The current COVID-19 pandemic and it’s imposed restrictions is causing us to rapidly rethink conventional approaches to the provision of health care. One positive impact has been the escalation in the adoption of virtual care models, now supported by expanded access to MBS funding for GP and specialist telehealth consultations. Extending beyond the direct impact of COVID-19 there can be little doubt that virtual care models supported by information and communication technologies have much to offer in meeting the needs of the growing number of patients with chronic and complex conditions.  

Virtual care can be understood as a healthcare delivery approach that is directed towards driving continuous, connected and coordinated care using information and communication technologies. There have been many successful examples of impactful virtual care innovations that demonstrate its potential to improve patient outcomes, experience, efficiency and access. (Deloitte, 2019)

While there is a great deal of enthusiasm for digital health interventions (DHIs) at-scale adoption and uptake has proved to be far more difficult than many would have expected. The primary focus of digital health adoption in Australia has been on digitalising paper-based information systems and shifting to electronic medical (eMR) and health (eHR) records. The uptake of other DHIs – mobile health, connected devices, wearables and telehealth – has been at best sporadic, mainly limited to small scale, bespoke applications difficult to replicate at scale.

Organising virtual care around patients seems to be just plain common sense. It has the potential to improve access, reduce cost, improve patient outcomes and experience but to date we are lagging in its adoption. Social, organisational, structural, financial and cultural barriers operate to maintain siloed and disconnected care that more commonly serves the interests of clinicians and organisations than patients. Some of the reasons for the slow uptake in DHI appear to be related to the difficulty in achieving wholesale clinical engagement, the cost of implementation and the long lead time before ROI expectations can be realised.

There are digital and telehealth technologies currently available to support the delivery of safe, real-time, patient centric virtual care. But technology alone will not solve all the problems encountered along the virtual care adoption pathway. Practice will also have to change. How clinicians work together, how they participate as part of virtual care teams, how they communicate with each other within and across organisational firewalls will also have to be reimagined. Secure communication is fundamental to virtual care. Unless clinicians can communicate using synchronous and asynchronous channels it will be difficult to achieve the lofty goals promised by virtual care proponents. Organisations must change, practice must evolve to incorporate these new approaches and the focus of adoption must shift to collaborative rather than competitive models.

A KPMG poll of 120 health professionals identified four challenges to adoption of telehealth ²:

1. Too many other technological priorities (19%)
2. Maintaining a sustainable business model (18%)
3. Organisational readiness to implement new services (15%)
4. Regulatory compliance and risk concerns (15%)

All of these challenges impact on the adoption of virtual care models in Australia. Join our live discussion on August 26 where we will be discussing these findings.  Clinicians and health services are overwhelmed by the scale and pace of technological advancement. Financial and business models do not currently adequately support adoption of virtual care and organisations are struggling to keep up with current demand and service requirements. Standards and governance for virtual care, while they exist, have not been widely promulgated and risk is a bit of an unknown at this stage. Adoption and integration of virtual health care is not an endeavour that will be achieved by individual clinicians or organisations. By its very nature virtual care requires communication, collaboration and shared commitment to address these major challenges. Collaborative action will sharpen our focus, enable execution with impact and drive transformation so that we may become a learning health system.

Sources

1. Deloitte (2019) Virtual care by Deloitte. https://www2.deloitte.com/au/en/pages/life-sciences-and-healthcare/solutions/virtual-care.html Accessed 1103 on22 July 2020.
2. KPMG Cited in Beckers Review https://www.beckershospitalreview.com/healthcare-information-technology/5-drivers-4-challenges-to-adopting-virtual-care-services.html Accessed 1106 on 22 July 2020.