Telehealth to combat Australia’s growing demand for healthcare?

An article in IT Brief tackles the topic of how Australia is going to tackle the increased need for healthcare moving forward. According to a report in the Newcastle Herald Australian men are ranked in the top three countries worldwide in life expectancy, while women are in the top fourth. This is great news for Australians, and can cause sleepless nights for policy makers. The World Health Organization reports that currently Australia as of 2014 spends 9.4% of Gross Domestic Product on healthcare, that equates to approximately $4,357 per person. With the baby boomers expected to reach their senior age this figure is surely going to rise.

The IT Brief discussed several

items relating to IT and healthcare. One such discussion was over the My Health Record program by the federal government. I have previously discussed the My Health Record in another post. I believe it is a vital and important forward step in advancing the Australian healthcare system.

Another item discussed was the use of smartphone apps and other personal IT devices to aid in chronic disease management. This is a field that is sure to improve as our tech-savy population ages.

But the item discussed that interested me was that of individuals being able to visit with a doctor via an online medium. This was described in the article as a potential way for people to access medical care without needing to wait in a doctor’s office and would allow access in rural areas. In Australia we have a similar system in place in rural areas. However, looking to rely on this as a measure to markedly decrease the reliance on in-person healthcare is suspect.

While visual clues and interviews are important in assessing health concerns palpation, auscultation and the ability to have the patient in front of you make up much of both doctors’ and nurses’ assessments. Additionally, many presentations we see in hospital that have come from GPs requires further acute assessment not available in a doctor’s surgery: ultrasounds, CT scans, and urgent blood tests. These items would not be available to a patient sitting in their lounge room speaking with a doctor over the internet.

If there are chronic and stable conditions which only call for simple follow-up then online medical consultation would be fine. However, I wonder if that is not being done already? My concern is that moving forward the need for acute in-person healthcare will only increase. And with that increase will be the need for more acute beds in hospitals and more healthcare facilities to deal with demand.

Your thoughts?

References

IT Brief: Digital tech – the answer to Aussie healthcare’s biggest ailments?

Newcastle Herald: Australia about to lose top spot in this world health ranking

WHO: Australia

Coroner asks NSW health privacy rules be relaxed to fight terrorism

A report by SKY news has indicated that the Coroner Michael Burns in investigating the Lindt Cafe siege has found the Personal Information Protection Act and the Health Records Information act were too stringent and did not allow ASIO investigators to have information needed. Coroner Burns has asked the NSW government to review the privacy legislation through his findings. The Sydney Morning Herald, reporting on the findings stated that “Mr Barnes says the government should consider whether NSW Health should more readily share information so that “fixated lone actors”  can be identified and monitored earlier.

However, reviewing the coroner’s report the findings aren’t so clear. Monis did visit several General Practitioners (GPs) who referred him to psychiatrists. Monis did, on one occasion, see a psychiatrist (through a private practice) who diagnosed him with mild depression. He was also seen by the Cantebury mental health team over a period of 16 months. However, according to the coroner’s report Monis was felt to have a personality condtion and not a psychiatric disorder. Additionally, Monis was felt to have manipulated the system to present him as a person with mental instability for some reason.

While the report is obviously a summary of the information gained at the inquest I wonder what good the health information would be in assisting ASIO or any other agency in identifying and removing Monis from the streets prior to the Lindt cafe siege? He appeared to be using the system for his own gains. Monis saw at least 10 GPs within the community, all who I would presume to be in private practice; and therefore not within the confines of the NSW Health system regarding privacy and information sharing. I am wondering how ASIO would be able to know that Monis had seen so many private practitioners and that he failed to follow-up on psychiatric referrals?

I, like many of my countrymen and women, do not want to see terrorist attacks in Australia as occurred in the Lindt cafe siege and in other horrific attacks around the world. And I would be prepared to assist authorities if it was needed. But unless there could be a reasonable explanation as to what benefit would be gained from relaxing the two privacy legislative bills in regards to apprehending potential ‘lone actors’ and preventing terrorist attacks then I fail to see how this would provide benefit over cost to the general public?

NSW Health takes privacy very seriously, and that is a welcome position in my book as a healthcare practitioner and patient. While I am not completely opposed to relaxing privacy legislation I do think we owe it to the general public to have an open discussion regarding what we as that public would be prepared to give up in terms of our privacy for the safety of others. By relaxing privacy legislation, particularly in mental health situations, you risk potential patients staying away from treatment in order to protect their privacy.

Yes, it is a slippery slope. But I am willing to take that slide if there would be real benefit and recognized limits on who the information is shared with and how it will be used. The public has a right to be involved in any discussion.

Your thoughts?

References

Coroner’s report into the Lindt Cafe siege

Sky news report on the findings

Sydney Morning Herald: Lindt inquest: Mistakes cannot be papered over, coroner Michael Barnes finds