Good intent short on policy detail results in less than ideal outcome
The recent articles in the SMH and The Age this weekend stated that GPs are flocking to Skype as a means of accessing their $6,000 On-Board Incentive to get set for becoming telehealth equipped. The inference in the article is that dodgy ‘pink bat’ style service providers were offering services to profit from the $600 million plus allocation to enable GPs, Specialists and Aged Care providers to become telehealth equipped.
It just does not make sense to suggest that the intent of the Commonwealth Government’s policy was anything other than commendable at every level. The policy makes perfect sense given the public pressure on the healthcare budget and the national shortage of medical services, especially if you complement it with the NBN roll-out. Telehealth is a great use of such an initiative.
But it is true that without direction from the policy maker, the Department of Health and Ageing, as to what services are appropriate, the well intended policy may well fall short of the intended outcome. The obvious selection of a service to an uninformed and sometimes self-serving market is a no-cost service. A consumer product not designed for the sharing of sensitive healthcare information, unable to provide the detail required of a diagnostic tool and far from a robust product which interoperates with other healthcare services – Skype.
The intent of DoHA in stating that the policy is designed to improve business processes is admirable but lacks any focus which specifies how to achieve this as an outcome. By saying to the market – ”we will let your associations tell you what to use”, completely abdicates the responsibility of good governance and the proper use of the allocated funds. In this environment there is no wonder that many of the 1200 recipients of the Government’s On-Board Incentive have used Skype simply to access the $6,000 grant without any serious intention of being Telehealth equipped.
It is less about dodgy service providers and more about unhelpful policy detail. Skype in its current form is not a telehealth product. One only has to look at the example of the largest Telemedicine network in the world, that of the Ontario Telemedicine Network and the nature of the technology that they have used for a number of years to understand that they are a global model to follow.
They have adopted a low cost, robust technology which delivers high quality interoperable diagnostic (think dermatology, eye, ear and throat) plus very capable services across a sparsely populated Province with variable bandwidth capacity. (Sounds much like the Australian environment.)
Delivery of a service model which facilitates:
- videoconferencing and telepresence solutions enabling real-time, rich interactive video collaboration;
- while allowing participants to connect seamlessly from their desktops or home offices
- with diagnostic capability in a secure, reliable user friendly manner
is complex, especially when the variables are bandwidth capability and end user interoperable requirements.
There are only two reasons that anyone in healthcare would consider a consumer product like Skype to equip themselves for a telehealth future. One; if there was a financial incentive to do so, or two; if they knew of nothing better. In this case ignorance may prevail because of poor policy detail.
On the other hand those who take a professional approach will see that there are complete solutions available that will reward their practices much more than the instant gratification of a $6,000 grant. There is a huge professional future out there for those who can see the bigger picture.