[LINK] Online medical consultations

[Tom Worthington]

The Australian Prime Minister Julia Gillard announced that if 
re-elected, the ALP government would provide $400M for online medical 
consultations: 
<http://www.alp.org.au/agenda/health-reform/connecting-health/>.

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 
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 
Internet." <http://www.unijobs.com.au/show.php?id=23888>.

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: 
<http://blog.tomw.net.au/2008/11/canberra-health-system-first-hand.html>.


-- 
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/