Smartphones, tablets and computers are increasingly expanding the availability of health services. This means we can access help anonymously at a time and place that suits us.
Currently, only about one-third of people with mental health difficulties obtain help. While there are various reasons for this, practical factors such as availability of health professionals and travel, time and financial restrictions may limit access to mental health care.
People may also be reluctant to seek help, either because of concerns about the stigma attached to mental illness or because of a preference to self-manage symptoms.
While technology is not always a replacement for face-to-face treatment for mental health difficulties, it can offer increased choice and flexibility. It may also motivate some people to take that first step in seeking help.
Let’s explore the benefits and downsides of technology-delivered care – and where you can go for help.
Patients in remote and rural areas of Australia requiring specialist psychological care are often required to travel or be transported to larger centres. In many cases Psychiatrists have to drive for hours to visit them, both mean high travel costs, lost time for patients and clinicians. With Telehealth PSYCH2U bring your patients to you!
For more information on how to launch your own psychiatry practice online with Telehealth and PSYCH2U Platform contact me, Jo@vircruit.com to arrange an informal chat.
Following the approval of Australia’s National Digital Health Strategy for 2018-2022, the health services ecosystem now has a mandate for transformation to digital healthcare. As healthcare moves to harness the power of digital and implement digital strategies like providing easy access to My Health Record, the Government and healthcare practitioners are critical enablers to ensure new technologies will provide consumers with improved control of their own health and wellbeing.
According to Accenture’s Person-Centric: Reimagining Australian Digital Healthcare report, Australia’s public healthcare system must acknowledge the limitations of the current ‘one-size-fits all’ mentality and embrace a more ‘person-centric’ culture; enabling a more manageable, realistic and effective system.
Digital healthcare that is person-centric has been shown to decrease medication error rates, reduce length of stay in hospital and reduce re-admission to hospital. By focusing on the needs of distinct segments, policy-makers, payers and service providers can optimise resources and deliver the right services, at the right time, in the right way.
The report explores how this change in mindset begins with the definition of person-centred segments. Accenture identified seven clusters of people, differentiated by their attitudes, feelings and abilities, which are key drivers of behaviours and preferences.
While these segments are by no means the final word on how to segment Australian society for healthcare delivery; they begin to reveal the complex distribution of Australian attitudes toward the future of healthcare. In order to realise the benefits of a more person-centric, digital healthcare system, providers and payers must personalise their offerings:
Creating efficiency through technology
Australian consumers surveyed in the Person-Centric: Reimagining Australian Digital Healthcare report feel public funds should be used more effectively, with 67 percent of respondents believing the health system to be inefficient and wasteful.
An important part of being less wasteful with funding is the introduction of electronic health records: patients are recently able to view their own medical and pharmaceutical records in one place, which should reduce waste and promote collaboration and efficiency between patients and treating clinicians. Pathology and imaging reports that have been requested by a GP, need not be re-done by a specialist who could easily view those same reports securely online.
Improving the information flow
Patients need options relating to access and privacy settings, however these options cannot limit accessibility of information to time-poor clinicians trying to deliver better health outcomes, or who find themselves in emergency situations. The data kept by GPs and hospitals is typically extremely siloed, but most Australians surveyed are in favour of treating practitioners having access to full medical records, as well as allowing data to be shared automatically between treating doctors. Less fragmented communication of health information could have a major positive impact on re-admission rates, hospital-acquired complications and avoidable medical harm.
Understanding diverse attitudes to privacy
The Person-Centric: Reimagining Australian Digital Healthcare report shows that patients trust health organisations – especially public services – with their personal data far more than other organisations. Urgent action is therefore required to securely unlock access to healthcare data by authorised, trusted individuals for reasonable purposes such as treatment or medical research. The transparency and simplicity of privacy and security policy – along with proactive education of citizens about these policies – will be crucial to reassuring the public about data sharing. The healthcare system must begin to provide consumers with the tools to easily select to share, hide or remove identifiable details from their information.
