australia is a vast land of startling beaches, red deserts, scrappy bush and rainforests. Seventy-eight percent of the population is primarily clustered around the continent in cities. According to the Australian Bureau of Statistics (ABS) 32% or approximately 6.6 million* people live in rural and regional areas. These small segments of population peppered throughout the landscape are often without access to the same level of medical services and quality specialists as those that reside in the densely populated cities. There is a large and promising opportunity emerging in the form of telehealth and telemedicine that may address that gap. One that may change the whole experience and quality of care for patients all over Australia.
Globally, the telehealth market is estimated to be worth $2.2B in 2016*. The global CAGR is 24.2% and is expected to grow the category to $6.5B by 2020. The Australian and New Zealand CAGR for telemedicine is estimated to be at 43.5% by 2109*. Interestingly, Australia’s mobile health market is predicted to grow at a CAGR of 57.1% over the same time period. These figures highlight the opportunities for telehealth in Australia if we get it right.
The confidence in the growth of this industry is further evidenced by the strategic support for the industry from the government in the form of startup and research funding and the higher telehealth medicare payment for GPs and specialists. It’s also generated significant private investment from the business community, especially the insurance sector.
The Commonwealth Scientific and Industrial Research Organisation (CSIRO) has recently quantified a significant $3 billion saving to Australia’s health care system* through the adoption of telehealth devices and technology.
They conducted a telehealth trial involving videoconferencing and the use of devices that monitored cardio health, body weight and temperature and glucometry. Extrapolation of the data from the 287 patients involved in the study, has resulted in an estimated 24% saving to the healthcare system and 36% reduction in hospital visits.
The current primary beneficiaries of this style of care are those living remotely, the elderly and those with critical and or multiple conditions. Doctors and specialists can also gain valuable access to specialist information and potentially centralised information from all of a patient’s care givers. From a commercial perspective, opportunities also abound, in the convenience offered to the general populace. There is also a potentially large economic cost benefit from the reduction in potential hospitalisation through early detention via regular monitoring through the widespread adoption of telehealth tracking apps and devices .
Considerations for Telehealth Success in Australia.
The Australian medical system is complex due to the way it is funded and it’s geographical diversity. For telehealth apps and devices to be successful there are a number of considerations to be factored into any app or device development:
- Additional resources will be required to train patients and care givers in using the devices and wearables. Much of the telehealth and telemedicine equipment requires the application of devices and the use of technology that may not have been utilised before. To ensure accuracy in the measurement, reporting and effectiveness in communication, patients will need to receive initial training and support in usage. This will be particularly relevant for the ageing and those with mobility issues.
- Doctors’ willingness to take on this form of care. This is new and with all innovation there needs to be a preparedness to adopt a new way of operating.
- Access and integration of current and future electronic medical records are an issue from multiple platforms and the IoT. There are many current patient recording systems and platforms that are not able to feed into the My eHealth Record system as yet. The integration of data, reports and analytics from wearables and devices is fundamental across all sectors of medical care for telehealth to be successful.
- Currently, doctors and specialists only have access to a patient’s medical records if they elected to do so. Privacy is a considerable concern and roadblock when it comes to people’s willingness to give electronic access to their medical and health records.
- Diagnostic responsibility. Concerns have been raised about who has actual diagnostic responsibility with the advent of Telehealth. Some wearables and devices have diagnostic functions and general practitioners are now part of a team of specialist care givers. What happens when disagreements over care, diagnosis and medication arise?
- Currently, patients must live at least fifteen kilometers distance by road to the closest specialist to be able to claim a medicare rebate for telehealth care*. This then rules out those at home residents who are too ill to make the visit to the doctor on a particular day or those who wish to use the system purely for convenience.
There is little doubt that telehealth will make a valuable contribution to Australia’s medical system and economic environment. Patients will have more ownership of their own medical data and a lot more responsibility over their care. The challenges for real take up and success are the functionality of the technology to upload, interpret and integrate a patient’s medical records from a number of sources and people’s willingness to adopt new methods of healthcare both patients and specialists alike. Yet, the future is promising and if even one patient’s chances for effective treatment are improved because of it, it will be well worth it.