One of the core principles of belief in why Australia needs to deploy a full fibre-to-the-premises (FttP) National Broadband Network (NBN) across the country is telehealth. However, in a panel session that should give FttP proponents nightmares, a quartet of health experts have identified the issues with increasing the use of telehealth as being cultural and operational, not bound by the speed of a data connection.
Speaking at the Connect conference in Melbourne on Thursday, a panel consisting of professor Branko Celler, chief scientist at the CSIRO; Lyn Davies, managing director of Tunstall Healthcare; Stephen Leeder, professor of public health and community medicine, University of Sydney; and Dr Elaine Saunders, managing director, Blamey Saunders agreed that telehealth could start saving governments money today, if only the will existed to implement it.
"Telehealth is a solution, the technology is here, the patients have never been the problem ... but we have some quite overwhelming organisational, workplace culture issues that are really hard to overcome — plus the absence of a proper funding model to scale up nationally telehealth," said Celler.
The panel was in agreement that telehealth, if implemented properly, is not a technical issue, but one that changes the entire delivery method of health service.
"When you are looking at technologies most effectively to solve the health problems we have, that doesn't necessarily mean doing things the old way but with an internet connection," said Saunders. "It means that you've got the latitude to do things quite, quite differently. That means we need our leaders in government to be open to suggestions about solutions, not about specific products."
"I think the real barrier [to widespread telehealth adoption] is thinking about things in the old way," she said.
Without proper incentives and general practitioner engagement, Davies said that any telehealth program is doomed, and it isn't a cure-all for issues in the health sector.
"[Telehealth] is not the only answer, and everybody knows that we can't sustain the Medicare system by just adding more onto it," she said.
"We have to realise those cost savings, first in some ways, so it's the chicken and egg ... before telehealth has some mainstream capability."
Professor Leeder said it is important for Australia to realise that many aspects of telehealth are being done in other places around the world.
"My estimate is that we are 20 years behind," he said.
"The problems of connectivity of patients to their professional careers, whether they be 100 metres down the road or 1,000 kilometres away, have been dealt with.
"You don't need a whole bunch of new technology to do that, it's there, it's working ... it's a question of implementing it."
Leeder said successful enterprises spend as much on change management as they do on IT hardware and software, and that was what changed the mind of every stakeholder in the health sector.
"It's got to be done sensibly, carefully, thoroughly, and professionally — otherwise, the IT device is not worth it."
For places where IT is needed immediately in health delivery, Leeder listed three areas where IT could help: Medical research; using big data to predict health issues, rather than explain what has already happened; and using IT in the clinical care of patients.
"We've mastered the art of providing health care using pieces of paper and telephones and ignoring IT — it's unbelievable," he said.
"All we need is the money to do it. My proposition is this country be contemplating the next big IT spend, equivalent to what we put into the NBN, on health IT."