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While health tech advances, a video chat with GPs still fails to receive Medicare benefits

Email Telehealth still failing to connect Medicare with regional GPs as technology elsewhere keeps advancing ABC Mid West & Wheatbelt By Laura Meachim

Updated September 10, 2019 08:02:47

Picture of telehealth screen in a doctors surgery. Photo: Rooms like this at the Wheatbelt Health Network can video link with specialists in Perth. (ABC Midwest and Wheatbelt: Laura Meachim) Related Story: Telehealth saves lives and time on the road in NSW Related Story: Remote outback town with 12 residents to get telehealth clinic Related Story: Expanding telehealth support to farmers a step in right direction, doctor says Map: Northam 6401

Regional general practitioners in Western Australia are calling for changes to the Medicare Benefits Schedule (MBS) which currently denies GPs a connection with patients via telehealth, despite advances in technology.

Key points:

  • Telehealth services can provide good primary healthcare without the need to travel long distances, WA's Health Minister says
  • WA has a significantly lower proportion of GPs per head of population than any other state
  • Canberra plans to extend Medicare benefits to allow GP telehealth in remote, but relatively large population areas known as MMM 6 and 7

Telehealth is a method of health delivery that uses video conferencing as a simple way to connect regional and remote patients with health services.

Its main use is connecting regional patients with specialists based in metropolitan areas, but it has potential to change the way people also access general practitioners.

Northam-based GP and CEO of Western Australia's Wheatbelt Health Network, Harry Randhawa, said being able to use the system for routine appointments would improve the accessibility of primary care for regional patients.

"I think if any specialty of medicine could cater through telehealth, [then] general practitioners are well placed to do so," Dr Randhawa said.

"Mrs X who lives 162 kilometres away and accesses a GP here would not be forced to hop in a car for a minor issue.

"She could just link in with a GP, she could get an appointment within the next 24 to 48 hours.

"She is not spending the fuel to drive here, she is not having the angst and issues that goes with that, and she is still being able to access care."

Portrait of Dr Harry Randhawa Photo: Harry Randhawa would like to see GPs using telehealth to offer routine consultations. (ABC Midwest and Wheatbelt: Laura Meachim)

State Government lobbying for GP telehealth

Currently there are plans to extend the MBS to allow for GP telehealth consultations in areas covered by the Modified Monash Model (MMM) 6 and 7.

This would include areas like Eneabba, Gascoyne Junction, Southern Cross, and Meekatharra.

But it does not cover many places in the state's south-west and Wheatbelt which is dotted with small communities that have no GP or little access to one.

Picture of Health Minister Roger Cook Photo: Health Minister Roger Cook says regional patients in MMM 5-7 should be able to use telehealth and be reimbursed by Medicare for routine GP appointments. (ABC News: Eliza Laschon)

WA Health Minister Roger Cook wants to see the MBS extended to cover those MMM 5 areas.

"At the moment we have people right around the state who don't have a GP in their town or even nearby," he said.

"Western Australia has a significantly lower proportion of GPs per head of population than any other state of Australia so this is a particularly important issue for us."

Mr Cook said the widely dispersed population across the state means ensuring everyone has access to a GP is even more challenging.

He said it all comes down to how much the Federal Government is willing to spend on general practice.

"We know that there are nine communities in WA with populations greater than 100 people that have no resident GP service or no adequate visiting service," he said.

"So if we can allow people in these smaller communities to have access to these telehealth services then they can continue to get good primary healthcare without the need to travel long distances."

AMA say regulation holding up MBS extension

Australian Medical Association WA has been piloting the use of telehealth in aged care homes and hopes that this approach could one day be adopted by regional GPs.

Portrait of Dr Simon Torvaldsen Photo: Simon Torvaldsen says they are waiting on the regulatory framework to catch up with technological advances in healthcare. (Supplied: AMA WA)

Chair of the AMA WA general practice group Simon Torvaldsen said using telehealth to solve issues that may not require physically visiting a GP would benefit regional patients.

"If you have to travel a 50 kilometre trip there and a 50 kilometre trip back, that is a significant time and travel cost that could potentially be avoided by the use of telehealth," he said.

Dr Torvaldsen said the problem was that regulation had not caught up with technology and there needed to be a system in place to ensure the MBS was not used by health practitioners to drive profit.

"The issue is technology is readily available, but the regulatory framework to make sure it is used appropriately and consultations are appropriate to the patients needs [is not]," he said.

"And also, that there is not opportunity for misuse of any proposed telehealth item numbers.

"That regulatory framework is still being developed, and in fact that is much more difficult."

In a statement, a spokeswoman for the Department of Health said while there is currently no Medicare items for GP telehealth attendances, that will change in November.

"These services will be eligible for Medicare rebates for patients living in remote or very remoted regions [MMM areas 6 and 7] who have an established clinical relationship with their GP," she said.

"This measure was announced at the 2018-19 Mid-Year Economic and Fiscal Outlook with an estimated cost of $33.5 million over four years."

Patients will only be eligible for GP telehealth if they live in MMM areas 6 and 7, have an existing relationship with the GP, and at the time of consultation are at least 15km by road from the GP.

Topics: health, health-administration, health-policy, healthcare-clinic, healthcare-facilities, government-and-politics, federal-government, parliament, federal—state-issues, state-parliament, community-and-society, regional, northam-6401, meekatharra-6642, southern-cross-6426, gascoyne-junction-6705, eneabba-6518, wa

First posted September 10, 2019 08:00:17

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