[LINK] Online medical consultations
tom.worthington at tomw.net.au
Tue Aug 17 09:56:29 EST 2010
The Australian Prime Minister Julia Gillard announced that if
re-elected, the ALP government would provide $400M for online medical
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
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
particuarly 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
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:
Tom Worthington FACS CP HLM, TomW Communications Pty Ltd. t: 0419496150
PO Box 13, Belconnen ACT 2617, Australia http://www.tomw.net.au
Adjunct Senior Lecturer, School of Computer Science, The
Australian National University http://cs.anu.edu.au/courses/COMP7310/
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