Delivering more meaningful analytic insights
Behavioural traits of patients like anxiety and disengagement cannot be identified by traditional demographic analysis. When it comes to person-centric segmentation, the right questions can be narrowed down to a streamlined set of “golden questions” – a small set of variables that can correctly allocate an individual to a defined cluster with high accuracy.
From here, an in‑depth understanding of those defined groups allows us to predict attitudes and behaviours for individual patients. Multivariate techniques can identify groups of patients with similar needs and beliefs, then generate simplified algorithms that make future person centred segmentation quicker and easier. This is an essential step for the design of future health services and policies.
Services need to adapt to different types of patients
When discussing digital healthcare, there is always the stereotyped assumption that older patients avoid new technology. In recent years, Accenture research has shown this to be incorrect. The Person-Centric: Reimagining Australian Digital Healthcare research reveals a more granular picture, identifying both a group that drives the stereotype and a group of tech-confident seniors. While digital services for older patients should be increased, we cannot expect all groups to welcome them. Initially, most new digital services will need to exist in parallel with traditional services, rather than replace them.
Smarter segmentation of Australian patients will enable Australian policy-makers, payers and health service providers to embrace person-centric digital healthcare solutions. This approach equips healthcare professionals with better insights that improve the safety and quality of patient care. The person-centric approach engages with people from all walks of life and offers them services that are tailored to their needs.
Author Ian Manovel is a principal director within Accenture Australia’s health practice. Original Article published 21 August, 2017 by
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The clinical value of e-records and other e-health tools has been argued for years, but one of the lesser discussed issues is what impact they have on the art of general practice.
As GPs everywhere will tell you, making a diagnosis is only part of the job – being able to connect with patients is just as important.
So three US academics decided to find out how e-records affect doctorpatient interactions.
The two researchers from Brown University in Rhode Island, plus a hospital consultant, surveyed 2500 doctors and asked them what they thought — and plenty of their observations will resonate with Australian GPs.
“It is like having someone at the dinner table texting,” one doctor described the act of taking patient notes on a computer during a consult.
“It takes 90% of the time that would otherwise go to the patient,” said another.
Some doctors said they didn’t update computer records at all during a consult.
“I do not use electronic health records when I am with patients. I have tried this in other settings and it degrades the quality of my interactions. It’s rude as well.”
“I can’t stand typing instead of making eye contact with a patient,” one doctor said.
“The art of medicine and treating is lost in this process,” said another, summarising the views of many.
If the use of computers during consults does undermine the doctorpatient relationship, what can GPs do to fix this, aside from chucking their monitor out the window?
The researchers, writing in the Journal of Innovation in Health Informatics, have a few suggestions:
- Asking patients to look over your shoulder so they can see what you’re doing
- Learning to touch-type so eye contact can be maintained
- Honouring the ‘golden minute’ by engaging totally with patients the minute they walk in the room, rather than waiting for them to sit down before looking up to greet them.
E-records weren’t all bad though when it came to the doctor-patient relationship. Some of those surveyed said taking electronic notes gave them the opportunity to show patients images, notes and results.
“I love showing Google images to patients in the office for the purpose of patient education. I save meaningful graphic representatives with which to teach,” one doctor revealed.
And it was this positive attitude that shone through, with the doctors widely acknowledging that e-health records were here to stay and they would need to adapt their work and workflow accordingly.
Dr Ross Kirkman spent many years practising as a Consultant Psychiatrist in regional and remote areas of Australia and understands how difficult it is for Doctors and patients to gain easy access and advice from specialists.
“I made a decision to spend less time on the road and therefore more time with my patients and my family, so now I offer Telehealth (Telepsychiatry) appointments. Psychiatry is well suited to Telehealth and I have found that with the appropriate technology I am able to interact with patients almost as if I was in the room with them.”
In 2012 Dr Ross Kirkman began consulting full time with GP2U, now with a dedicated Psychiatry Platform PSYCH2U. Last year he carried out more than 1500 consultations using technology like Skype and means he treats patients in Tasmania’s Northwest, East Coast and Interstate without leaving his Sandy Bay home.
