Australian Medical Association calls for telehealth permanency
The Australian Medical Association (AMA) has thrown its support behind making e-prescriptions and telehealth a lasting feature of Australia’s health system, even once COVID-19 restrictions are eased.
The 2018-19 Budget funded a national electronic prescribing system with an aim to improve Pharmaceutical Benefits Scheme efficiency, compliance, drug safety and data collection, and to enable a more efficient and user-friendly system for patients and prescribers.
That work was sped up in response to the COVID-19 pandemic. Telehealth services were made available to all Australians in March and a fast-tracked e-prescriptions solution has also been pushed out.
“While the benefits of telehealth extend beyond mere cost savings, the permanent adoption of telehealth will reduce costs across the health system while improving patient outcomes,” the AMA said in response to questions from the Senate Select Committee on Financial Technology taken on notice.
The AMA’s response listed several factors contributing to financial savings by moving to digital health initiatives, such as travel costs. Other factors were societal expense for the patient, such as time off work to attend outpatient clinics.
“Travel costs, including fuel, meals, and potentially accommodation increase with patient rurality, and can present a barrier to accessing care,” AMA wrote.
“Telehealth can also reduce the cost of providing health care when considering the costs associated with health professionals needing to travel for home visits, and the cost to the government for rural aeromedical evacuation and health care in institutions like correctional facilities.”
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While many of the savings described by the AMA are associated with the cost of rurality, it said research has suggested that the use of telehealth for metropolitan patients may achieve cost savings through economies of scale.
“The lack of uptake in telehealth services by metropolitan-based doctors (until COVID-19) is influenced by a lack of reimbursement for these services,” it wrote. “Overall, larger investment into telehealth under Medicare and more flexible arrangements around their use will likely result in long-term savings to the health care system.”
It said telehealth has also been shown to improve physician productivity using an online case management system for triaging patients by geriatricians.
The AMA also discussed the problematic paper-based prescription model, saying the ongoing use of paper scripts does not make sense for many patients when there’s a digital e-prescribing alternative.
“Paper prescriptions interrupt a mostly digital workflow, from clinical to pharmacist software systems. While there are several causes of medicine-related problems that amount to an annual cost of AU$1.4 billion in Australia, e-prescribing has the potential to contribute to reducing some of this cost,” it said.
Further, on the cost-savings involved with moving to an e-prescription model, the AMA said lost prescriptions could result in unnecessary hospital admissions if the patient cannot afford the time or financial cost of paper script renewal.
Illegible handwriting or poorly printed or faxed prescriptions can also make it difficult for pharmacists and patients to determine medication and dose, which the AMA said increases the risk of medication error as well as the time and money spent to obtain a replacement prescription.
Having scripts visible through the active script list may also reduce prescription misuse, the AMA said, as prescription dispensing data is more readily available for real-time prescription monitoring.
The AMA said earlier this month that telehealth was accounting for 20% of all doctor consultations funded by the Medicare Benefits Schedule.
“The AMA has said for many years that telehealth should become a feature of our health system, complementing face to face care,” it said. “We must now turn to the task of fully integrating telehealth into day-to-day medical practice while ensuring continuity of care for patients and that we follow best practice standards.”