2.3 Telehealth

General Practice: Health of the Nation 2020 highlighted that the introduction of MBS-supported telehealth in general practice was a welcome innovation amid the COVID-19 pandemic. Patients and GPs alike reported high rates of satisfaction with telehealth. Telehealth (via phone and video) has complemented face-to-face services as clinically appropriate, improving patient access to healthcare and ensuring general practice is supported to provide modernised care.

Figure 26 illustrates the first 15 months of MBS-supported telehealth in general practice compared to the previous year’s activity, underlining GPs’ ability to adapt to new technology.

The first 15 months of MBS-supported telehealth via phone in general practice — Measure: Number of services March 2019 to May 2021.
Telehealth (phone): Standard consultations: 91790,91800,91801,91802,91795,91809,91810,91811 Mental Health: 92112,92113,92114,92115,92116,92117, 92124,92125,92126,92127,92128,92129 CDM: 92024,92025,92026,92028,92068,92069,92070,92072 After Hours: 92210,92216 RACF Mental Health: 93404,93405,93406,93407,93422,93408,93409,93410,93411,93423.

Face-to-face items: Standard consultations: 3,23,36,44,4,24,37,47,90020, 90035,90043,90051 CDM: 721,723,729,732 Mental Health: 2700,2701,2715,2717,2712,2713 Health assessments:701,703,705,707,715,699 After hours: 5003,5023,5043,5063,5000,5020,5040,5060,5010,5028,5049,5067,585,594,599.
Source: Services Australia MBS item number reports.

Although phone consultations have been widely embraced, video has not been widely adopted in general practice. In April 2020, 1.3% of all GP attendances used video, falling to 0.29% by May 2021. By comparison, phone consultations represented 17.1% of all GP attendances in May 2021, a decline from around one-third of all GP consultations in April 2020.²⁹

In June 2020, 55% of GPs reported having used video technology at least once in their practice,³⁰ an increase from 30% in April 2020, indicating a willingness to attempt to use new technology.⁶ However, there are several reasons GPs have not commenced or continued using video technology.

Of those who had never attempted to use video, the most common reasons were lack of technology, no perceived benefit compared to phone consultations and patients not wanting to
use video (Figure 27).

Free-text responses in the survey included concern about older patients’ ability to use video technology, the high costs involved with acquiring the necessary technology, inadequate internet connections, the amount of time required to help patients understand video technology and privacy concerns regarding the use of video on personal devices/accounts. GPs practising in lower socioeconomic areas also had concerns about patient access to technology.³⁰

The most common devices GPs use to provide video consultations are their personal device (smartphone or tablet) (35%), the practice’s computer (29%) or their personal computer (23%).³⁰ This reflects the lack of infrastructure within practices and highlights the need for greater government support to facilitate video telehealth before it can be widely used in general practice. More than half (53%) of surveyed GPs said they have invested more than initially budgeted in technology to meet demand for telehealth consultations.³¹

When asked if they would be willing to use video if their concerns were addressed, 66% of GPs said they would.³⁰

One in four GPs reported they do not have the technical capability to provide video consultations — Measure: GP responses to the question, ‘Please outline the reason/s you have not undertaken telehealth consultations using video (select all that apply).’
Base: GPs who had indicated they had never attempted using video technology in their practice, n = 342.
Source: RACGP Telehealth survey, June 2020.

A similar perception of video consultations among staff and patients is reflected in other healthcare settings.

Phone is seen as an easy and accessible platform for communicating, with most survey respondents indicating no added benefit to using a video function. In some cases, patients did not have the equipment to support video consultations, or staff and patients reverted to a phone call after experiencing connection problems in an attempted video consultation. Staff reported that patients needed considerable support setting up their devices and connecting to video appointments.³²

Medicare data show that patients in lower socioeconomic areas are less likely to use telehealth, particularly via video. Older patients are also less likely to use telehealth, with those aged 70 and older showing the lowest uptake of video consultations in general practice.³³

GPs reported that almost half (48%) of video consultations were provided to adults aged 25–44 (Figure 28).

Adults aged 25–44 are most likely to use video consultations — Data of less than 5% not labelled.
Measure: GP responses to the question, ‘Of the telehealth consultations conducted using video, what is the most common age group of patients?’
Base: n = 199.
Source: RACGP Telehealth survey, June 2020.

6. RACGP. General Practice: Health of the Nation 2020. East Melbourne: RACGP, 2020.
29. Services Australia. Medicare Item Number Reports. 2021.
30. RACGP. Telehealth survey. 2020. Unpublished data.
31. Commonwealth Bank of Australia. CommBank GP Insights Report: Opportunities and challenges amid the pandemic recovery. Sydney: CommBank, 2021.
32. Smithson R, Roche E, Wicker C. Virtual models of chronic disease management: Lessons from the experiences of virtual care during the COVID-19 response. Aust Health Rev 2021;45(3):311–16. doi:10.1071/AH20190.
33. Hardie RA, Sezgin G, Dai Z, et al. Socioeconomic and demographic comparisons in the uptake of telehealth services during COVID-19. Sydney: Macquarie University, 2021.

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2.3 Telehealth

Figure 26. The first 15 months of MBS-supported telehealth via phone in general practice

Figure 27. One in four GPs reported they do not have the technical capability to provide video consultations

Figure 28. Adults aged 25–44 are most likely to use video consultations