![](https://thelimbic.com/wordpress/wp-content/uploads/2020/03/Liam_Caffery_headshot-249x300.jpg)
Associate Professor Liam Caffery, Centre for Online Health, UQ
MBS items numbers have been made available for specialists to engage with COVID-19 vulnerable patients via videoconference or telephone consultations but most doctors have no experience of telehealth.
The limbic spoke to two people with telehealth expertise for their advice.
Associate Professor Liam Caffery, Telehealth Technology Director at the University of Queensland’s Centre for Online Health, said he hoped the emergency provisions would be a catalyst for advancing telehealth.
However the experience from previous releases of MBS item numbers for disaster response such as the bushfires had shown very poor uptake.
“Whilst it is a good move, and there are some doctors that are using telehealth and these item numbers will help with the COVID-19 response, there are a lot of doctors that haven’t used telehealth before and it’s not a case of just flicking a switch.”
“It can require a different skill and it is quite disruptive to actually get started.”
Associate Professor Caffery said doctors had to first assess which patients were amenable to telehealth
“If they require a physical examination, they may not be. The general rule of thumb is if they can do the consultation without getting up from their desk and walking around to the patient, it is amenable to telehealth.”
However doctors also needed to consider the patients’ level of self efficacy.
“It’s also challenging patients to self manage in a certain way. Say you were looking at a chronic disease patient with hypertension, you would need to decide if they were capable of going down to the chemist, buying a home blood pressure monitor and being able to take their own blood pressure.”
He said telehealth also challenges clinicians’ habits.
“It questions whether they do things because that’s the way they’ve always done it and challenges them to think of alternative ways to get information they need such as relying on a patients’ or families’ observations.”
He said telephone consultations were typically less disruptive yet the same reimbursement applied for both video and phone consults.
“So I would guess when we review in 6 or 12 months, that the majority of those item numbers will have been for telephone consultations as opposed to video.”
He said the advantage of using FaceTime and Skype was that people were familiar with the platforms however cloud based providers such as Zoom and Coviu were both of excellent quality.
“We won’t be monitoring what platform people are using during the COVID response. Privacy and security has, and rightly so, become secondary to the actual need to provide services.”
He said more important than the choice of platform was its optimisation.