Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
REVIEW

Video-based telehealth in Australian primary health care: current use and future potential

Melissa Raven A B , Caryn Butler A and Petra Bywood A

A Primary Health Care Research and Information Service, Discipline of General Practice, Level 3, Health Sciences Building, Registry Road, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.

B Corresponding author. Email: melissa.raven@flinders.edu.au

Australian Journal of Primary Health 19(4) 283-286 http://dx.doi.org/10.1071/PY13032
Submitted: 28 February 2013  Accepted: 3 September 2013   Published: 18 October 2013

Abstract

Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers’ skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions.


References

Australian Institute of Health and Welfare (2011) ‘The health and welfare of Australia’s Aboriginal and Torres Strait Islander people: an overview.’ (Australian Institute of Health and Welfare: Canberra)

Baigent MF, Lloyd CJ, Kavanagh SJ, Ben-Tovim DI, Yellowlees PM, Kalucy RS, Bond MJ (1997) Telepsychiatry: ‘tele’ yes, but what about the ‘psychiatry’? Journal of Telemedicine and Telecare 3, 3–5.
Telepsychiatry: ‘tele’ yes, but what about the ‘psychiatry’?CrossRef | 9218364PubMed | open url image1

Buist A (2003) Telepsychiatry in Australia. In ‘Telepsychiatry and e-mental health’. (Eds R. Wootton, P. Yellowlees, P. McLaren). pp. 113–123. (Royal Society of Medicine Press: London)

Cochrane Library (2010) Telemedicine. Available at http://www.thecochranelibrary.com/details/collection/806797/Telemedicine.html [Verified 24 July 2012]

Day K, Kerr P (2011) Telemedicine: rethinking healthcare roles for smarter care. HINZ Conference and Exhibition, 23–25 November 2011, Aotea Centre, Auckland. Available at http://www.hinz.org.nz/uploads/file/2011conference/P11_Day.pdf [Verified 24 September 2013]

Deshpande A, Khoja S, McKibbon A, Jadad AR (2008) ‘Real-time (synchronous) telehealth in primary care: systematic review of systematic reviews.’ (Canadian Agency for Drugs and Technologies in Health (CADTH): Ottawa).

Dillon E, Loermans J (2003) Telehealth in Western Australia: the challenge of evaluation. Journal of Telemedicine and Telecare 9, 15–19.
Telehealth in Western Australia: the challenge of evaluation.CrossRef | open url image1

Ellis I (2008) General practitioner, veteran, defence force personnel and consumer acceptance of e-Health. Centre for Veterans and Military Health, Darwin.

Fielke K (2005) Mental health services in rural and remote South Australia: from ‘awful neglect’ to gaining respect. 8th National Rural Health Conference, 10–13 March 2005, Alice Springs. Available at http://nrha.org.au/8thNRHC/Papers/fielke,%20ken.pdf [Verified 24 September 2013]

Fielke K, Cord-Udy N, Buckskin J, Lattanzio A (2009) The development of an ‘Indigenous team’ in a mainstream mental health service in South Australia. Australasian Psychiatry 17, S75–S78.
The development of an ‘Indigenous team’ in a mainstream mental health service in South Australia.CrossRef | 19579113PubMed | open url image1

Gray L, Smith AC, Armfield NR, Travers C, Croll P, Caffrey LJ (2011) Telehealth assessment final report. Uniquest, Centre for Online Health, University of Queensland, St Lucia.

Harrison R, Macfarlane A, Murray E, Wallace P (2006) Patients’ perceptions of joint teleconsultations: a qualitative evaluation. Health Expectations 9, 81–90.

Kalucy R, Hawker F, Delin J, Muenstermann I (2000) ‘Evaluation of specialist psychiatric services in rural and remote South Australia.’ (Flinders University: Adelaide)

Kerr P, Day K (2010) ‘Buller Health Telehealth Pilot: evaluating an opportunity whose time has come.’ (West Coast District Health Board: Greymouth)

Loane MA, Bloomer SE, Corbett R, Eedy DJ, Evans C, Hicks N, Jacklin P, Lotery HE, Mathews C, Paisley J, Reid P, Steele K, Wootton R (2001) A randomized controlled trial assessing the health economics of real-time teledermatology compared with conventional care: an urban versus rural perspective. Journal of Telemedicine and Telecare 7, 108–118.
A randomized controlled trial assessing the health economics of real-time teledermatology compared with conventional care: an urban versus rural perspective.CrossRef | 1:STN:280:DC%2BD3MzgvFajsw%3D%3D&md5=7b56e0e6ea4e0d3b0518e1f74aa8a62aCAS | 11331049PubMed | open url image1

MBS Online (2012) Specialist video consultations under Medicare. Available at http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/mbsonline-telehealth-landing.htm [Verified 14 August 2012]

Ministry of Health (2011) Better, sooner, more convenient health care in the community. New Zealand Ministry of Health, Wellington.

Moffatt JJ, Eley DS (2010) The reported benefits of telehealth for rural Australians. Australian Health Review 34, 276–281.
The reported benefits of telehealth for rural Australians.CrossRef | 20797357PubMed | open url image1

Norman S (2006) The use of telemedicine in psychiatry. Journal of Psychiatric and Mental Health Nursing 13, 771–777.
The use of telemedicine in psychiatry.CrossRef | 1:STN:280:DC%2BD28nlsFarsA%3D%3D&md5=6525d6c263288284d45040d3242b39c2CAS | 17087682PubMed | open url image1

Sitzia J (1999) How valid and reliable are patient satisfaction data? An analysis of 195 studies. International Journal for Quality in Health Care 11, 319–328.
How valid and reliable are patient satisfaction data? An analysis of 195 studies.CrossRef | 1:STN:280:DyaK1MvivFOisg%3D%3D&md5=34f38b26f201c222f9caeff393590b1aCAS | 10501602PubMed | open url image1

Wade VA, Karnon J, Elshaug AG, Hiller JE (2010) A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Services Research 10, 233
A systematic review of economic analyses of telehealth services using real time video communication.CrossRef | 20696073PubMed | open url image1

Wallace P, Barber J, Clayton W, Currell R, Fleming K, Garner P, Haines A, Harrison R, Jacklin P, Jarrett C, Jayasuriya R, Lewis L, Parker S, Roberts J, Thompson S, Wainwright P (2004) Virtual outreach: a randomised controlled trial and economic evaluation of joint teleconferenced medical consultations. Health Technology Assessment 8,

Williams TL, May CR, Esmail A (2001) Limitations of patient satisfaction studies in telehealthcare: a systematic review of the literature. Telemedicine Journal and e-Health 7, 293–316.
Limitations of patient satisfaction studies in telehealthcare: a systematic review of the literature.CrossRef | 1:STN:280:DC%2BD387ltl2itA%3D%3D&md5=6533a29a0c31abd4e42cb622135e3054CAS | 11886667PubMed | open url image1

Wootton R (2012) Twenty years of telemedicine in chronic disease management - an evidence synthesis. Journal of Telemedicine and Telecare 18, 211–220.
Twenty years of telemedicine in chronic disease management - an evidence synthesis.CrossRef | 22674020PubMed | open url image1

Wootton R, Bloomer SE, Corbett R, Eedy DJ, Hicks N, Lotery HE, Mathews C, Pailey J, Steele K (2000) Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis. British Medical Journal 320, 1252–1256.
Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis.CrossRef | 1:STN:280:DC%2BD3c3lvFehug%3D%3D&md5=41fc2cd3e4bb895a763b3a81ec0af7c1CAS | 10797038PubMed | open url image1



Export Citation Cited By (6)