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Tuesday, 23 February 2010 17:19

Medicare slow to cotton on to IT revolution


The continued lack of a Medicare claim number for videoconference based medical consultations is holding back the deployment of technology that could help rural and regional health authorities tackle ballooning skills shortages.

David Ryan, executive officer of the Grampians Rural Health Alliance (GRHA) which has deployed a videoconferencing application in its hospitals says State and Territory health department CIOs are all keenly aware of the problem and that a meeting earlier this month raised the issue again.

GRHA' s videoconference based system - called Clever Health - has after four years achieved a full return on the $7.6 million investment involved. But that has to some extent relied on the goodwill of medical practitioners who have been willing to use the system in spite of there not being a Medicare claim facility for video consults.

As Ryan explained; 'If you are a non salaried doctor in the hospital,' then there is no way to claim back from Medicare the costs associated with the time taken for the consultation. Ryan said despite this problem, medical practitioners in his region had given their time willingly.

Nevertheless the lack of a Medicare number for video-consults was; 'Far and away the biggest impediment in moving the technology out of the hospital's four walls.'

He added that; 'Everyone wants it addressed and the Department of Health and Ageing is aware of it. It is a major area of interest for all states and territories with remote operations. The biggest thing to drive this is the lack of skills in remote and regional areas. There are few technical impediments - but there are some political ones.'

Health minister Nicola Roxon has yet to respond to iTWire's enquiry about a Government response to the problem.

The GRHA which comprises 12 hospital based health services, four bush nursing centres and several community health centres, selected Melbourne's iVision to establish the network using Tandberg equipment. This was then customised to create so called MediLink systems which are mobile and tailored for health application.

According to Ryan; 'We are seeing demand in ad hoc usage where doctors and nurses and allied health professionals can use the mobile video conference unit where they need specialist advice. They have not necessarily booked - but use a quick call to see who is available.'

According to the GRHA there are now more than 1,200 videoconferencing hours being used each quarter and in the three months to the end of December demand rose 43 per cent over the previous quarter. According to Ryan; 'We are not limiting the use - if they feel like using it they use it.'

He said that there had also been improved patient outcomes, particularly when compared to situations where only a phone call based consult was available. This was particularly the case with wound management as specialists could use the videoconferencing system to see a wound and recommend treatment.

The authority now has 17 MediLink videoconferencing units and another two just purchased which connect over the wireless networks in its hospitals. It also has more than 130 semi mobile units

'At present all the systems are being used in hospitals,' said Ryan. 'The next step is to take this out into the community.

'We are implementing Next G networking and looking at technology to take with us. It's not a bandwidth issue - just the technology has not caught up for home monitoring,' said Ryan who believes that the next generation of hardware will have the camera quality required to allow home monitoring to become possible.

But without a Medicare claim number, uptake of the technology is likely to be slow.

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