Here Dr Kirkam answers the Top Questions around the hot topic of Telehealth and how it benefits his work life balance as well as his patients.
Interviewer: So, it seems like you’ve found a way to create a few extra days off for yourself? Tell us why you got into Telehealth.
Dr Kirkman: “Someone once said ‘happiness is a well-paid part time job’ and that’s what I’ve got with Telehealth and with working with PSYCH2U.”
“Partly I chose to work 3 days a week because that’s what I wanted to do and the way I’ve been able to do that is to work very efficiently. So I work 3 intense days and in those days I see a lot of new patients. The reason why I can work 3 days a week are due to a number of things. Telehealth is better paid than face to face medicine, you get a 50% uplift, so if you’re just doing your 3 days but with the uplift, then that’s the equivalent to 5 days anyway!”
How does PSYCH2U enable you to reduce or eliminate typical costs associated with being a Psychologist?
“PSYCH2U help me reduce typical costs in 2 or 3 ways really. Firstly, you don’t have to have publicly accessible rooms because you work from home. Also because you run a ‘home office’ you can gain a lot of tax deductions. PSYCH2U essentially make this as easy as possible because it’s really a one-stop-shop. You have an appointment system, you have a simple billing system and you have a note taking facility so that you can send your notes through straight away at the end of each consultation.”
Did the referring GP’s have any concerns when you moved to a fully online practice?
“The referring GP’s did have some concerns initially, but once they start using the system they find it a great advantage. For a start, It’s very much a ‘shared care model’ so the GP’s often come in at the beginning of the consultation, the nursing staff can help set up the patients at the beginning of the consultation, I then send my notes of the consultation straight away back to the GP at the end of the consultation, so the patients also have a sense that the GP and I are working very much hand in hand.”
“The GP’s find it a terrific model of care, they also feel very happy to refer patients, so your referral rate goes up greatly. And that generates new patients for you, and that generates income.”
How long did it take you to move to a 100% online practice?
“It took me about 2-3 months of thinking about moving to full-time online, but the actual process only really took about 2-3 weeks. PSYCH2U allows you to pretty much set up and start from day one – taking in patient referrals and seeing patients online, it’s so easy and very cost effective and once you’ve established a good relationship with a particular group practice, for example, you will suddenly get a lot of referrals.”
Has your scope of practice narrowed, given your online clinic?
“My scope of practice with online has in fact widened, it’s a bit like being a country surgeon, you end up treating everyone who comes to your clinic with whatever surgical problem they have because there’s no other option. The same a psychiatry, you end up treating the whole DSM gamut really of psychiatric disorders. So you have to be prepared to actually give things a go, even if you haven’t done much of that kind of work in the past.”
Are there greater risks associated with Telehealth Psychiatry?
“I think not, in-fact I think that the risks are less. There’s the simple physical risk that every now and again you have with a patient, that no longer occurs with Telehealth of course. The other ‘medico-legal’ risks I think are less as-well as it’s very much a shared care model with the GP, so working in tandem with the general practitioner, for example, the general practitioner will do all the prescriptions for the medication, and that means that you share that risk of prescribing with the GP. The GP also then has the full list of medications that the patient is on within their software which will highlight any drug interactions that they’ll be able to spot.”
Clinically, is it as accurate when using Telehealth vs face to face contact?
“One thought that might arise with my colleagues is, is it as accurate in terms of your assessments and mental state examinations for example? I think it is. Patients end up establishing a report with you in a very similar way that they do when your face to face, for some patients in-fact, the rapport is better as some people may get a little bit confronted with face to face interviews. So I think that the accuracy of your assessment is as good, hence the risk is the same.”
Would you recommend Telehealth to your colleagues?
“I would recommend Telehealth to all colleagues. It’s a great way of helping people outside of capital city’s, there’s a huge amount of unmet need for psychiatric services outside of the capital city’s and it’s great working from home.”
You can view the full interview with Dr Ross Kirkman via the PSYCH2U website here – https://psych2u.com.au/
For further information or questions on how you too can benefit from Telehealth please drop me a line Jo@vircruit.com.