Training for the future of digital medicine


By Dr Andrew Baird* and Dr Silvia Pfeiffer^
Wednesday, 21 April, 2021



Training for the future of digital medicine

We delve into how training and technology must evolve to equip the healthcare practitioners of today and tomorrow with the skills and knowledge they need to support patients in our digitised world.

The evolution of digital medicine, which was quickly rolled out and accelerated in response to the pandemic, has transformed the healthcare industry as we know it. Overnight, healthcare practitioners were forced to find alternative ways to provide care for patients as conducting in-person appointments became too risky.

While many have contemplated the potential of telehealth services for years, a lack of financial reimbursements, infrastructure and accessibility hindered widespread implementation. During the pandemic priorities dramatically shifted, allowing telehealth to prove its value to the industry. The uptake during this period has been significant, with nearly 30% of GP consultations being conducted by telehealth either via phone (28%) or video (0.8%).

Healthcare practices are now facing a new challenge — ensuring their doctors, nurses and allied health professionals have the skills and tools to provide the same level of care via telehealth as the patient would receive from in-person care. In order to achieve this, Medicare states that video telehealth is the preferable method for non-in-person consultations.

The role of video telehealth

Video telehealth provides an alternative to many in-person consultations. However, there are contraindications to video telehealth including emergencies, consultations that require direct in-person examinations, consultations that require procedures, unsatisfactory audio-visual quality and patients who do not consent to video telehealth. In any of these circumstances an in-person consultation will be required, although it is possible for GPs to initially manage emergencies in a remote first-responder role.

The role of audio-only or phone telehealth is limited to defined, specific, low-acuity encounters in GP–patient communication. Examples of this include managing repeat routine prescriptions, discussing normal investigation results, and following up a previous video telehealth or in-person consultation.

Training for video telehealth

Digitised healthcare is a relatively new paradigm and the rapid shift to digital-first offerings during the COVID-19 pandemic had many practitioners and clinics scrambling to ramp up their efforts. Not only was the industry compelled to acquire new technologies to support video telehealth, but thousands of providers and staff required training to become equipped with this new wave of connectivity.

It’s clear that the impetus of COVID-19 supercharged the acceleration of telehealth services, with over 43 million telehealth consultations taking place across Australia last year alone according to Medicare data. However, with around 2.5 million of these consults being conducted via video telehealth, it’s clear that the healthcare industry needs a reality check: the only sensible way of delivering health care online is through video telehealth.

The rapid adoption of digital health care has restricted GPs and allied health professionals from being able to learn, upskill and ask questions. Training is required to understand what consultations can be conducted via video, how practice should be modified for a quality consultation and how to virtually build rapport with patients. To provide a strong foundation for education, training providers like Telemedhub and Telemedicine Training have developed clinical guidelines for telehealth, designed to assist doctors and allied health professionals to conduct telehealth consultations safely and effectively.

This lack of education has left many feeling like they’ve had telehealth dropped into their laps without being consulted. They are not receiving adequate ongoing support or training to refine new skills and adapt clinical practice. This is critical to ensuring proper care is delivered and to provide a safe and seamless experience that’s comparable to an in-person consultation.

Overcoming barriers to video telehealth

Some practitioners have hesitations about the widespread adoption of digital health care and video telehealth, which is frequently informed by pre-existing attitudes and misconceptions.

There’s a commonly held belief that digital health care and the adoption of telehealth, specifically video, will disrupt business-as-usual and normal workflows, which prevents many practitioners from including it as a service offering. What this misconception fails to recognise is the value of a hybrid healthcare model, whereby video telehealth can be used to supplement in-person consultations. This paradigm has a multitude of benefits for practitioner and patient alike, including convenience, accessibility, time savings, cost savings, efficiency, infection control and increased appointment flexibility.

Other barriers include the perception that the quality of care is reduced with digital health care, as well as the notion that patients simply don’t like telehealth.

Overcoming these barriers and misconceptions is no easy feat, which is why training and upskilling our healthcare workforce from early on is critical to accelerating the new hybrid healthcare paradigm, more seamlessly integrating video telehealth into our system and providing greater health care access.

Creating a digital-friendly culture

The lasting impacts of the pandemic will present ongoing challenges to the way people receive health care, meaning digitisation of the sector will continue to grow. But in order to create a digital-friendly healthcare culture, early training is critical.

There’s much more to digital health care than simply connecting with patients via a phone consult. Just like any healthcare tool, providers and practitioners alike must be thoroughly educated about the workflows and capacities of the platform. Our current cohort of practitioners has been forced to retrofit existing practices to integrate video telehealth and digital health care, resulting in teething issues that can disrupt patient support.

However, with earlier training, these challenges can be mitigated. For example, our current healthcare students and trainees should be both theoretically and practically learning the future of healthcare practice and digital communication as part of their curriculum.

With one year of telehealth consultations under our belt, Aussie patients are increasingly expecting high-quality audio, video and personalised interactions with doctors delivered remotely.

Education is a powerful lever for transformation and our healthcare leaders must have strong digital healthcare literacy skills to meet evolving patient expectations.

Today, video telehealth has proven its worth to patients and businesses. Tomorrow, stakeholders must work together to better integrate video-based virtual services into the care continuum and improve the patient experience. Implementing video telehealth has the potential to improve health outcomes for individuals and populations. As more people look to rely on virtual healthcare options, doctors and healthcare practitioners must upskill to meet the future of health care and provide consistent and high-quality services.

*Dr Andrew Baird is a GP at Elwood Family Clinic in Victoria and is a Tutor in Professional Practice for medical students at The University of Melbourne.

^Dr Silvia Pfeiffer is CEO at Coviu, helping clinicians set up video consultation services for their patients via Coviu’s telehealth solution.

Image credit: ©stock.adobe.com/au/Konstantin

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