How far can telehealth go in terms of servicing healthcare demand? “Let’s not put the genie back in the bottle”

The advancement and accessibility of healthcare services are crucial indicators of a society’s development. Consequently, remote access to health-related services, known as telehealth, has emerged as an effective paradigm to enhance healthcare accessibility.

Many patients find telehealth more convenient, while numerous clinicians and healthcare systems appreciate the ability to treat patients safely at home. However, this transition has posed a financial burden on practices lacking the infrastructure to rapidly adapt to telehealth, leading to a decline in in-person visits that has been devastating for these practices and their communities.

Research tells us that prior to the pandemic, most clinicians were receptive to telehealth, recognising its potential to increase access to care. Nonetheless, they harboured concerns regarding the maintenance of care standards, technical challenges, uncertain reimbursement, insufficient training in telehealth, and a preference for in-person care. Conversely, patients have consistently exhibited strong preferences for virtual care, outpacing provider readiness and willingness for telehealth adoption.

A recent evaluation by the NZ Telehealth Forum and Resource Centre revealed that the COVID-19 pandemic has spurred strategic investment and funding in telehealth across various districts. However, disparities in telehealth readiness persist both between and within districts. Investment planning for telehealth is unevenly distributed, leading to differing levels of preparedness in delivering digital services that align with the goals of Pae Ora and Te Pae Tata.

The report also indicated that while telehealth is utilised across most specialties and services to some extent, it is not universally embedded as a complement to in-person care. Its use remains contingent on individual clinicians or specific circumstances. Support structures for telehealth are underdeveloped, with clinicians reporting a lack of guidance within their specialties to confidently use telehealth across clinical scenarios. Although software solutions have facilitated increased videoconferencing and reduced barriers related to hardware and room availability, there have been multiple reports of poor telehealth implementation experiences at the service level.

Without adequate support, clinicians are likely to revert to in-person only healthcare, necessitating organisational backing and skilled change management to ensure successful telehealth adoption.

For telehealth utilisation to progress further, policymakers and health system leaders must understand which telehealth services and modalities are most frequently used by providers and patients.

Where does this leave telehealth in New Zealand? I welcome your thoughts on this matter.

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