Last night Australian Prime Minister Julia Gillard announced that if re-elected, the ALP government would provide $400M for online medical consultations. Given the political debate over what use a high speed NBN fibre optic network was to the community, this is a case of prescribing fibre in the diet. ;-)
The ALP's "Connecting Health: Modernising Medicare by providing rebates for online consultations" policy proposes providing Medicare rebates for online consultations. These would not just be for general practitioners, but for specialists as well. The policy is targeted at rural, remote and outer metropolitan areas, but may also appeal to city dwellers.
The proposal envisages $250M being spent on half a million "services" over four years. Also $57M will be available to help GPs and specialists set up for online consultations and $35M for training.
This is a relatively modest proposal. The amount set for training appears a little low and that for equipment too high. The equipment needed for an online video consultation is minimal. An ordinary laptop computer, web camera and ADSL connection is more than enough. What is needed is training of medical staff in how to use the technology and particularly how to talk to people online.
What would be particularly effective would be to train nursing staff to assist specialists. Having expensive specialists fiddling around trying to get computer equipment to work is not an effective use of their time. A process where a nurse first talks to the patient, takes details and gets the patent used to the system would be more cost effective and better for the patent. The needed training could be conducted online. The ANU Medical School for example, already teaches medical staff for regional areas online. Even the professors are required to have "Competence and demonstrated experience in using a variety of software applications in a PC environment, including Microsoft Office and use of email and the Internet."
It should be noted that the media staff working with a patient do not need to be located in the same medical facility, or event the same city or country. This raises some interesting possibilities and also some challenges. As an example, a typical consultation might first have the patient talking to the nurse, then their GP and then a specialist. That would be an effective use of everyone's time. But there would be a temptation to cut costs, for example by using medical staff located in lower wage countries, or by using AI robot doctors.
An online medical consultation also implies the use of online medical records. If a patient, GP and specialist are communicating online, the medical records will also need to be online. This is an area where considerable amounts have been invested by the federal government with little progress being made. My own first hand experience of being a patent in Canberra's major hospital shows that little progress has been made. Perhaps the online consultation is a way to push medical staff into using online records.