This document discusses the history and impact of telehealth in Australia. It provides a brief history of past telehealth projects that failed due to lack of technology, funding, and patient uptake. The coronavirus pandemic has led to a rapid adoption of telehealth, with the government now funding all telehealth consultations until September. This has saved the government money while allowing healthcare to continue. The document examines the impact on general practices, with practices seeing a 30-50% drop in revenue but being able to continue operating through telehealth. It considers whether telehealth could be a "savior" through increased access and convenience, or a "grim reaper" by diminishing relationships and traditional practice models. The future of telehealth will depend

2. Telehealth: Saviour or grim reaper?

3. COMMENTS AND
PERSPECTIVES
30APRIL2020
By Martina Stanley @ Alecto

4. Discussion points
for today
Is telehealth the ‘saviour’ of
healthcare in the modern
Australian context?
Or is it the ‘grim reaper’?
Brief history of
telehealth projects
Brief history of
recent weeks
Reaction from
patients and
doctors
Impact on the
broader health
sector
Impact on
government
decision making
Business
implications for
practice owners
and recruiters
Future utilisation
of Telehealth

5. A personal history of telehealth
My first experience in 1996:
◦ $200,000 donated by Telecom NZ to support
telehealth
◦ Investment in expensive equipment and
multiple telephone lines
◦ Technology worked well
◦ Client response: nil

6. History of responses
to telehealth in
Australian health
sector
Multiple attempts to launch different products
Political focus on rural areas
Limited success for some procedural consults
(skin cancers etc)
Client and clinician response: abysmal

7. Enter the
coronavirus…..
Week
beginning
Govt actions Observations
13 March Nothing Chaos and despair. Patients and clinics unsure
what to do. Variety of responses. Medicare
saves $$$$$
16 March MBS bulk billed funding
for vulnerable clients
Revenue plummets. Patients refuse to pay for
consults. More chaos. Nurses sidelined and can’t
be funded. Medicare saves Medicare saves $$$.
30 March MBS billing for all client
consults – bulk billed
Patient and GP uptake improves.
Medicare still saves $$
30 March Jobkeeper announced
with $130 billion
Practices see lifeline for nursing and reception
staff. Some GPs applying for Jobkeeper
7 April Private billing allowed in
some cases
Patients refuse to pay for consults when faced
with an abundance of options. Minimal impact
29 April First 1 million telehealth consults for mental
health
Currently MBS telehealth till
September
Private health funds
support
Steady increase in patient visits through
telehealth and some increase to in-person
consults. Practices down 20-50% on revenue.
Survival through flu shots.

8. Trends and outcomes -GPs
Practices invest in technology and develop telehealth capacity < 2
weeks
Providers add new modules to support scripts, appointments, video
etc.
Telehealth seen as an alternative to being on the frontline of the ‘war
zone’.
Doctors of all persuasions embrace telehealth (even those over 55)
Some GPs see advantages and increase their hours and availability –
fighting underemployment
GPs earn less

9. Trends - broader health sector

10. Why does the government save $$$?
Revenues
fall by
>30%
Consults are shorter
Less referrals
Proactive health ignored
Subleases cancelled

11. WHAT DOES THIS MEAN FOR
GP CLINICS?

12. Two current business models
1. Traditional GP Owner/s
◦ Essentially ‘buying a job’ with some additional
income and support
◦ Profits come from a higher percentage of
billings
◦ Risk carried by GP owner
◦ Limited opportunity for investment

13. 2. Corporate owner/s
◦ GPs bring patients through the door and do care
plans and procedures
◦ Most profits come from ‘subleases’ including:
◦ Allied health (e.g podiatry)
◦ Pharmacy
◦ Pathology/radiology
◦ Coffee shop
◦ Skin clinic/cosmetics
◦ Specialist clinics
◦ Risk is carried by the owner/s
◦ Significant investments possible

14. If you were a practice
owner you be
seeing…
30-50% drop in revenue from GP work (mostly Medicare
funded)
Almost no income for procedures (usually quite lucrative)
Increased costs for supplies and PPE
Significant drop in income from nurse-led work (care plans,
vaccinations etc)
Reduced income from subleases (physio, dietician etc)
Lease payments for pathology cancelled or halved

15. WHAT IS THE FUTURE?

16. Future of Telehealth – is it this?

17. Or like this hologram?
◦ Photo taken on an iPhone 7
◦ Live 3 hour presentation from Florida to
Melbourne - June 2015
◦ Technology was flawless

18. Or stay the way it is?

19. Is telehealth a Saviour?
 Doctors can do more work more easily
 Patients love convenience
 Business interruptions minimized – next
virus?
 Better links with wearable technologies
 24/7 hour healthcare is easy
 Infrastructure costs lowered
 Governments balance budgets?

20. Or Grim Reaper?
 Patient/doctor relationships diminish?
 Doctor satisfaction diminishes?
 Doctor/practice relationships diminish?
 Private practice models struggle?
 Traditional doctor recruitment dies ?
 Old business models die

21. “The Genie is out of
the bottle”
(The Medical Republic)
The future of telehealth
depends on business - not
technology