Counties Manukau DHB touts replacing outpatient clinics with virtual appointments

09-Mar-2018


Source: 
NZ Herald By Nikki Preston

A virtual service allowing patients to check-in with a doctor via a smart device from their homes is being touted as a possible solution for treating the soaring number of sick people amid funding restraints.

Counties Manukau DHB is considering introducing virtual appointments to outpatients who currently travel to Manukau SuperClinic or Middlemore Hospital as one of a number of ways to ease the load and treat the growing number of patients as the hospital reaches near breaking point.

The number of patients seeking treatment at Counties Manukau DHB's Emergency Care services over summer peaked to the same levels which are usually only seen during the traditionally busier winter months.

DHB chairman Rabin Rabindran said they were working with frontline clinicians, healthcare users and providers, and manawhenua representatives to prioritise resources.

"We're looking at all of our options including what services we provide, how we can work better with our providers and possibly increasing our investment in some areas in the expectation that this will reduce our costs in the long-term.

"For example each year thousands of patients make the trip to Middlemore Hospital and the Manukau SuperClinic for outpatient appointments. What if some of these outpatient appointments could be done virtually - from the comfort of a person's home? We are currently looking at what this would mean from a cost saving and patient perspective."

Waikato DHB has been offering virtual appointments through its virtual health app SmartHealth since May 2016. The service uses an app, called Health Tap, to connect doctors and patients via a smart device such as a phone or iPad and includes video consults, text messaging, calls and an after-hours service. However the service has so far cost the DHB at least $12.09m and has failed to attract the targeted numbers even after they have been lowered.

Association of Salaried Medical Specialists (ASMS) executive director Ian Powell said virtual appointments were a good thing to be looking at as long as it made good clinical sense for each individual patient and was practical.

"In principle, it's not a new idea. It's not an extensive practice, but it's not a new idea. It doesn't raise alarm bells with us. The critical thing is having effective engagement with specialists on the basis of which it should work and the basis where it should not work."

Powell said in some cases it could be used for an exploratory consultation, which could lead to a face-to-face appointment.

"Somethings could be nipped in the bud quite quickly and some things could be sped up for more urgent treatment."

Age Concern Auckland chief executive Kevin Lamb did not believe virtual appointments would work for the elderly as there was only a small percentage - between 25 and 30 per cent - who were online.

"The problem is and there's no escaping it, the majority of people do not use the internet, the do not use online services at all, they don't have access to computers or smartphones or anything like that and these are going to be some of the older most at risk, most vulnerable people within our communities who will not be able to access these services."

Hamilton Grey Power president Roger Hennebry said that none of the Grey Power members he was in contact with were actively online and he feared they would miss out on appointments.

While an online healthcare service app HealthTap was already available in Waikato, he was not aware of anyone who accessed it.

Last month Auckland health bosses told a parliamentary health select committee the health system was stretched from underfunding and population growth.

An increase in patients being treated for acute services was also taking its toll on staff who were stressed due to working longer hours and because of the number of extremely sick people they were having to deal with.



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