Telehealth and the new normal: using electronic patient data to study its impacts on care activities within general practice during the COVID-19 pandemic
Abstract
Title: Telehealth and the new normal: using electronic patient data to study its impacts on care activities within general practice during the COVID-19 pandemic
Background: Telehealth has provided a practical mode of care delivery in Australian general practice since its rapid implementation in 2020. While widely utilised, limited data exists on how telehealth has impacted general practice activities. This may impact on the delivery and quality of care
Aims: To investigate several facets of telehealth in general practice: general practitioners’ perspectives, medication prescribing rates, diagnostic testing, utilisation in residential aged care facilities (RACFs), and care for chronic conditions (e.g., diabetes and mental health).
Methods: Mixed methods study including qualitative ‘Action Research’ focus groups, and quantitative retrospective observational study of routinely-collected electronic patient data from 807 general practices across New South Wales and Victoria, comparing periods before (from January 2019) and after the March 2020 introduction of MBS telehealth funding.
Results: Telehealth has had several key benefits for general practice, including access to care for RACF residents, high uptake for monitoring of Type 2 diabetes patients, and practice benefits (funding and safety). Potential barriers included quality of care (lower pathology referral and prescribing rates, quality of antibiotic prescribing) and technology (lower video uptake). A key factor was evolution of telehealth, which has been driven by adaptations to changes and MBS funding.
Conclusions: This study emphasises the importance of several key areas where telehealth can deliver the greatest value (chronic disease monitoring, access to care) as well as factors that should be considered for quality improvement, from infrastructure to workflows (pathology ordering, medication prescribing, technology barriers, funding changes). These lessons learnt may improve digital care delivery.
