Not far enough
The dietitians have waded into the debate over Medicare rebates for telehealth, and makers of medical technology are still not satisfied.
Above: Dietitians Association of Australia chief executive officer, Claire Hewat.
By Stephen Easton
The Dietitians Association of Australia (DAA) has hit out at the government’s new Medicare rebates for telehealth, claiming their members are “fuming” at the lack of support for long-distance allied health services delivered remotely.
According to DAA chief executive, Claire Hewat, the government has “once again snubbed dietitians and other allied health professionals who, along with doctors and nurses, play a crucial role in improving the health of Australians”.
She said by excluding allied health professionals from its new telehealth scheme, the government had “missed the mark” in meeting the needs of patients, especially those from groups who are disadvantaged in terms of access to social services, such as Indigenous Australians.
Ms Hewat agreed that aged care recipients, especially in rural and remote areas, were “definitely” another disadvantaged group in terms of access to primary healthcare and allied health services, a view supported by many other health and medical professionals.
“Any initiatives aimed at improving the health of rural and regional Australians must involve all the health disciplines, including allied health, along with nurses and doctors, to reflect the reality of health care in Australia,” she said.
“Conditions like obesity and type-two diabetes are real issues in rural and regional Australia. We’re calling on the government to include a seat at the ‘telehealth table’ for dietetic services, to help tackle the many diseases that result from poor nutrition.”
Ms Hewat added that many allied health services could be easily delivered remotely via video link, but had been largely ignored by Medicare for some time, with each Australian only able to claim rebates for a maximum of five services per year in total.
“So unless you have plenty of money or a higher level of private cover, you either try to find a way to pay for it yourself, or wait in impossibly long queues in public hospitals.”
The $620 million system of rebates and incentives, known as the telehealth initiative, aims to provide patients in rural and regional areas with remote access to GPs and specialists, through videoconferencing, between major metropolitan centres and regional clinics, hospitals, and residential aged care facilities.
As well as ignoring allied health services, the initiative also fails to go far enough by ignoring its use in community care, according to proponents of this version of the technology. Home vital signs monitoring equipment can be used to support community nursing, and a growing number of aged care providers and health services in Australia, and around the world, have achieved positive outcomes in small trials of telehealth in the home.
Australian manufacturers of medical devices have consistently campaigned in this area, and released their own response to the government’s recent announcement.
According to the statement, the Medical Technology Association of Australia (MTAA) “believes that the funding for telehealth consultations has stopped wide of the mark by not covering remote patient monitoring, including the assessment and monitoring of medical data collected from the patient’s home”.
MTAA chief executive officer, Anne Trimmer, said that the government funding should also support “the use of smart technology designed to keep patients in the home”.
“The funding of monitoring consultations is money well spent,” Ms Trimmer said. “Because it has the potential to save money in the health system by allowing healthcare consultations at the patient’s home, and avoiding unnecessary face-to-face consultations, hospital stays and patient travel.”
In a submission to the Department of Health and Ageing, in response to its January 2011 discussion paper, Connecting health services with the future: Modernising Medicare by providing rebates for online consultations, the MTAA claims telehealth could result in potential savings of $3.1 billion per year to the total national health bill.
